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Ng JY, Li SY, Cramer H. Perceptions and attitudes regarding complementary, alternative, and integrative medicine among published neurology authors: a large-scale, international cross-sectional survey. BMC Neurol 2024; 24:215. [PMID: 38914963 PMCID: PMC11194990 DOI: 10.1186/s12883-024-03661-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/30/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND While many patients with neurological disorders and conditions use complementary, alternative, and integrative medicine (CAIM), little is known about the use, perceptions, and attitudes regarding CAIM among published neurology authors. With the increasing popularity of CAIM, our objective was to assess practices, perceptions, and attitudes towards CAIM among published neurology authors. METHODS We conducted an anonymous online survey of authors who had published articles in neurology journals indexed in MEDLINE. We emailed potential participants our cross-sectional electronic survey after extracting their email addresses from one of their publications in our sample of journals. Basic descriptive statistics were drawn from quantitative data, and thematic content analysis was used to analyse qualitative data from any open-ended questions. RESULTS The survey was completed by 783 published neurology authors (1.7% response rate, 83.9% completion rate). Overall, respondents perceived CAIM to be promising in preventing, treating, and/or managing neurological diseases. Mind-body therapies received the most positive responses, indicated by over half of respondents cumulatively agreeing that they are promising (n = 368, 59.0%) and safe (n = 280, 50.3%). Whole medical systems and biofield therapy were less favourable. Most neurology clinicians reported a lack of formal (n = 211, 70.3%) and supplementary training (n = 158, 52.5%) on CAIM. Nearly half of clinicians did not feel comfortable counselling patients about CAIM therapies (n = 121, 44.5%), and over half did not feel comfortable recommending them (n = 161, 59.3%). A lack of scientific evidence for CAIM's safety and efficacy was reported as the greatest challenge to CAIM (n = 515, 92.5%). The majority of respondents believed there is value to conducting research on this topic (n = 461, 82.0%) and supported increasing allocation of research funding towards CAIM (n = 241, 58.9%). CONCLUSIONS Although many participants found CAIM to be promising to the field of neurology, the vast majority did not feel open to integrating CAIM into mainstream medical practices on account of a perceived lack of scientific evidence for its safety and efficacy. Future studies can use our findings to gather more detailed insights, improve educational resources on CAIM within neurology, as well as examine what effects a tailored CAIM education has on the perceptions and attitudes of published neurology authors towards CAIM.
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Affiliation(s)
- Jeremy Y Ng
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany.
| | - Stephanie Y Li
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Holger Cramer
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
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Carrillo-Mora P, Rodríguez-Barragán MA, Quinzaños-Fresnedo J, Del Refugio Pacheco-Gallegos M, Soto-Lara M, Velázquez-Ortega M, Villarreal-Azamar MF, Aguirre-Medina IJ, Rubalcava-Gracia-Medrano M. Alternative and complementary medicine in neurological disorders and neurological disability patients: Prevalence, factors, opinions and reasons. Complement Ther Med 2023; 72:102920. [PMID: 36646394 DOI: 10.1016/j.ctim.2023.102920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This cross-sectional study is aimed to investigate the prevalence of the use of complementary and alternative medicine (CAM), types of CAMs used, as well as reasons and factors found in patients with neurological diseases or neurological disability. METHODS An anonymous, self-administered survey was designed to collect information about demographics, personal medical history, CAM usage habits, and different opinions about CAM vs. conventional medicine (CM). The survey was applied by non-medical personnel in a rehabilitation hospital to patients older than 18 years, with a confirmed diagnosis of neurological disorder or neurological disability. RESULTS 453 patients were included, 59.7 % were female. Mean age: 49 years (SD: 18.2). 200 patients (44.2 %) had a history of chronic diseases. Depression was found in 139 patients (30.7 %). Neurological disorders were: peripheral neuropathy: 97 (21.4 %), headache or migraine: 78 (17.2 %), neurodegenerative diseases: 69 (15.2 %) and stroke: 58 (12.8 %). 60.2 % (n = 273) had some degree of disability. Prevalence of CAM use was 36 % (n = 163). Most common CAMs were: Biological therapies: 133 (71.1 %), energy-based therapies: 63 (33.7 %) and body manipulation therapies: 51 (27.3 %). Reasons to use CAM were: "to complement the pharmacological treatment" (45 = 27.6 %), and "treatment failure with CM" (43 = 26.4 %). Finally, older age (p = 0.0280) and having a chronic disease (p = 0.0229) or depression (p < 0.001) were the factors associated with the current use of CAM. CONCLUSION One third of patients with neurological pathologies use CAM, the most popular type of CAM is biologic therapies. As in other pathologies, CAM use was associated with older age, history of depression, and chronic diseases. Therefore, it is suggested that physicians routinely ask patients about the use of CAM, if they need more information about CAM, and even verify the possibility of drug interactions or adverse effects.
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Affiliation(s)
- Paul Carrillo-Mora
- División de Neurociencias Clínicas, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico.
| | - Marlene A Rodríguez-Barragán
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico
| | - Jimena Quinzaños-Fresnedo
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico
| | | | - María Soto-Lara
- Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
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Jaafar Z, Ayoub J, Hamadeh R, Baydoun S, Honein-AbouHaidar G, Banna J, Alameddine M, Naja F. A triangulated perspective for understanding CAM use in Lebanon: a qualitative study. BMC Complement Med Ther 2022; 22:204. [PMID: 35918687 PMCID: PMC9347103 DOI: 10.1186/s12906-022-03685-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
Background Existing evidence marked a prevalent use of Complementary and Alternative Medicine (CAM) therapies in Lebanon that is concomitant with low rates of disclosure to health care providers and limited knowledge among the general public of safety and side effects of CAM use. Objectives To examine the perspectives of Lebanese CAM users, CAM providers, and health care providers (HCPs) regarding their understanding of CAM and of the Push and Pull factors that drive its use. Methods A qualitative research study was conducted using in-depth interviews, targeting Lebanese adults (CAM users; 18-65 years) (n=14), CAM providers such as yoga instructors, owners of CAM product outlets, herbalists, and religious figures (n=13); and HCPs including physicians, nurses, dietitians, and pharmacists (n=14). The topic guide covered, in addition to the understanding of CAM, the Push and Pull factors driving CAM use. The adults were recruited by convenient sampling, and CAM providers and HCPs using a purposive sampling approach. Interviews were audiotaped, transcribed, and translated into English. Analysis was performed using a qualitative thematic approach. Similarities and differences in the perceptions of the participants with regards to factors that influence CAM use were charted and contrasted, using a triangulated approach. Results The three study groups exhibited a similar understanding of CAM, referring to non-conventional therapies used to prevent/treat diseases or to enhance wellbeing. CAM users and CAM providers identified “distrust in HCPs”, “lack of patient-centered care in CM”, and “limitations and side effects of CM” as important Push factors. All study groups highlighted the limited CAM knowledge of HCPs as a main reason for the lack of patient-centered care. All three groups also underscored the affordability and the social and cultural support for CAM as main enablers of its prevalent use. Unlike HCPs who were skeptical about the safety and effectiveness of CAM, CAM users and CAM providers indicated that most of CAM therapies are safe and efficient. Conclusions The triangulation of perspectives (CAM users, CAM providers, and HCPs) in this study allowed a comprehensive appraisal of CAM use and its drivers. Improving the HCPs’ CAM-related knowledge, promoting patient-centered care and fostering an open dialogue between HCPs and CAM providers are among the recommendations of the study. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03685-z.
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Rajendran T. Addressing the need for personalizing music therapy in integrative oncology. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:281-283. [PMID: 35078746 DOI: 10.1016/j.joim.2022.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
Music therapy is an integrative oncology practice that has been rapidly emerging, over the past two decades, as a field of its own, clinically and academically. The randomized controlled trials that evaluate the clinical impact of music therapy are growing in number, and at the same time, there has been progress in understanding the neurobiological mechanisms that underly the beneficial effects of music therapy. Cultural background and autobiographical memories may uniquely influence music perception and cognition. It is vital to personalize music therapy because music preferences are unique; one size does not fit all. Cognitive music science studies and clinical music therapy trials that study individualized music choices will serve as a vital step forward in providing patient-directed personalized integrative cancer care. The field of music therapy is advancing, and its ability to improve a patient's quality of life can be understood only through robust, personalized, evidence-based initiatives that focus on research, advocacy, education, and delivery of care.
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Affiliation(s)
- Tara Rajendran
- Department of Music, Faculty of Fine Arts, Annamalai University, Annamalai Nagar, Chidambaram, Tamil Nadu 608002, India.
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Cramer H. With Us or Against Us? As to the Claim That Complementary Health Care Providers Are Undermining Biomedical Care. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:549-551. [PMID: 35787701 DOI: 10.1089/jicm.2022.29107.hc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Makarem NN, Brome D, Romani M. Knowledge, attitude, and practices of complementary and alternative medicine: a survey of physicians and nurses at an academic medical center in Beirut. Libyan J Med 2022; 17:2071813. [PMID: 35603591 PMCID: PMC9132421 DOI: 10.1080/19932820.2022.2071813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Nisrine N. Makarem
- Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Dayana Brome
- Psychology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Romani
- Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Goel AR, Henderson CR, Reid MC. Do Palliative Care Providers Use Complementary and Integrative Medicine? A Nationwide Survey. J Pain Symptom Manage 2022; 63:599-609. [PMID: 34788656 PMCID: PMC9121789 DOI: 10.1016/j.jpainsymman.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 11/20/2022]
Abstract
CONTEXT Given the high prevalence of burdensome symptoms in palliative care (PC) and increasing use of complementary and integrative medicine (CIM) therapies, research is needed to determine how often and what types of CIM therapies providers recommend to manage symptoms in PC. OBJECTIVES To document recommendation rates of CIM for target symptoms and assess if, CIM use varies by provider characteristics. METHODS Nationwide survey's of physicians (MD and DO), physician assistants, and nurse practitioners in PC. RESULTS Participants (N = 404) were mostly female (71.3%), physicians (74.9%), and cared for adults (90.4%). Providers recommended CIM an average of 6.82 times per-month (95% CI: 6.04-7.60) and used an average of 5.13 (95% CI: 4.90-5.36) out of 10 CIM modalities. Respondents recommended mind-body medicines (e.g., meditation, biofeedback) most, followed by massage, and acupuncture and/or acupressure. The most targeted symptoms included pain; followed by anxiety, mood disturbance, and distress. Recommendation frequencies for specific modality-for-symptom combinations ranged from little use (e.g., aromatherapy for constipation) to occasional use (e.g., mind-body interventions for psychiatric symptoms). Finally, recommendation rates increased as a function of pediatric practice, noninpatient practice setting, provider age, and proportion of effort spent delivering palliative care. CONCLUSION To the best of our knowledge, this is the first national survey to characterize PC providers' CIM recommendation behaviors and assess specific therapies and common target symptoms. Providers recommended a broad range of CIM but do so less frequently than patients report using CIM. These findings should be of interest to any provider caring for patients with serious illness.
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Affiliation(s)
- Anurag Ratan Goel
- Departments of Medicine and Pediatrics (A.R.G.), Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Charles R Henderson
- Department of Human Development (C.R.H.), Cornell University, Ithaca, New York, USA
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Dudla S, Herron PD, Marantz PR, Milan FB, Campbell C, Anderson BJ. Comparing scientific worldviews between allopathic medical degree and East Asian medicine degree students utilizing the thinking about science survey instrument (TSSI). BMC MEDICAL EDUCATION 2021; 21:546. [PMID: 34711228 PMCID: PMC8553399 DOI: 10.1186/s12909-021-02956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Integrative medicine has become a new healthcare model due to the growing evidence base for complementary and integrative therapies. However, some question whether complementary and integrative therapies can truly be integrated with biomedicine due to differences in underlying paradigms and theoretical bases. This study aimed to explore differences in scientific worldviews between students studying East Asian medicine and those completing an allopathic medical degree using the validated Thinking about Science Survey Instrument (TSSI). METHODS 122 medical students from Albert Einstein College of Medicine (Einstein) and 48 East Asian medicine students from the Pacific College of Health and Science (Pacific College) participated in this study. Participants completed the TSSI, a 60-item Likert-scale instrument that quantitatively measures the sociocultural resistance to, and support for science. Item and category means were compared between each group using an independent sample t-test. RESULTS Distinct differences were seen between the two groups of students with regard to age, gender distribution and prior education. Einstein students were generally supportive of science and Pacific College students were generally supportive of/positively neutral to science. Einstein students more strongly affirmed the relationship of science in relation to the categories of Epistemology, Public Health, Emotion and Aesthetics, the Economy, and Public Policy. Pacific College students more strongly affirmed the relationship between science and the category Race and Gender. There were no differences in the categories of Environment and Resource, Science for All, and Religion and Morality. CONCLUSION This study suggests that there are differences underlying the scientific worldviews of Einstein and Pacific College students, particularly with regard to Epistemology and Public Health. Such differences may be related to the different theoretical knowledge bases and ways of viewing health within the two disciplines. Despite demographic and educational differences between the two groups their overall scientific worldviews were similar with neither group expressing disparate views. This suggests that both groups may be receptive to the value of other paradigms. Providing courses that focus on different therapeutic approaches and paradigms during medical training may foster interprofessional understanding and collaborative practice between health professionals of different medical disciplines.
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Affiliation(s)
- Saikaew Dudla
- Pacific College of Health and Science, 110 William St, New York, NY, 10038, USA.
| | - Patrick D Herron
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Paul R Marantz
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Felise B Milan
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Corbin Campbell
- American University, 4400 Massachusetts Ave, NW, Washington, DC, 20016, USA
| | - Belinda J Anderson
- Pacific College of Health and Science, 110 William St, New York, NY, 10038, USA
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
- Pace University, 163 William St, New York, NY, 10038, USA
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Ng JY, Verma KD, Gilotra K. Quantity and quality of complementary and alternative medicine recommendations in clinical practice guidelines for type 2 diabetes mellitus: A systematic review. Nutr Metab Cardiovasc Dis 2021; 31:3004-3015. [PMID: 34627698 DOI: 10.1016/j.numecd.2021.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/07/2021] [Accepted: 07/26/2021] [Indexed: 01/17/2023]
Abstract
AIMS Approximately 70% of Americans with diabetes have used complementary and alternative medicine (CAM) in the past year. Healthcare providers often receive minimal training on these therapies and subsequently rely on clinical practice guidelines (CPGs) to supplement their knowledge about the safe and effective use of CAM for the treatment/management of type 2 diabetes mellitus (T2DM). The purpose of this systematic review is to determine the quantity and assess the quality of CAM recommendations in CPGs for the treatment and/or management of T2DM. DATA SYNTHESIS MEDLINE, EMBASE, and CINAHL were systematically searched from 2009 to 2020, in addition to the Guidelines International Network and the National Center for Complementary and Integrative Health websites. CPGs containing treatment and/or management recommendations for T2DM were eligible; those with CAM recommendations were quality-assessed with the AGREE II instrument twice, once for the overall CPG and once for the CAM sections. Twenty-seven CPGs were deemed eligible, of which 7 made CAM recommendations. Mean scaled domain percentages were (overall, CAM): scope and purpose (89.7%, 79.8%), clarity of presentation (85.7%, 48.4%), stakeholder involvement (67.9%, 28.2%), applicability (54.8%, 20.2%), rigour of development (49.7%, 35.7%), and editorial independence (44.1%, 44.1%). CONCLUSIONS Quality varied within and across CPGs; domain scores across CAM sections generally scored lower than the overall CPG. Given that CAM therapies for T2DM are only represented in one-quarter of eligible CPGs and are of lower quality, a knowledge gap exists for healthcare providers who seek evidence-based information on this topic in order to effectively counsel inquiring patients.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Kiran D Verma
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Kevin Gilotra
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
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Aprilio K, Wilar G. Emergence of Ethnomedical COVID-19 Treatment: A Literature Review. Infect Drug Resist 2021; 14:4277-4289. [PMID: 34703254 PMCID: PMC8541748 DOI: 10.2147/idr.s327986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/06/2021] [Indexed: 12/24/2022] Open
Abstract
The emergence of COVID-19 as a new pandemic in the modern era has led the public to a new perspective of health. In the earlier days of the COVID-19 pandemic, many factors made people go on their own ways in finding its supposed "cure". With conventional medicines' limited availability and access, traditional medicines become more appealing due to its widespread availability and increased perception of safety. Several herbal medicines are then believed to be able to alleviate or cure COVID-19 and its symptoms. Similarities and patterns in herbal medicines being used show local wisdom of the respective communities regarding their knowledge of diseases and its treatment, known as ethnomedicine. Despite not being approved yet by regulatory bodies as a definitive guideline in COVID-19 management, the application of ethnomedicine results in several herbal medicine candidates that show a promising result regarding its efficacy in managing COVID-19. This literature review aims to study how a society and its knowledge of medicine responds to a new and currently developing disease, and whether if that knowledge merits further study in search of a cure for the pandemic. Furthermore, the narrative aspect in this review also explores socio-politics and public health aspects and considerations of non-conventional COVID-19 treatment.
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Affiliation(s)
- Kevin Aprilio
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Gofarana Wilar
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
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Jafari A, Zanganeh M, Kazemi Z, Lael-Monfared E, Tehrani H. Iranian healthcare professionals' knowledge, attitudes, and use of complementary and alternative medicine: a cross sectional study. BMC Complement Med Ther 2021; 21:244. [PMID: 34592983 PMCID: PMC8485522 DOI: 10.1186/s12906-021-03421-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background The present study aims to investigate the knowledge, attitude, and performance of Iranian Healthcare Professionals (HP) about Complementary and Alternative Medicine (CAM) modalities. Methods This cross-sectional study was carried out on 210 HP in 2019. Samples were selected from healthcare centers, clinics, and hospitals using census sampling. Data collection tools included demographic information, attitude, knowledge, and the amount of use of CAM modalities. Data analysis was performed using SPSS ver. 24. Results In this study, the response rate was 85.3% (n=209). A majority of respondents had a positive attitude toward CAM (n=166, 79%), but their level of knowledge was limited (n=154, 73.6%). The most commonly used CAM modalities were herbal medicine (93.2%), exercise therapy (75.4%), and hydrotherapy (75.2%), respectively, and the least commonly used ones were magnetic therapy (2.9%) and hypnosis (4.8%). The most important reasons for the use of CAM modalities by HP included fewer side effects than medical treatments (57.4%), its lowest cost than medical treatments (34.9%), non-serious disease with no need for referral to a clinic (32.1%), and its more convenient access than medical treatments (30.6%). The results showed that there was a significant relationship between the education level and the use of CAM modalities (p<0.05). There was also a significant relationship between the suggestion of CAM modalities and the amount of use of these modalities, and those who used these modalities would also have recommended them to their clients more frequently (p<0.05). Conclusion The results showed that most of HP used at least one of the CAM modalities and had a positive attitude towards CAM. As the level of knowledge was limited, training courses should be implemented to increase health practitioner’s level of knowledge on CAM. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03421-z.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohaddeseh Zanganeh
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences , Torbat Heydariyeh, Iran
| | - Zahra Kazemi
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences , Torbat Heydariyeh, Iran
| | - Elaheh Lael-Monfared
- Student Research Committee, School of Public Health and Safety , Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Wieland LS, Moffet I, Shade S, Emadi A, Knott C, Gorman EF, D'Adamo C. Risks and benefits of antioxidant dietary supplement use during cancer treatment: protocol for a scoping review. BMJ Open 2021; 11:e047200. [PMID: 33849858 PMCID: PMC8051392 DOI: 10.1136/bmjopen-2020-047200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/15/2021] [Accepted: 03/24/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Antioxidant dietary supplements are used by many patients with cancer to reduce the side effects of chemotherapy and improve prognosis. While some research indicates oral antioxidant supplementation reduces side effects and improves patient survival, other studies suggest the use of antioxidant dietary supplements may interfere with chemotherapy and reduce its curative effects. There is a need to clarify the evidence base on the impact of dietary antioxidant supplementation during chemotherapy on both side effect and treatment efficacy outcomes. We will use a scoping review approach to identify what systematic review evidence exists regarding beneficial and harmful effects of dietary antioxidant supplements when used during cancer treatment. METHODS AND ANALYSIS We will use Arksey & O'Malley and Joanna Briggs Institute methods for scoping reviews. We will systematically search PubMed, Embase, CINAHL, Scopus, Dissertations & Theses Global and the Cochrane Library from inception to October 2020. Systematic reviews of randomised controlled trials of oral dietary antioxidant supplements used by participants receiving curative chemotherapy, radiotherapy or other biological therapy for cancer will be eligible. Two reviewers will screen citations and full texts for inclusion and chart data on research questions from included reviews. Two reviewers will assess the overall confidence in systematic review results using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2), and summarised evidence will focus on reviews rated at high or moderate overall confidence. Tables will be used to map existing evidence and identify evidence gaps for safety and effectiveness outcomes. ETHICS AND DISSEMINATION This scoping review does not require ethical approval as it is a secondary assessment of available literature. The results will be presented at conferences and submitted for publication in a peer-reviewed journal. We will also disseminate results to community and clinical stakeholders and involve them in developing subsequent research to address critical existing gaps in the evidence as identified by the scoping review.
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Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ilana Moffet
- University of Michigan College of Literature, Science, and the Arts, Ann Arbor, Michigan, USA
| | - Sydney Shade
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Ashkan Emadi
- School of Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Cheryl Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
- Office of Community Outreach and Engagement, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Emily F Gorman
- Health Sciences and Human Services Library, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Christopher D'Adamo
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Casbarro N, Ezomo O, Woolley K, Smith R, Hardin C, Feinn R, Myrick K. Complementary and integrative medicine: An observational study on pediatric clinicians' knowledge, beliefs and practices. Complement Ther Med 2021; 58:102693. [PMID: 33652091 DOI: 10.1016/j.ctim.2021.102693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/23/2020] [Accepted: 02/20/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Complementary and Integrative Medicine (CIM) is a group of diverse health care therapies that often serve as adjuncts to conventional medical treatments. Our aim for this study was to evaluate the current knowledge, beliefs and practices of pediatric clinicians regarding CIM. METHODS Clinicians from the pediatric unit of a large US based teaching hospital in Connecticut were surveyed, through self-administered questionnaires. RESULTS We sampled 70 participants with a response rate of 99 %. Of the 70, 32 were Registered Nurses, 9 were Attendings, 7 were Fellows, 15 were Residents and 4 were Nurse Practitioners. Regarding use, 24 % had referred a patient to a CIM practitioner, 43 % reported using CIM while 47 % had a family member who had used CIM in the past year. Respondents were most familiar with massage (70 %) and yoga (69 %) least familiar with Ayurvedic medicine (20 %) and Qi Gong (24 %). Regarding attitude, 67 % believed that some CIM therapies hold promise for the treatment of symptoms while 59 % believed that incorporation of CIM would increase patient satisfaction. Most of the respondents indicated that they did not have easy access to clinical information on many CIM treatment modalities. Nurses were more familiar (p = 0.024), had more positive attitudes and beliefs (p = 0.001) and thought CIM therapies had a higher impact (p = 0.002) on patient care compared to physicians, even when controlled for gender. CONCLUSION This study highlights the need to bridge the gap in evidence based medicine and clinician's knowledge with the rise in CIM use. It also stresses the need for standardized learning competencies in the field of PIM.
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Affiliation(s)
- Nicole Casbarro
- Community Health Center, University of Connecticut, Connecticut, USA
| | - Olohirere Ezomo
- Frank H. Netter School of Medicine, Quinnipiac University, United States.
| | - Katherine Woolley
- Frank H. Netter School of Medicine, Quinnipiac University, United States
| | - Ryan Smith
- Frank H. Netter School of Medicine, Quinnipiac University, United States
| | - Claire Hardin
- Colorado Children's Hospital, Pediatric Emergency Department, United States
| | - Richard Feinn
- Frank H. Netter School of Medicine, Quinnipiac University, United States
| | - Karen Myrick
- Frank H. Netter School of Medicine, Quinnipiac University, United States; University of Saint Joseph, Connecticut, School of Interdisciplinary Health and Science, United States
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Roberts K, Betts D, Nie JB, Dowell A. Navigating the path: a qualitative exploration of New Zealand general practitioners' views on integration of care with acupuncturists. Acupunct Med 2020; 39:334-342. [PMID: 32631154 DOI: 10.1177/0964528420929341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Increasingly, many patients believe that a combined approach of complementary and alternative medicine (CAM), including acupuncture, and conventional medicine is better than either on its own, and more patients now have the desire to discuss CAM with well-informed general practitioners (GPs). However, to our knowledge, the interaction and collaboration between GPs and acupuncturists specifically in relation to shared care have not been investigated. This research explored interprofessional communication between GPs and acupuncturists in New Zealand. This article specifically reports the GPs' viewpoints. METHODS This study was part of a larger mixed-methods research project. Semi-structured interviews of 14 purposively sampled GP participants were conducted and analysed using thematic analysis. RESULTS The data analysis identified both facilitators of and barriers to integrative health care. Facilitators included the willingness of GPs to engage in communication and a recognition of the importance of patient choice. Barriers included the limited opportunities for sharing information and the lack of current established pathways for communication or direct referrals. GPs also highlighted the confusion around scopes of practice in terms of the different styles of and approaches to acupuncture. CONCLUSION This research contributes to the body of knowledge concerning interprofessional communication and collaboration between GPs and acupuncturists and suggests that while there are significant barriers to collaboration, there is also the potential to impact provider satisfaction and patient well-being. It provides context within a New Zealand health care setting and also provides additional insights regarding acupuncture, specifically through the disaggregation of specific CAM modalities.
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Affiliation(s)
- Kate Roberts
- Department of Primary Health Care and General Practice, University of Otago, Wellington, Wellington, New Zealand
| | - Debra Betts
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Jing-Bao Nie
- Bioethics Centre, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Anthony Dowell
- Department of Primary Health Care and General Practice, University of Otago, Wellington, Wellington, New Zealand
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15
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Munk N, Church A, Nemati D, Zabel S, Comer AR. Massage perceptions and attitudes of undergraduate pre-professional health sciences students: a cross-sectional survey in one U.S. university. BMC Complement Med Ther 2020; 20:213. [PMID: 32641024 PMCID: PMC7346672 DOI: 10.1186/s12906-020-03002-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attitudes and beliefs about massage therapy have been explored among health professionals and health profession students, but not for undergraduate preprofessional health sciences students. METHODS This cross-sectional survey sought to determine pre-professional health students' attitudes and perceptions toward massage therapy and determine the extent demographic variables such as age, gender, race, along with lifetime massage experience are associated with neutral/negative perceptions. RESULTS N = 129 undergraduate students completed the Attitudes Toward Massage scale and 7 supplemental items pertaining to sexuality and therapist gender preference along with questions regarding lifetime massage utilization. Prevalence of massage therapy utilization was 35.6% (lifetime) and 18.6% (last 12-months). Overall, positive attitudes towards massage therapy was observed with participants reporting massage experience expressing more positive massage attitudes (lifetime; p = 0.0081, the past 12 months; p = 0.0311). Participants with no massage experience were more likely to report neutral/negative attitudes toward massage (p = 0.04). Men were more likely to prefer their massage therapist to be of the opposite sex (38.9%) compared to women (2.1%) (p = < 0.0001). Men were less confident than women in their concern of becoming sexually aroused during massage (p = 0.0001) and in the belief that massage is sexually arousing (p = 0.048). Both genders expressed comfort with female and/or male massage therapists, but if given a choice, both prefer a female massage therapist. CONCLUSIONS Undergraduate pre-professional health sciences students have generally positive attitudes towards massage therapy however more research is needed regarding implicit gender bias and/or preferences. This work should inform future research designs examining the impact of attitudes and beliefs on patient referrals to massage therapy.
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Affiliation(s)
- Niki Munk
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA. .,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Massage & Myotherapy Australia Fellow and Visiting Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Abby Church
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Donya Nemati
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Samantha Zabel
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Amber R Comer
- Department of Health Sciences, School of Health and Human Sciences, Indiana University - IUPUI, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA.,Indiana University Robert H. McKinney School of Law, 530 W. New York St, Indianapolis, IN, 46202, USA.,Regenstrief Institute, Inc., 1101 W. 10th St, Indianapolis, IN, 46202, USA
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16
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Cross-sectional survey of complementary and alternative medicine used in Oregon and Southwest Washington to treat multiple sclerosis: A 17-Year update. Mult Scler Relat Disord 2020; 41:102041. [DOI: 10.1016/j.msard.2020.102041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/12/2020] [Accepted: 03/02/2020] [Indexed: 11/19/2022]
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17
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Izgu N, Gok Metin Z. Complementary and alternative therapies from the Turkish Physician's perspective: An embedded mixed-method study. Complement Ther Clin Pract 2020; 39:101144. [DOI: 10.1016/j.ctcp.2020.101144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/25/2020] [Accepted: 03/11/2020] [Indexed: 01/09/2023]
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Stussman BJ, Nahin RR, Barnes PM, Ward BW. U.S. Physician Recommendations to Their Patients About the Use of Complementary Health Approaches. J Altern Complement Med 2019; 26:25-33. [PMID: 31763927 DOI: 10.1089/acm.2019.0303] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: There are no nationally representative studies using a probability sample that have been published examining whether physicians recommend complementary health approaches (CHAs) to their patients, as previous research has focused only on selected medical specialties or a particular U.S. region. This article fills a void in the current literature for robust data on recommendations for CHAs by office-based physicians in the United States. Design: Descriptive statistics and multivariable regression analyses of physician-level data were from the 2012 Physician Induction Interview of the National Ambulatory Medical Care Survey (NAMCS PII), a nationally representative survey of office-based physicians. Weighted response rate among eligible physicians sampled for the 2012 NAMCS PII was 59.7%. Setting/Location: United States. Outcome measures: Recommendations by physicians to their patients for any CHA, and individual CHAs: massage therapy, herbs/nonvitamin supplements, chiropractic/osteopathic manipulation, yoga, acupuncture, and mind-body therapies. Differences in recommendations by physician demographic characteristics were identified. Results: Massage therapy was the most commonly recommended CHA (30.4%), followed by chiropractic/osteopathic manipulation (27.1%), herbs/nonvitamin supplements (26.5%), yoga (25.6%), and acupuncture (22.4%). The most commonly recommended CHAs by general/family practice physicians were chiropractic/osteopathic manipulation (54.0%) and massage therapy (52.6%). Of all U.S. physicians, 53.1% recommended at least one CHA to patients during the previous 12 months. Multivariable analyses found physician's sex, race, specialty, and U.S. region to be significant predictors of CHA recommendations. Female physicians were more likely than male physicians to recommend massage therapy (adjusted odds ratio [aOR] = 1.76, 95% confidence interval [CI] = 1.40-2.20), herbs/nonvitamin supplements (aOR = 1.85, 95% CI = 1.46-2.35), yoga (aOR = 2.16, 95% CI = 1.70-2.75), acupuncture (aOR = 1.65, 95% CI = 1.27-2.13), and mind-body therapies (aOR = 2.63, 95% CI = 2.02-3.41) to patients. Psychiatrists (aOR = 0.13, 95% CI = 0.07-0.23), OB/GYNs (aOR = 0.38, 95% CI = 0.24-0.60), and pediatricians (aOR = 0.26, 95% CI = 0.18-0.38) were all less likely to recommend chiropractic/osteopathic manipulation than general and family practitioners. Conclusions: Overall, more than half of office-based physicians recommended at least one CHA to their patients. Female physicians recommended every individual CHA at a higher rate than male physicians except for chiropractic and osteopathic manipulation. These findings may enable consumers, physicians, and medical schools to better understand potential differences in use of CHAs with patients.
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Affiliation(s)
- Barbara J Stussman
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, Maryland
| | - Richard R Nahin
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, Maryland
| | | | - Brian W Ward
- National Center for Health Statistics, Hyattsville, Maryland
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Bruns EB, Befus D, Wismer B, Knight K, Adler SR, Leonoudakis-Watts K, Thompson-Lastad A, Chao MT. Vulnerable Patients' Psychosocial Experiences in a Group-Based, Integrative Pain Management Program. J Altern Complement Med 2019; 25:719-726. [PMID: 31314560 PMCID: PMC6648209 DOI: 10.1089/acm.2019.0074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: To use a psychosocial framework to examine the pain experiences of low-income, ethnically diverse patients before and after an Integrative Pain Management Program (IPMP). Design and methods: IPMP is a 12-week, multimodal pain group incorporating mindfulness, acupuncture, massage, education, movement, and health coaching. The authors conducted semistructured interviews at the beginning, end, and 3 months following completion of IPMP. Interviews were digitally recorded and transcribed and analyzed using inductive coding methods. Setting: A primary care clinic in San Francisco, CA, serving low-income, ethnically diverse patients, many of whom are marginally housed and living with disabilities. Subjects: Forty-one patients with a diagnosis of chronic pain, currently receiving prescription opioids and referred by their primary care provider, who participated in IPMP. Results: Authors thematically analyzed 104 individual interviews with 41 IPMP participants, including 41 baseline, 35 three-month follow-up, and 28 six-month follow-up. Before IPMP, participants described a psychologic "vicious cycle" of pain symptoms that worsened with movement and anxiety, while increasing their sense of disempowerment and social isolation. Following IPMP, patients reported using new strategies to manage pain, including lowering medication use, resulting in an emerging sense of psychologic resilience, and more social connections. Conclusions: IPMP offers an accessible model for addressing psychosocial aspects of chronic pain. Vulnerable patients engaged with integrative medicine groups and developed new perspectives and tools for managing their pain; they emerged feeling hopeful and resilient. These results support the use of integrative medicine groups for targeting psychosocial aspects of chronic pain within primary care.
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Affiliation(s)
- Elizabeth B. Bruns
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Deanna Befus
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Barbara Wismer
- San Francisco Department of Public Health, San Francisco, CA
- Department of Family & Community Medicine, History, and Social Medicine, University of California, San Francisco, San Francisco, CA
| | - Kelly Knight
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, San Francisco, CA
| | - Shelley R. Adler
- Department of Family & Community Medicine, History, and Social Medicine, University of California, San Francisco, San Francisco, CA
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Ariana Thompson-Lastad
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA
| | - Maria T. Chao
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA
- Division of General Internal Medicine at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA
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20
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Gok Metin Z, Karadas C, Ozdemir L. Usage and attitudes related to complementary and alternative medicine among Turkish academicians on the basis of the five-factor model of personality: A multi-centered study. Complement Ther Med 2019; 44:151-156. [DOI: 10.1016/j.ctim.2019.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/08/2019] [Accepted: 04/18/2019] [Indexed: 12/20/2022] Open
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21
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Rodondi PY, Lüthi E, Dubois J, Roy E, Burnand B, Grass G. Complementary Medicine Provision in an Academic Hospital: Evaluation and Structuring Project. J Altern Complement Med 2019; 25:606-612. [DOI: 10.1089/acm.2019.0062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Pierre-Yves Rodondi
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Emmanuelle Lüthi
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Anesthesiology, Center for Integrative and Complementary Medicine, Pain Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Julie Dubois
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Edith Roy
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Bernard Burnand
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Geneviève Grass
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Foley H, Steel A, Cramer H, Wardle J, Adams J. Disclosure of complementary medicine use to medical providers: a systematic review and meta-analysis. Sci Rep 2019; 9:1573. [PMID: 30733573 PMCID: PMC6367405 DOI: 10.1038/s41598-018-38279-8] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 12/20/2018] [Indexed: 12/03/2022] Open
Abstract
Concomitant complementary medicine (CM) and conventional medicine use is frequent and carries potential risks. Yet, CM users frequently neglect to disclose CM use to medical providers. Our systematic review examines rates of and reasons for CM use disclosure to medical providers. Observational studies published 2003-2016 were searched (AMED, CINAHL, MEDLINE, PsycINFO). Eighty-six papers reporting disclosure rates and/or reasons for disclosure/non-disclosure of CM use to medical providers were reviewed. Fourteen were selected for meta-analysis of disclosure rates of biologically-based CM. Overall disclosure rates varied (7-80%). Meta-analysis revealed a 33% disclosure rate (95%CI: 24% to 43%) for biologically-based CM. Reasons for non-disclosure included lack of inquiry from medical providers, fear of provider disapproval, perception of disclosure as unimportant, belief providers lacked CM knowledge, lacking time, and belief CM was safe. Reasons for disclosure included inquiry from medical providers, belief providers would support CM use, belief disclosure was important for safety, and belief providers would give advice about CM. Disclosure appears to be influenced by the nature of patient-provider communication. However, inconsistent definitions of CM and lack of a standard measure for disclosure created substantial heterogeneity between studies. Disclosure of CM use to medical providers must be encouraged for safe, effective patient care.
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Affiliation(s)
- H Foley
- Faculty of Health, University of Technology Sydney, Ultimo, Australia.
| | - A Steel
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - H Cramer
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - J Wardle
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - J Adams
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Brewer NJ, Turrise SL, Kim-Godwin YS, Pond RS. Nurses’ Knowledge and Treatment Beliefs: Use of Complementary and Alternative Medicine for Pain Management. J Holist Nurs 2019; 37:248-259. [DOI: 10.1177/0898010118822212] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To examine the relationship between nurses’ knowledge, attitudes, and beliefs about medicines, in general, and complementary and alternative medicine (CAM) and identify the predictors of referrals for pain management. Method: This descriptive, correlational study utilized an online survey to collect data from direct care nurses at a large medical center in southeastern United States. The online survey consisted of the Complementary and Alternative Medicines and Beliefs Inventory (CAMBI), the Beliefs about Medicine Questionnaire, and four open-ended questions. Referral data were obtained from the Information Management Department at this medical center. Results: Among the 218 nurses who completed the survey (15.12%), majority (85%) supported CAM use, but only 32% reported utilizing CAM therapies with patients. Medical surgical, emergency department, and perioperative nurses scored higher on their CAMBI total score and were more likely to refer for CAM therapies when compared with intensive care unit nurses. Conclusions: Beliefs about CAM specifically were not related to referrals for CAM therapies. This study suggests the need for further education on the nurse’s role in CAM usage. Understanding the link between nurses’ knowledge, attitudes, and treatment beliefs and their relationship to CAM usage provides direction for future educational interventions.
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James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Glob Health 2018; 3:e000895. [PMID: 30483405 PMCID: PMC6231111 DOI: 10.1136/bmjgh-2018-000895] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 12/31/2022] Open
Abstract
Background The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region. Methods We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken. Results Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers. Conclusion TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Queensland, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Rodondi PY, Dubois J, Bill AS, Koutaïssoff D, Ros J, Aveni E, Pasquier J, Herzig L, Decosterd I, Burnand B. Primary care physicians' attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study. PLoS One 2018; 13:e0204613. [PMID: 30261029 PMCID: PMC6160127 DOI: 10.1371/journal.pone.0204613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/11/2018] [Indexed: 12/28/2022] Open
Abstract
Objective Recent guidelines for chronic or recurrent low back pain recommend non-pharmacologic treatments as first-line options. The objective of this study was thus to explore the perceived usefulness of several conventional and complementary medicine treatments for chronic or recurrent low back pain by primary care physicians and their reported prescribing behavior. Design An exploratory cross-sectional study. Setting and participants Primary care physicians of the French-speaking part of Switzerland. Main outcome measures Primary care physicians’ perceived usefulness of each conventional and complementary medicine treatment and their reported recommendation behavior were considered dependent variables in multivariate logistic regression models. All correlations were computed between binary variables, and phi coefficients were calculated to estimate correlation strengths. Results 533 primary care physicians answered the questionnaire (response rate: 25.6%). The top 3 conventional treatments most often considered useful by primary care physicians for chronic or recurrent low back pain were physiotherapy (94.8%), nonsteroidal anti-inflammatory drugs (87.9%), and manual therapy (82.5%), whereas the most prescribed conventional treatments were physiotherapy (99.2%), nonsteroidal anti-inflammatory drugs (97.4%), and acetaminophen (94.4%). Osteopathic treatment (78.4%), yoga (69.3%), and therapeutic massage (63.9%) were the complementary medicine treatments most often considered useful by primary care physicians in managing chronic or recurrent low back pain. Being a female physician, younger than 56 years, trained in complementary medicine, or using complementary medicine were all associated with higher perceived usefulness of complementary medicine treatments in general. The most recommended complementary medicine treatments by primary care physicians were osteopathic treatment (87.3%), acupuncture (69.3%), and therapeutic massage (58.7%). Being a female physician, younger than 56, and using complementary medicine were all associated with more complementary medicine recommendation in general. Conclusion Our results highlight the importance of better understanding the prescribing patterns of primary care physicians for chronic or recurrent low back pain. Considering the frequency and burden of chronic or recurrent low back pain, programs focusing on the most (cost-) effective treatments should be implemented.
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Affiliation(s)
- Pierre-Yves Rodondi
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Julie Dubois
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
- * E-mail:
| | - Anne-Sylvie Bill
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Daria Koutaïssoff
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Jenny Ros
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Eléonore Aveni
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Jérôme Pasquier
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Lilli Herzig
- Institute of Family Medicine, University of Lausanne, Lausanne, Switzerland
| | - Isabelle Decosterd
- Pain Center and Center for integrative and complementary medicine, Department of anesthesiology, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Bernard Burnand
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Mahapatra S, Bhagra A, Fekadu B, Li Z, Bauer BA, Wahner-Roedler DL. Incorporation of integrative medicine education into undergraduate medical education: a longitudinal study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 15:442-449. [PMID: 29103413 DOI: 10.1016/s2095-4964(17)60367-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Integrative medicine (IM) combines complementary medical approaches into conventional medicine and considers the whole person. We implemented a longitudinal IM short-course curriculum into our medical school education. This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding IM among students. METHODS A mandatory short IM curriculum across all years of medical school was created and taught by IM professionals and physician faculty members with expertise in integrative therapies. Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school. Paired data analysis was done, and only students who completed surveys at both time points were included in final analyses. RESULTS Of 52 students in each class, 17 (33%) in the class of 2015 and 22 (42%) in the class of 2016 completed both surveys. After the IM curriculum, students' knowledge of and comfort with several IM therapies-biofeedback, mindfulness, and the use of St. John's wort-improved significantly. Students' personal health practices also improved, including better sleep, exercise, and stress management for the class of 2015. Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year. CONCLUSION It is feasible to incorporate IM education into undergraduate medical education, and this is associated with improvement in students' knowledge of IM and personal health practices.
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Affiliation(s)
- Saswati Mahapatra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Anjali Bhagra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Bisrat Fekadu
- Mayo Clinic School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota 55905, USA
| | - Zhuo Li
- Biostatistics Unit, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
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Ormsby SM, Dahlen HG, Ee CC, Keedle H, Smith CA. ‘Acupuncture for antenatal depression: It’s worth giving it a go’ — A qualitative study. Women Birth 2018; 31:166-176. [DOI: 10.1016/j.wombi.2017.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 12/18/2022]
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Healthcare professionals' sources of knowledge of complementary medicine in an academic center. PLoS One 2017; 12:e0184979. [PMID: 28961256 PMCID: PMC5621686 DOI: 10.1371/journal.pone.0184979] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 09/04/2017] [Indexed: 11/19/2022] Open
Abstract
Background Complementary medicine (CM) is utilized in a growing number of academic centers despite the debate concerning its value, risks and benefits. Healthcare professionals often feel uncomfortable discussing CM with patients, and little is known about their sources of knowledge in the field of CM. Objective To assess healthcare professionals’ sources of knowledge and attitude toward CM in an academic hospital. Design and participants The cross-sectional web-based survey took place from October to December 2013. A total of 4,925 healthcare professionals working at Lausanne University Hospital, Switzerland, were invited to answer the questionnaire. Main measures Factors influencing healthcare professionals’ opinion toward CM, knowledge and communication about CM. Key results The questionnaire was answered by 1,247 healthcare professionals. The three key factors influencing professionals’ opinion toward CM were personal experience, clinical experience and evidence demonstrating the physiological mechanism of CM. Personal experience was more associated with nurses’ and midwives’ opinion compared to physicians’ (80.8% vs 57.1%, OR = 3.08, [95% CI: 2.35–4.05], P<0.001 and 85.3% vs 57.1%, OR = 3.83, [95% CI: 1.95–7.53], P<0.001, respectively) as well as with professionals trained in CM compared to non-trained professionals (86.0% vs 73.2%, OR = 2.60, [95% CI: 1.92–3.53], P<0.001). Physicians relied more on randomized controlled clinical trials compared to nurses (81.3% vs 62.9%, OR = 0.43, [95% CI: 0.33–0.57], P<0.001). A majority of the respondents (82.5%) agreed that they lacked knowledge about CM and 65.0% noted that it was the patient who initially started the discussion about CM. Conclusions Different professionals used different strategies to forge opinions regarding CM: physicians relied more on scientific evidence, while nurses and midwives were more influenced by personal experience. Regardless of preferred information source, most respondents did not feel prepared to address patient questions regarding CM. Enhancing interprofessional education opportunities is an important strategy to help providers become empowered to discuss CM with patients. This in turn will help patients making informed decisions in their healthcare.
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Mccubbin T, Kempe KL, Beck A. Complementary and Alternative Medicine in an Integrated Health Care Delivery System: Users of Chiropractic, Acupuncture, and Massage Services. Perm J 2017; 21:16-172. [PMID: 28746026 DOI: 10.7812/tpp/16-172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Complementary and alternative medicine research has relied primarily on survey data from community populations rather than from patient populations receiving these services in integrated health care delivery systems (IHDS). OBJECTIVES To describe patients seeking chiropractic, acupuncture, or massage therapy in a dedicated Center for Complementary Medicine (CCM) within an IHDS. METHODS Patient surveys at the initial CCM visit included chief complaint, prior treatments, and relief with treatment (0% to 100% relief). A modified Brief Pain Inventory assessed average and current pain (0 = no pain; 10 = unbearable pain) and interference with life domains (1 = does not interfere; 10 = completely interferes). Demographics and CCM provider type were obtained from medical records. Analysis included patients who completed the survey. RESULTS Between 2007 and 2014, a total of 27,225 patients sought CCM services (median age = 50 years). Most (62%) were female, and 73% were white. Modalities included chiropractic (66.9%), acupuncture (18.1%), and massage (15.0%). Spine/truncal pain was most commonly reported (70.5%). A majority of patients (59%) saw their physician for their condition, 59% had not used CCM services previously, and 60% received medications for their condition. Mean ratings included pain relief with prior treatment (30.07%, standard deviation [SD] = 27.01%), current pain (4.33, SD = 2.4), and functional impairment ranging from 3.03 (SD = 3.09) for relationships to 5.42 (SD = 3.22) for enjoyment of life. CONCLUSION Spine/truncal pain was the most common complaint and chiropractic the most common modality among patients receiving CCM services in an IHDS. More than one-third of patients self-referred to the CCM.
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Affiliation(s)
- Tracy Mccubbin
- Founder and former Medical Director for the Centers for Complementary Medicine at Kaiser Permanente in Denver, CO.
| | - Karin L Kempe
- Former Medical Director of Clinical Prevention Services in the Department of Population Care and Prevention Services at Kaiser Permanente in Denver, CO.
| | - Arne Beck
- Director for Quality Improvement and Strategic Research at the Institute for Health Research in Denver, CO.
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Bowden BS, Ball L. Nurse practitioner and physician assistant students' knowledge, attitudes, and perspectives of chiropractic. THE JOURNAL OF CHIROPRACTIC EDUCATION 2016; 30:114-120. [PMID: 26771903 PMCID: PMC5067119 DOI: 10.7899/jce-15-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The purpose of this study was to assess nurse practitioner (NP) and physician assistant (PA) students' views of chiropractic. As the role of these providers progresses in primary care settings, providers' views and knowledge of chiropractic will impact interprofessional collaboration and patient outcomes. Understanding how NP and PA students perceive chiropractic may be beneficial in building integrative health care systems. METHODS This descriptive quantitative pilot study utilized a 56-item survey to examine attitudes, knowledge, and perspectives of NP and PA students in their 2nd year of graduate studies. Frequencies and binomial and multinomial logistic regression models were used to examine responses to survey totals. RESULTS Ninety-two (97%) students completed the survey. There were conflicting results as to whether participants viewed chiropractic as mainstream or alternative. The majority of participants indicated lack of awareness regarding current scientific evidence for chiropractic and indicated a positive interest in learning more about the profession. Students who reported prior experience with chiropractic had higher attitude-positive responses compared to those without experience. Participants were found to have substantial knowledge deficits in relation to chiropractic treatments and scope of practice. CONCLUSION The results of this study emphasize the need for increased integrative initiatives and chiropractic exposure in NP and PA education to enhance future interprofessional collaboration in health care.
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Aveni E, Bauer B, Ramelet AS, Kottelat Y, Decosterd I, Finti G, Ballabeni P, Bonvin E, Rodondi PY. The Attitudes of Physicians, Nurses, Physical Therapists, and Midwives Toward Complementary Medicine for Chronic Pain: A Survey at an Academic Hospital. Explore (NY) 2016; 12:341-6. [DOI: 10.1016/j.explore.2016.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Indexed: 11/30/2022]
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Nguyen J, Liu MA, Patel RJ, Tahara K, Nguyen AL. Use and interest in complementary and alternative medicine among college students seeking healthcare at a university campus student health center. Complement Ther Clin Pract 2016; 24:103-8. [DOI: 10.1016/j.ctcp.2016.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/25/2016] [Accepted: 06/03/2016] [Indexed: 11/16/2022]
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Griffin KH, Nate KC, Rivard RL, Christianson JB, Dusek JA. Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews. BMJ Open 2016; 6:e012006. [PMID: 27456330 PMCID: PMC4964262 DOI: 10.1136/bmjopen-2016-012006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. DESIGN Retrospective electronic health record review and structured qualitative interviews. SETTING A 630-bed tertiary care hospital with an IM service available to inpatients. PARTICIPANTS IM referrals of all inpatients aged ≥18 years between July 2012 and December 2014 were identified using the hospital's electronic health record. Fifteen physicians, 15 nurses and 7 administrators were interviewed to better understand roles and perspectives in referring patients for IM services. RESULTS In the study hospital, primary sources of referrals for IM services were the orthopaedic and neuroscience/spine service lines. While the largest absolute number of IM referrals was made for patients with lengths of stay of 3 days or fewer, a disproportionate number of total IM referrals was made for patients with long lengths of stay (≥10 days), compared with a smaller percentage of patients in the hospital with lengths of stay ≥10 days. Physicians and nurses were more likely to refer patients who displayed strong symptoms (eg, pain and anxiety) and/or did not respond to conventional therapies. IM referrals were predominantly nurse-initiated. A built-in delay in the time from referral initiation to service delivery discouraged referrals of some patients. CONCLUSIONS Conventional providers refer patients for IM services when these services are available in a tertiary hospital. Referral patterns are influenced by patient characteristics, operational features and provider perspectives. Nurses play a key role in the referral process. Overcoming cultural and knowledge differences between conventional and IM providers is likely to be a continuing challenge to providing IM in inpatient settings.
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Affiliation(s)
- Kristen H Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Kent C Nate
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Rachael L Rivard
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Jon B Christianson
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jeffery A Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
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Amundstuen Reppe L, Spigset O, Schjøtt J. Drug Information Services Today: Current Role and Future Perspectives in Rational Drug Therapy. Clin Ther 2016; 38:414-21. [PMID: 26831829 DOI: 10.1016/j.clinthera.2015.12.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/28/2015] [Accepted: 12/30/2015] [Indexed: 12/01/2022]
Abstract
Polypharmacy and complex drug treatment regimens are becoming increasingly common, which may lead to adverse drug reactions, drug interactions, medication nonadherence, and increasing costs and thus challenge the rational use of drugs. At the same time, the accessibility of drug information increases, and health care professionals may have limited opportunities and capabilities to search and critically evaluate drug information. Clinicians have reported difficulties in searching the best evidence and translating study findings into clinically meaningful information applicable to specific patients. Consequently, it remains a challenge to ensure the rational use of drugs in the years to come. Drug information centers (DICs) have been established to promote the rational use of drugs. One of the most important tasks of DICs is the question and answer services for health care professionals posing drug-related questions. DICs staffed by pharmacists and clinical pharmacologists hold expertise in searching for drug information and critical evaluation of the literature. The uniqueness in this service lies not only in the identification and interpretation of the scientific literature but also in the adaptation of the findings into specific clinical situations and the discussion of possible solutions with the enquirer. Thus, DICs could provide valuable decision support to the clinic. Taking into account the increasing number of possible drug-related questions that will arise today and in the future, the DICs will remain highly relevant in the years to come. However, the DICs must follow the developments in health information technology to disseminate relevant, unbiased drug information to old and new users of the service. Moreover, the DICs are important tools to counterbalance the drug information published by the pharmaceutical industry.
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Affiliation(s)
- Linda Amundstuen Reppe
- Faculty of Health Sciences, Nord University, Steinkjer, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Regional Medicines Information and Pharmacovigilance Centre, Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim, Norway.
| | - Olav Spigset
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Regional Medicines Information and Pharmacovigilance Centre, Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim, Norway
| | - Jan Schjøtt
- Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Regional Medicines Information and Pharmacovigilance Centre, Haukeland University Hospital, Bergen, Norway
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Mann B, Burch E, Shakeshaft C. Attitudes Toward Acupuncture Among Pain Fellowship Directors. PAIN MEDICINE 2015; 17:494-500. [DOI: 10.1093/pm/pnv001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 05/29/2015] [Accepted: 08/30/2015] [Indexed: 11/14/2022]
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Ben Natan M, Perelman M, Ben-Naftali G. Factors Related to the Intention of Israelis to Use Complementary and Alternative Medicine. J Holist Nurs 2015; 34:361-368. [PMID: 26620812 DOI: 10.1177/0898010115619088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Despite the significant rise in the use of complementary and alternative medicine (CAM) in Israel, the factors affecting the decision to do so remain unclear. Thus, the purpose of the study was to explore factors that affect Israelis' intention to use CAM, using the theory of planned behavior (TPB). DESIGN A quantitative correlational study. METHOD A convenience sample of 200 Hebrew-speaking Israelis aged 21+ completed a questionnaire based on the TPB. FINDINGS Respondents expressed moderate intention to use CAM. The TPB predictability of this intention was 57% (R2 = .57), with behavioral beliefs being the most influential factor. The family was identified as another significant factor. Previous experience with CAM was also found to raise the intention to use it in the future. CONCLUSIONS When referring a patient for services of CAM, it is important to provide in-depth explanations emphasizing positive anticipated outcomes of these services in order to effect a change in the patient's behavioral beliefs. Patient's family should be considered as a possible resource to promote usage of CAM.
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Affiliation(s)
- Merav Ben Natan
- Hillel Yaffe Medical Center, Hadera, Israel .,Tel Aviv University, Tel Aviv, Israel
| | - Maayan Perelman
- Hillel Yaffe Medical Center, Hadera, Israel.,Tel Aviv University, Tel Aviv, Israel.,Hillel Yaffe Medical Center, Hadera, Israel
| | - Gal Ben-Naftali
- Hillel Yaffe Medical Center, Hadera, Israel.,Tel Aviv University, Tel Aviv, Israel.,Hillel Yaffe Medical Center, Hadera, Israel
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Highfield ES, Broderick M, Goldstein L, Dickman L, Neri CM. Acupuncture as Part of a Pediatric Pain Clinic in a Safety-Net Hospital: Acupuncture Wednesday. Med Acupunct 2015. [DOI: 10.1089/acu.2015.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ellen Silver Highfield
- Program for Integrative Medicine and Health Disparities, Boston Medical Center, Boston, MA
- Department of Family Medicine, Boston Medical Center, Boston, MA
| | - Maria Broderick
- Program for Integrative Medicine and Health Disparities, Boston Medical Center, Boston, MA
- Department of Family Medicine, Boston Medical Center, Boston, MA
| | - Laura Goldstein
- Department of Child and Adolescent Psychology, Boston Medical Center, Boston, MA
- Pediatric Hematology/Oncology and Pediatric Pain Clinic, Boston University School of Medicine, Boston MA
| | - Laura Dickman
- Department of Child and Adolescent Psychology, Boston Medical Center, Boston, MA
- Pediatric Hematology/Oncology and Pediatric Pain Clinic, Boston University School of Medicine, Boston MA
| | - Caitlin M. Neri
- Pediatric Hematology/Oncology and Pediatric Pain Clinic, Boston University School of Medicine, Boston MA
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Practitioner Perspectives on Delivering Integrative Medicine in a Large, Acute Care Hospital. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:394040. [PMID: 26693242 PMCID: PMC4674616 DOI: 10.1155/2015/394040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/12/2015] [Indexed: 02/08/2023]
Abstract
Background. We describe the process and challenges of delivering integrative medicine (IM) at a large, acute care hospital, from the perspectives of IM practitioners. To date, minimal literature that addresses the delivery of IM care in an inpatient setting from this perspective exists. Methods. Fifteen IM practitioners were interviewed about their experience delivering IM services at Abbott Northwestern Hospital (ANW), a 630-bed tertiary care hospital. Themes were drawn from codes developed through analysis of the data. Results. Analysis of interview transcripts highlighted challenges of ensuring efficient use of IM practitioner resources across a large hospital, the IM practitioner role in affecting patient experiences, and the ways practitioners navigated differences in IM and conventional medicine cultures in an inpatient setting. Conclusions. IM practitioners favorably viewed their role in patient care, but this work existed within the context of challenges related to balancing supply and demand for services and to integrating an IM program into the established culture of a large hospital. Hospitals planning IM programs should carefully assess the supply and demand dynamics of offering IM in a hospital, advocate for the unique IM practitioner role in patient care, and actively support integration of conventional and complementary approaches.
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Liu MA, Nguyen J, Nguyen A, Kilgore DB. Longitudinal survey on integrative medicine education at an underserved health centre. EDUCATION FOR PRIMARY CARE 2015; 26:404-9. [DOI: 10.1080/14739879.2015.1101870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Johnson PJ, Kozhimannil KB, Jou J, Ghildayal N, Rockwood TH. Complementary and Alternative Medicine Use among Women of Reproductive Age in the United States. Womens Health Issues 2015; 26:40-7. [PMID: 26508093 DOI: 10.1016/j.whi.2015.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 08/04/2015] [Accepted: 08/27/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND The purpose of this study was to examine the prevalence of complementary and alternative medicine (CAM) use, types of CAM used, and reasons for CAM use among reproductive-age women in the United States. METHODS Data are from the 2007 National Health Interview Survey. We examined a nationally representative sample of U.S. women ages 18 to 44 (n = 5,764 respondents). Primary outcomes were past year CAM use, reasons for CAM use, and conditions treated with CAM by pregnancy status (currently pregnant, gave birth in past year, neither). Multivariate logistic regression was used to estimate the odds of CAM use by pregnancy status. FINDINGS Overall, 67% of reproductive-age U.S. women reported using any CAM in the past year. Excluding vitamins, 42% reported using CAM. Significant differences in use of biologically based (p = .03) and mind-body therapies (p = .012) by pregnancy status were found. Back pain (17.1%), neck pain (7.7%), and anxiety (3.7%) were the most commonly reported conditions treated with CAM among reproductive-age women. However, 20% of pregnant and postpartum women used CAM for pregnancy-related reasons, making pregnancy the most common reason for CAM use among pregnant and postpartum women. CONCLUSIONS CAM use during the childbearing year is prevalent, with one-fifth of currently or recently pregnant women reporting CAM use for pregnancy-related reasons. Policymakers should consider how public resources may be used to support appropriate, effective use of alternative approaches to managing health during pregnancy and postpartum. Providers should be aware of the changing needs and personal health practices of reproductive age women.
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Affiliation(s)
- Pamela Jo Johnson
- Center for Spirituality & Healing, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota.
| | - Katy B Kozhimannil
- Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota
| | - Judy Jou
- Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota
| | - Neha Ghildayal
- Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota
| | - Todd H Rockwood
- Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota
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Gregory PJ, Jalloh MA, Abe AM, Hu J, Hein DJ. Characterization of Complementary and Alternative Medicine-Related Consultations in an Academic Drug Information Service. J Pharm Pract 2015; 29:539-542. [PMID: 25952592 DOI: 10.1177/0897190015579450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines. METHODS A retrospective review and descriptive analysis of drug information consultations was conducted. RESULTS A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations. CONCLUSION Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions.
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Affiliation(s)
| | | | - Andrew M Abe
- Pharmacy Practice, University of Kansas, Lawrence, KS, USA
| | - James Hu
- Pharmacy Practice, Creighton University, Omaha, NE, USA
| | - Darren J Hein
- Pharmacy Practice, Creighton University, Omaha, NE, USA
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Characteristics and health perceptions of complementary and alternative medicine users in the United States. Am J Med Sci 2015; 349:140-4. [PMID: 25379625 DOI: 10.1097/maj.0000000000000363] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) use has been increasing and these unconventional therapies do have important adverse effects. We evaluated predictors of CAM use among U.S. adults. METHODS We analyzed the 2007 Health Information National Trends Survey (n=7503) and used logistic regression models to evaluate the association of demographic, lifestyle characteristics and healthcare perceptions of respondents who used CAM within the previous 12 months (n=1980) versus those who did not (n=5523). We used survey weights in all analyses and performed variance estimations using Taylor series linearization to account for the complex survey design. RESULTS Females (odds ratio [OR]=1.46; 95% confidence interval [CI]: 1.15-1.86), college graduates (OR=1.61; 95% CI: 1.24-2.08) and those who considered the quality of their healthcare to be poor (OR=2.16; 95% CI: 1.28-3.65) were more likely to use CAM, whereas blacks (OR=0.58; 95% CI: 0.39-0.85) were less likely to use CAM. Among CAM users, 47.6% did not inform their doctors. However, no factor predicted those who did not inform their doctors of their CAM use. CONCLUSIONS Many adults in the United States use CAM without informing their doctors. Care providers should inquire about CAM usage from their patients, document them and counsel their patients regarding their use of these less regulated therapies.
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Perceptions of providers and administrators in the Veterans Health Administration regarding complementary and alternative medicine. Med Care 2015; 52:S91-6. [PMID: 25397830 DOI: 10.1097/mlr.0000000000000225] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The integration of complementary and alternative medicine (CAM) therapies into a large organization such as the Veterans Health Administration (VHA) requires cultural change and deliberate planning to ensure feasibility and buy-in from staff and patients. At present, there is limited knowledge of VHA patient care providers' and administrators' viewpoints regarding CAM therapies and their implementation. OBJECTIVES Our purpose was to qualitatively examine knowledge, attitudes, perceived value and perceived barriers, and/or facilitators to CAM program implementation among VHA providers and administrators at a large VHA facility. RESEARCH DESIGN We are reporting the qualitative interview portion of a mixed-methods study. SUBJECTS Twenty-eight participants (patient care providers or administrators) were purposely chosen to represent a spectrum of positions and services. Participants' experience with and exposure to CAM therapies varied. MEASURES Individual interviews were conducted using a semi-structured format and were digitally recorded, transcribed, and coded for themes. RESULTS Recurrent themes included: a range of knowledge about CAM; benefits for patients and staff; and factors that can be facilitators or barriers including evidence-based practice or perceived lack thereof, prevailing culture, leadership at all levels, and lack of position descriptions for CAM therapists. Participants rated massage, meditation, acupuncture, and yoga as priorities for promotion across the VHA. CONCLUSIONS Despite perceived challenges, providers and administrators recognized the value of CAM and potential for expansion of CAM within the VHA. Interview results could inform the process of incorporating CAM into a plan for meeting VHA Strategic Goal One of personalized, proactive, patient-driven health care across the VHA.
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Winkler A, Sierpina VS, Kreitzer MJ. On harnessing the power of medical students to reach their peers. Explore (NY) 2014; 10:411-2. [PMID: 25456309 DOI: 10.1016/j.explore.2014.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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