A longitudinal analysis of self-prescribed complementary and alternative medicine use by a nationally representative sample of 19,783 Australian women, 2006-2010

Holistic healthcare in inflammatory bowel disease: time for patient-centric approaches?

Inflammatory bowel disease (IBD) is an emerging global disease characterised by chronic inflammation of the gastrointestinal tract. However, IBD is also manifested by several extraintestinal symptoms which, along with the intestinal symptoms, impact on the mental and emotional well-being of patients. Despite therapeutic advancements, only one-third of the diagnosed patients receiving approved medical treatments achieve short-term to medium-term remission. Consequently, patients who do not get successfully treated might resort to using complementary and alternative approaches to manage their symptoms, with or without consulting their treating clinician. Despite their possible potential, such approaches have various risks stemming from unknown adverse reactions and possible interference with medically approved therapies. In this study, we present the results of a well-performed literature review where we included randomised clinical trials which have assessed the efficacy of complementary approaches and dietary therapy on at least one of the following four outcomes: clinical remission, endoscopic remission, modulation of molecular biomarkers or quality of life metrics. By pointing out intraoutcome and interoutcome concordance, we identified possible candidates for clinical adoption and further study in larger randomised clinical trials covering the broad spectrum of IBD heterogeneity. We finally proposed a patient-centric clinical care model and a series of recommendations for stakeholders, with special attention to complementary approaches and dietary strategies, aimed at achieving holistic remission.

Prevalence of Use of Traditional, Complementary and Alternative Medicine by the General Population: A Systematic Review of National Studies Published from 2010 to 2019

INTRODUCTION

Traditional, complementary and alternative medicine (TCAM) refers to a broad range of health practices and products typically not part of the 'conventional medicine' system, and its use is substantial among the general population. TCAM products and therapies may be used in addition to, or instead of, conventional medicine approaches, and some have been associated with adverse reactions or other harms.

OBJECTIVES

The aims of this systematic review were to identify and examine recently published national studies globally on the prevalence of TCAM use in the general population, to review the research methods used in these studies and to propose best practices for future studies exploring prevalence of use of TCAM.

METHODS

MEDLINE, Embase, CINAHL, PsycINFO and AMED were searched to identify relevant studies published since 2010. Articles/reports describing the prevalence of TCAM use in a national study among the general population were included. The quality of included studies was assessed using a risk of bias tool developed by Hoy et al. Relevant data were extracted and summarised.

RESULTS

Forty studies from 14 countries, comprising 21 national surveys and one cross-national survey, were included. Studies explored the use of TCAM products (e.g. herbal medicines), TCAM practitioners/therapies, or both. Included studies used different TCAM definitions, prevalence time frames and data collection tools, methods and analyses, thereby limiting comparability across studies. The reported prevalence of use of TCAM (products and/or practitioners/therapies) over the previous 12 months was 24-71.3%.

CONCLUSION

The reported prevalence of use of TCAM (products and/or practitioners/therapies) is high, but may underestimate use. Published prevalence data varied considerably, at least in part because studies utilise different data collection tools, methods and operational definitions, limiting cross-study comparisons and study reproducibility. For best practice, comprehensive, detailed data on TCAM exposures are needed, and studies should report an operational definition (including the context of TCAM use, products/practices/therapies included and excluded), publish survey questions and describe the data-coding criteria and analysis approach used.

Longitudinal Analysis of Complementary Health Approaches in Adults Aged 25-74 Years from the Midlife in the U.S. Survey Sample

Objectives: Complementary health approaches include herbal products and mind-body practices. Several studies have identified predictors for complementary health approach use, yet there are two gaps: (1) How does use change? (2) Do factors associated with use influence this change over time? Using the Midlife in the United States (MIDUS), we examined how sociodemographic factors affected use longitudinally, and whether these associations differed between new and continued/discontinued use of herbal products, meditation, chiropractic, and massage therapy. Design: MIDUS is a national probability sample of adults aged 25 or older that has collected more than 20 years of longitudinal data, including the use of complementary health approaches. We employed the Andersen Model as a framework to identify predisposing, enabling, and health need factors associated with complementary health approach use based on previously identified and hypothesized factors. We ran Chi-square analyses to first test bivariate associations between our independent variables and four modalities to further guide logistic regression models. Results: Each of the four approaches examined saw substantial increases in prevalent use. However, only about 25% to 38% of individuals continued use from one wave to the next, whereas only 2%-9% of individuals who did not use a given approach in a wave reported use in the subsequent wave. Age, spiritual importance, and previous wave one use were all significantly associated with new use across all four modalities. Previous wave one use was associated with continued/discontinued use for all modalities. Age and education were significantly associated with discontinued use of chiropractic. Conclusion: We present the first longitudinal analysis of complementary health approaches in a nationally representative sample. These data distinguish between new and continued/discontinued use of complementary health approaches over time and provide insights into the interpretation of complementary health approach prevalence data, as well as important predictors of use.

Participant characteristics of users of holistic movement practices in Australia

OBJECTIVES

The aim of this study was to compare the characteristics of users of holistic movement practices in Australia to people who were physically active but not using holistic movement practices. A second aim was to compare characteristics of users of specific holistic movement practices (yoga/Pilates and t'ai chi/qigong).

DESIGN

We performed a secondary data analysis on pooled data of a nationally-representative physical activity survey conducted yearly 2001-2010 (n = 195,926).

SETTING

Australia-wide Exercise, Recreation, and Sport Survey (ERASS).

MAIN OUTCOME MEASURES

A range of socio-demographic and participation characteristics were documented and compared between users and non-users of holistic movement practices and between yoga/Pilates and t'ai chi/qigong users, employing descriptive statistics, chi square, and multiple logistic regression analyses.

RESULTS

Users of holistic movement practices (n = 6826) were significantly more likely than non-users to be female, older, have fewer children at home, and have higher levels of education, socio-economic background, and physical activity involvement (p < 0.001). Yoga/Pilates (n = 5733) and t'ai chi/qigong (n = 947) users were also found to differ on a number of characteristics, including age, sex, socioeconomic background, and marital status.

CONCLUSION

As a group, Australian users of holistic movement practices differ on a range of characteristics from those Australians active in other types of physical activities. However, differences between yoga/Pilates and t'ai chi/qigong users suggest these practices attract somewhat different sub-populations. To what extent these differences are due to characteristics inherent to the practices themselves or to differences in delivery-related parameters needs to be examined in future research.

Integrative Women's Health

This article addresses the common women's health concerns of menopause-related symptoms, premenstrual syndrome, and chronic pelvic pain. Each can be effectively addressed with an integrative approach that incorporates interventions such as pharmaceuticals, nutraceuticals, mind-body approaches, acupuncture, and lifestyle modification.

Participation trends in holistic movement practices: a 10-year comparison of yoga/Pilates and t'ai chi/qigong use among a national sample of 195,926 Australians

BACKGROUND

In recent decades, the evidence supporting the physical and mental health benefits of holistic movement practices such as yoga and t'ai chi have become increasingly established. Consequently, investigating the participation prevalence and patterns of these practices is a relevant pursuit in the public health field. Few studies have provided population-level assessment of participation rates, however, and even fewer have focused on patterns over time. The purpose of this study was to examine participation prevalence and trends in yoga/Pilates and t'ai chi/qigong over a ten-year period in a nationally representative sample of Australians aged 15 years and over, with particular attention to sex and age. A secondary purpose was to juxtapose these findings with participation trends in traditional fitness activities over the same period.

METHODS

Data comprised modes and types of physical activity, age, and sex variables collected through the Exercise, Recreation and Sport Survey (ERASS), a series of independent cross-sectional Australia-wide surveys conducted yearly between 2001 and 2010. For each year, weighted population estimates were calculated for those participating in yoga/Pilates, t'ai chi/qigong, and fitness activities (e.g. aerobics, calisthenics). Linear regression and multiple logistic regression analyses were used to examine trends in prevalence rates over time and differences among sex and age (15-34; 35-54; 55+ years) groups, respectively.

RESULTS

Average prevalence rates between 2001 and 2010 were 3.0% (95% CI 2.9-3.1) for yoga/Pilates, 0.6% (95% CI 0.5-0.6) for t'ai chi/qigong, and 19.2% (95% CI 18.9-19.4) for fitness activities. Across the decade, overall participation rates remained relatively stable for yoga/Pilates and t'ai chi/qigong, while increasing linearly for fitness activities. For both genders and in all three age groups, participation in fitness activities increased, whereas only in the 55+ age group was there a significant increase in yoga/Pilates participation; participation in t'ai chi/qigong declined significantly in the two younger age groups.

CONCLUSIONS

Participation rates in yoga/Pilates and t'ai chi/qigong in Australia were low and relatively stable. As fitness activities increased in popularity across the decade, holistic movement practices did not. These findings point to the need to investigate activity-specific barriers and facilitators to participation, including intrapersonal, interpersonal, organisational, and environmental factors.