Complementary and alternative medicine use among patients attending a hospital dermatology clinic in Taiwan

The assessment of complementary and alternative medicine use in acne vulgaris patients in Turkey: A cross-sectional study

Because acne vulgaris has a chronic course, can cause cosmetic problems, and negatively affects the psychosocial functionality and quality of life of patients, patients with acne vulgaris can frequently resort to complementary medicine practices. This study aimed to examine the frequency of complementary medicine use in patients diagnosed with acne vulgaris, the methods they used, the reasons for practicing these methods, and the factors affecting these practices. In this descriptive cross-sectional study, 400 (81.4%) of 491 patients aged ≥13 years who were diagnosed with acne vulgaris and treated at the dermatology outpatient clinic at Konya Numune Hospital between February and October 2020 were enrolled. A survey consisting of 37 questions was administered to patients in face-to-face interviews. Permission to conduct the study was obtained from the Faculty of Medicine Local Ethics Committee. The mean age of the patients was 20.0 ± 5.17, and 60% of the patients were women. It was stated by 87% of the patients that they used complementary medicine methods for the treatment of acne vulgaris. The first 3 methods used, in order of frequency, were topical herbal remedies at a rate of 61%, herbal medicines at 23.5%, and cupping/leeches at 2.5%. Complementary medicine use was significantly higher among the patients aged 19 to 25 and among the single patients. While practicing complementary medicine treatments, 33.5% also used the treatment given by their doctor simultaneously. It was determined that the physicians of 73.5% of the patients did not question their use of complementary medicine when prescribing treatment. In our study, it was determined that 87% of patients with acne vulgaris used complementary and alternative medicine (CAM) methods, and the majority of these patients were young. These treatment methods may affect the treatments that their physicians will recommend. Therefore, to prevent ill-advised practices, patients should be informed about the CAM methods they use when planning their treatment. Considering the possible side effects of CAM practices, physicians need to be aware that acne vulgaris patients frequently use CAM methods and improve themselves in raising the desired awareness on this issue.

Utilization, preference, perception and characteristics of people adopting traditional and AYUSH systems of medicine in India: a systematic review

Background Albeit Indian system of medicine has been practised since long however it has got recent prominence after some policy decisions made to make it more accessible to the people of India. Methods A two fold search strategy was adopted to obtain the literature; search through PUBMED and hand search through cross references. Of the 58 articles obtained through both the search approaches 13 articles were finally included in the review. Results The studies reviewed assessed the utilization, preference, perception and characteristics of people adopting traditional and AYUSH systems of medicine in India. Utilization was observed in a particular geographical area (states) and by a specific group of people such as tribal and general population, medical practitioners and religious groups. Perception about AYUSH system was mixed with different segments of the society. Preference among the general population revolved around distrust or frustration with allopathic medicine, cost effectiveness, accessibility, non-availability of other options and less side effects of AYUSH medicines. Moreover people primarily adopted AYUSH systems of medicine based on their personal experiences and recommended the same to other people as well. Conclusions A mixed response was observed through this systematic review with regard to utilization, preference, perception and characteristics of people adopting traditional and AYUSH systems of medicine in India. A higher level of awareness and governmental patronization is required to make it available to the common man at the last corner of the society for the benefit of the former and the system as well.

Taiwanese medical students' narratives of intercultural professionalism dilemmas: exploring tensions between Western medicine and Taiwanese culture

In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between Western medicine and Taiwanese culture. A narrative interview method was employed with 64 Taiwanese medical students to collect narratives of professionalism dilemmas. Noting the prominence of culture in students' narratives, we explored this theme further using secondary analysis, identifying tensions between Western medicine and Taiwanese culture and categorizing students' intercultural professionalism dilemmas according to Friedman and Berthoin Antal's 'intercultural competence' framework: involving combinations of advocacy (i.e., championing one's own culture) and inquiry (i.e., exploring one's own and others' cultures). One or more intercultural dilemmas were identified in nearly half of students' professionalism dilemma narratives. Qualitative themes included: family relations, local policy, end-of-life care, traditional medicine, gender relations and Taiwanese language. Of the 62 narratives with sufficient detail for further analysis, the majority demonstrated the 'suboptimal' low advocacy/low inquiry approach (i.e., withdrawal or inaction), while very few demonstrated the 'ideal' high advocacy/high inquiry approach (i.e., generating mutual understanding, so 'intercultural competence'). Though nearly half of students' professionalism narratives concerned intercultural dilemmas, most narratives represented disengagement from intercultural dilemmas, highlighting a possible need for more attention on intercultural competence training in Taiwan. The advocacy/inquiry framework may help educators to address similar disconnects between Western medicine and non-Western cultures in other contexts.

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers (P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine (P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.

Ethnopharmacological survey of medicinal plants used by patients with psoriasis in the West Bank of Palestine

Background

Psoriasis is a frequent skin inflammatory disorder that inflicts millions of patients around the globe. To meet their healthcare needs, patients with psoriasis often seek treatment outside the allopathic paradigm. Use of medicinal plants has emerged as one of the most common and preferred modalities of complementary and alternative medicine (CAM). The aim of this study was to investigate the use of medicinal plants by patients with psoriasis in the West Bank of Palestine.

Methods

The current study was a questionnaire based cross-sectional descriptive study on the use of medicinal plants by psoriasis patients in the West Bank of Palestine. A sample of 149 patients with psoriasis who were visiting outpatient clinics responded to the questionnaire in face to face interviews.

Results

Medicinal plants were used by 81 (54.4%) patients with psoriasis. Patients used 33 medicinal plants belonging to 26 families. Plants belonging to Lamiaceae and Leguminosae were the most commonly used by the study patients. Aloe vera, Trigonella arabica, Catharanthus roseus and Anthemis cotula were the most frequently used medicinal plants to treat psoriasis. Leaves and fruits were the most commonly used parts by the study patients. Paste was the most commonly used form of preparation. The use of medicinal plants was significantly associated with age and monthly household income of the patients. Enhancement of immunity, improving conventional therapy and reduction of side effects were the most commonly self-reported reasons for using medicinal plants.

Conclusions

Patients with psoriasis in Palestine seem to use medicinal plants as a CAM modality to manage their psoriasis. Many medicinal plants were commonly used by patients with psoriasis. More randomized clinical trials are needed to demonstrate safety and efficacy for the majority of these medicinal plants reported to be used by patients with psoriasis in Palestine.

Electronic supplementary material

The online version of this article (doi:10.1186/s12906-016-1503-4) contains supplementary material, which is available to authorized users.

A Systematic Review of Beliefs Involved in the Use of Complementary and Alternative Medicine

People might be attracted to and use complementary and alternative medicines (CAM) because they hold beliefs that are congruent with CAM. This article collates, examines and synthesizes the evidence surrounding this hypothesis. Most studies are cross-sectional and focus on a limited number of beliefs. Multivariate studies suggest that beliefs related to control and participation, perceptions of illness, holism and natural treatments, and general philosophies of life predict CAM use when controlling for demographic and clinical factors. Further research should examine the robustness of these relationships in different illness groups and the prospective relationships among beliefs and CAM use over time.

Acupuncture therapies for psoriasis vulgaris: a systematic review of randomized controlled trials

The purpose of this review was to evaluate the efficacy and safety of acupuncture therapies in the treatment of psoriasis vulgaris. Embase, CENTRAL, PubMed, AMED, CINAHL, CNKI, CQVIP, CBM, and Wanfang databases were searched from inceptions to May 2013 for prospective randomized controlled trials evaluating acupuncture therapies for psoriasis vulgaris. No language limitations were applied. Studies were assessed using the Cochrane risk of bias tool. The primary outcome was Psoriasis Area Severity Index (PASI) score. Six studies (involving 522 participants) met the eligibility criteria for this review, and 5 were included in quantitative analysis. Due to the diversity of interventions, comparators and reported outcomes, meta-analysis was not possible. Results from single studies produced conflicting results for the outcomes PASI reduction, lesion reduction (non-PASI), PASI score, and relapse rate. There is some evidence of benefit of acupuncture therapies for the treatment of psoriasis vulgaris. However, the conclusions are limited by the small number of included trials and conflicting results from single studies. More research is needed to clarify the effect of acupuncture therapies for psoriasis vulgaris.

Use of Complementary and Alternative Medicine Among Dermatology Outpatients: Results From a National Survey

BACKGROUND

Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia.

METHODS

This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained.

RESULTS

Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists.

CONCLUSIONS

There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM.

The use of complementary and alternative medicine among dermatology outpatients in Eastern Turkey

Introduction:

Over the past decade, complementary and alternative medicine (CAM) has become increasingly popular around the world.

Objectives:

In this study, we aim to investigate how frequently CAM is used and the types of CAM methods used for dermatological disease in Eastern Turkey.

Materials and methods:

We recruited 1610 patients from our clinic for this study. The sociodemographic features and the CAM methods were investigated with a survey.

Results:

The most common dermatological disorders included contact dermatitis (21.4%), acne vulgaris (17.5%), fungal infections (10.9%), eczema (6.3%), and warts (5.7%). The ratio of patients using at least one CAM method was 43.7% and that of those using two or more CAM methods was 20.8%. The most commonly used CAM methods were those using henna, cologne, moisturizing cream, prayer, and herbal therapy. Some patients were found to use some interesting and unusual CAM methods, such as putting out a cigarette over the skin on the back for anthrax, applying raw meat for furuncle, using fuel oil and nitric acid for contact dermatitis.

Conclusions:

CAM methods are commonly used in our population. CAM methods often cause adverse reactions that may alter diagnostic skin findings and interfere with the efficacy of other medical therapies. Therefore, physicians should ask their patients about the use of CAM methods while collecting patient history. Physicians have a critical role in preventing improper use of CAM. In addition, further investigations into the efficacy, benefits, and risks of CAM methods should be carried out for better insight into those CAM methods.

Use of complementary and alternative medicine by patients seen at the dermatology department of a tertiary care center

The use of complementary and alternative medicine (CAM) among patients with dermatologic conditions has not been well studied. The aim of this study was to evaluate the frequency and pattern of CAM use in patients referred to the dermatology department of a tertiary care center. Patients referred to the dermatology department of an academic tertiary referral center between February 2, 2010, and February 10, 2010, were invited to participate in an 86-question survey regarding CAM use during the previous year. A total of 300 patients completed the survey, of whom 154 (51%) were women. Eighty-two percent (n = 247) of the respondents had used some type of CAM during the previous year. The most frequently used treatment and technique was massage therapy (33%), and the most commonly used vitamin was vitamin C (31%). Herbs or other dietary supplements were used by 58% (n = 173) of patients. Seventy-eight percent (n = 235) of patients stated that physicians should consider incorporating CAM approaches into their treatment recommendations, and 89% of patients (n = 267) stated that our dermatology department should study CAM approaches in research studies. CAM utilization is high among patients at a large academic dermatology department. Patients indicated a strong preference for having CAM approaches incorporated into their treatment recommendations and believed in the value of clinical studies to further refine the role of CAM.

Use of complementary and alternative medicine among dermatology outpatients in Singapore

BACKGROUND/OBJECTIVES

Although the prevalence of complementary and alternative medicine (CAM) use has been studied among general and specific disease populations, little is known on the use of CAM among Asian dermatology patients. This study assesses prevalence, demographics, disease determinants, expectations and reasons for CAM use among patients visiting a major referral dermatology centre in Singapore.

METHODS

A descriptive cross-sectional study of 855 dermatology outpatients was done. Consecutive sampling using interviewer-administered questionnaires collected information on patient demographics, dermatological condition, prevalence, reasons and expectations of CAM use. Patient-perceived disease severity was measured via the Dermatological Life Quality Index (DLQI). Dermatologists completed Patient Data Forms, detailing diagnosis, diagnosis date and CAM use.

RESULTS

The prevalence of CAM use was 25.7%. Patients who were higher educated, held white collar occupations, had longer disease duration, higher DLQI scores or were suffering from psoriasis or eczema were more likely to have used CAM. More than 60% of patients expected dermatologists to provide at least basic CAM advice and 75% were willing to declare their CAM use. Forty percent of dermatologists accurately knew their patients' current CAM use.

CONCLUSIONS

Prevalence of CAM use in dermatology patients was high. Many doctors were unaware of patients' CAM use despite most patients being willing to declare it. Patients generally expected dermatologists to provide CAM advice. Dermatologists should make a concerted effort to identify likely CAM users and consider openly discussing CAM use with them.

Use of complementary and alternative medicine among adults with skin disease: updated results from a national survey

BACKGROUND

In the United States, complementary and alternative medicine (CAM) is used for a variety of diseases, including those of the skin. An estimate of the prevalence of CAM use among adults with skin disease using the alternative health supplement of the 2002 National Health Interview Survey (NHIS) has been published.

OBJECTIVE

We sought to analyze the 2007 NHIS data to update the prevalence of CAM use among adults with skin disease in the United States.

METHODS

We conducted a cross-sectional survey using the 2007 alternative health supplement of the NHIS.

RESULTS

Among those reporting skin problems in the past year, 84.5% (95% confidence interval 76.9-92.0) used CAM. Only 1.1% of this group (95% confidence interval 0.7-1.6) used CAM specifically for skin disease. Adjusting for race, sex, income, education level, and region, those reporting skin problems were more likely to use CAM than those who did not report skin problems (adjusted odds ratio 2.5, P ≤ .002, 95% confidence interval 1.4-4.4). Vitamin/mineral and herbal supplements were the most common CAM modalities used among those with skin disease in general, and among those who used CAM specifically for skin problems.

LIMITATIONS

As this is not a dermatology-focused database, the definition of skin disease is limited. It was not possible to comment on trends between the 2002 and 2007 data because the 2007 survey was significantly changed.

CONCLUSION

CAM use among adults with skin problems in the United States continues to be common. Addition of a specific dermatology supplement to a future NHIS survey would allow for population-based estimates not only of CAM use but of associations with other comorbid conditions among adults with skin disease in the United States.

Complementary and alternative medicine for psoriasis: a qualitative review of the clinical trial literature

BACKGROUND

Patients with psoriasis often inquire about complementary and alternative medicine in an effort to do everything possible to control the disease.

OBJECTIVE

We sought to review the clinical trial literature regarding complementary and alternative medicine for the treatment of psoriasis.

METHODS

We conducted qualitative systematic review of randomized, clinical trials.

RESULTS

Although many randomized controlled trials were found, both the results and the quality of the studies varied.

LIMITATIONS

The main limitations were the relatively low quality of studies (as assessed by Jadad scores), lack of inclusion of unpublished studies, and the fact that only one author determined inclusion of studies and assignment of Jadad scores.

CONCLUSION

There is a large body of literature in regard to complementary and alternative medicine for the treatment of psoriasis. More work is necessary before these modalities should be recommended to our patients.

Self-application of complementary and alternative medicine by patients with gynecologic cancer

OBJECTIVES

In this study we aimed to determine the epidemiology and demographic data on complementary and alternative medicine (CAM) use along with the medical/surgical treatment modalities in patients with gynecologic cancers in Turkey.

MATERIALS AND METHODS

A cross-sectional study was designed to determine demographic data on CAM use of patients with gynecologic cancers who had medical and/or surgical treatments. Semistructured questionnaires were used for collecting data from 126 patients.

RESULTS

When the CAM use ratio of patients was evaluated with respect to demographic characteristics, patients using any type of CAM were younger and more educated, and there were no significant differences between the patients who used and who did not use any type of CAM with respect to geographical region. There were no significant correlations between the use of CAM and the type of malignancy, treatment modality and time period after diagnosis.

CONCLUSION

There is critical concern about the probable serious risks associated with non-educated CAM practitioners. Therefore, informed and educated healthcare professionals should inform and help in relieving patients in a more professional and multidisciplinary way.

Use of complementary medicine among outpatients with dermatologic conditions within Yorkshire and South Wales, United Kingdom

BACKGROUND

The use of complementary and alternative medicine (CAM) is increasing throughout the Western world, particularly by patients with chronic disease. In 1999, 20% of the United Kingdom population reported that they had used CAM in the preceding 12 months.

OBJECTIVES

We sought to investigate the use of CAM by outpatients with general dermatologic conditions in 3 United Kingdom cities: Leeds (North England), and Cardiff and Swansea (South Wales).

METHODS

Independently constructed, anonymous, self-directed questionnaires were designed and distributed to 400 consecutive outpatients with dermatologic conditions in Leeds and 637 consecutive outpatients with dermatologic conditions in Cardiff and Swansea.

RESULTS

In Leeds 302/400 questionnaires were fully completed with 39% patients having used CAM. In South Wales 415/637 questionnaires were fully completed with 34% having used CAM. Of these, 45% of patients in Leeds and 50% of patients in South Wales were using CAM to treat their dermatologic condition. The most popular treatments in Leeds, Cardiff, and Swansea were herbal medicine and homeopathy.

LIMITATIONS

These results were obtained from outpatients with dermatologic conditions in the United Kingdom and may not be applicable to other populations.

CONCLUSIONS

More than one third of outpatients with general dermatologic conditions in two geographically distant regions are using CAM. More than 45% of these patients used CAM to treat their dermatologic condition.

The geography of complementary medicine: perspectives and prospects

While complementary and alternative medicine (CAM) research has benefited from a range of social scientific perspectives, geographical contributions have been only slowly forthcoming. In this context, this paper illuminates the possibilities for CAM researchers to develop dedicated geographical perspectives. Some fundamental changes in the empirical and theoretical foci of medical/health geography are outlined, from a concern with mapping services and diseases in macro-space to investigating the dynamic between health and place. Highlighted are some important relational dynamics among CAM providers, patients/consumers and places of treatment and some general issues that could benefit from a geographical analysis. The concurrent research agenda is located across the sub-disciplinary strata of human geography.