1
|
Prasopthum A, Insawek T, Pouyfung P. Herbal medicine use in Thai patients with type 2 diabetes mellitus and its association with glycemic control: A cross-sectional evaluation. Heliyon 2022; 8:e10790. [PMID: 36212012 PMCID: PMC9535297 DOI: 10.1016/j.heliyon.2022.e10790] [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: 10/29/2021] [Revised: 04/02/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Herbal medicine has been integrated into Thai culture for many centuries. However, studies on using herbal medicine in combination with antidiabetic agents for glycemic control in managing diabetes are limited. Herein, we aimed to assess the use of herbal medicines with different dosages of antidiabetic agents and their association with glycemic control in Thai patients with type 2 diabetes mellitus (T2DM). Methods This hospital-based study included 739 patients with T2DM who consecutively visited four district hospitals in Thailand. An interviewer-administered questionnaire was used to collect patient-specific information, including hemoglobin A1c (HbA1c) levels. Chi-square and logistic regression analyses were used to assess associations and predictors, respectively. Results The prevalence of herbal medicine use was 37.5% (n = 264); 70.5% of the patients received information about herbal medicine usage for glycemic control from their relatives and friends, and 21 herbal plants were consumed in combination with their prescribed antidiabetic drugs. The use of herbal medicine was associated with the patients’ educational level (p = 0.001), income (p < 0.001), and duration of diabetes (p < 0.001). Good glycemic control (HbA1c < 7.0%) was associated with the use of bitter gourd in combination with 500 mg/day of the antidiabetic drug metformin (adjusted odds ratio = 8.33, 95% confidence interval = 1.04–66.49, p = 0.046). These patients were 2.92 times more likely to have good glycemic control than those who relied solely on 500 mg/day of metformin (adjusted OR = 2.921, 95% CI = 1.227–6.952, p = 0.015). Conclusions The prevalence of herbal plant use was associated with different variables, including age, BMI, T2DM duration, and metformin dosage. Among the 21 herbal plants, the consumption of bitter gourd with 500 mg/day of metformin was associated with good glycemic control.
Collapse
|
2
|
Ho EY, Bylund CL, Wollney E, Peterson EB, Wong HN, Koenig CJ. A systematic review of communication about Complementary and Integrative Health (CIH) in global biomedical settings. PATIENT EDUCATION AND COUNSELING 2021; 104:2900-2911. [PMID: 34030929 DOI: 10.1016/j.pec.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES A systematic review to analyze communication rates of complementary and integrative health (CIH) and analyze how communication terms, such as "disclosure," are measured and operationalized. METHODS We searched seven databases for studies published between 2010 and 2018 with quantitative measurements of patients' communication of CIH to a biomedical clinician. We analyzed communication terms used to describe patients reporting CIH usage. We also examined the conceptual and operational definitions of CIH provided and whether those terms were explicitly operationalized. We aggregated the percentage, rate, or ratio of CIH users that communicated about CIH with their clinicians by disease type and geographical region. RESULTS 7882 studies were screened and 89 included in the review. Studies used a wide range of conceptual and operational definitions for CIH, as well as 23 different terms to report communication related to reporting CIH usage. Usage varied by disease type and geographical region. CONCLUSIONS Studies of CIH and CIH communication may measure different kinds of social and communicative phenomena, which makes comparison across international studies challenging. PRACTICE IMPLICATIONS Future studies should employ standardized, replicable measures for defining CIH and for reporting CIH communication. Clinicians can incorporate questions about prior, current, and future CIH use during the medical visit.
Collapse
Affiliation(s)
- Evelyn Y Ho
- Department of Communication Studies, University of San Francisco, San Francisco, USA; Asian American Research Center on Health, San Francisco, USA.
| | - Carma L Bylund
- College of Journalism and Communications, University of Florida, Gainesville, USA
| | - Easton Wollney
- College of Journalism and Communications, University of Florida, Gainesville, USA
| | - Emily B Peterson
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, USA
| | - Hong-Nei Wong
- Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, Stanford, Palo Alto, USA
| | - Christopher J Koenig
- Department of Communication Studies, San Francisco State University, San Francisco, USA; Medical Cultures Lab, University of California, San Francisco, San Francisco, USA
| |
Collapse
|
3
|
Chung VC, Wong CH, Zhong CC, Tjioe YY, Leung TH, Griffiths SM. Traditional and complementary medicine for promoting healthy ageing in WHO Western Pacific Region: Policy implications from utilization patterns and current evidence. Integr Med Res 2021; 10:100469. [PMID: 32874912 PMCID: PMC7452244 DOI: 10.1016/j.imr.2020.100469] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND With increasing burden of chronic non-communicable diseases (NCD), ageing becomes a global public health concern, and the World Health Organization Western Pacific Region has no exception. To address the NCD challenge, priority should be given to promote healthy ageing across the life-course. As traditional and complementary medicine (T&CM) is popular within the Region, it is of policy interest to explore possibilities of applying T&CM for promoting healthy ageing. METHODS We first summarized sources of clinical evidence supporting the use of T&CM. We then searched publications through MEDLINE from its inception to April 2020 to identify studies focusing on the perception of T&CM among older people. Finally, taking current evidence base and patient choice into account, we generated policy recommendations for of integrating T&CM into health systems. RESULT Experiences from countries with different income levels suggested that promoting evidence-based T&CM as self-care modalities would be the most efficient way of maximizing impact among the older population, especially via a train the trainer approach. Meanwhile, popularity of natural products in the Region mandates policy makers to implement appropriate regulation and quality assurance, and to establish pharmacovigilance to detect potential harm. The role of pharmacists in advising patients on self-medication using natural products needs to be strengthened. CONCLUSION Policy-makers will benefit from continued global dialogue and sharing of experience in T&CM policy development and implementation. Harmonizing regulatory frameworks for natural products at regional and global levels, including mutual recognition of regulatory approval, to improve standards and protect patients could be a priority.
Collapse
Affiliation(s)
- Vincent C.H. Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Charlene H.L. Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Claire C.W. Zhong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yan Yin Tjioe
- School of Biological Sciences, College of Science, Nanyang Technological University, Singapore
| | - Ting Hung Leung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Sian M. Griffiths
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
4
|
Lin CH, Chiu HE, Wu SY, Tseng ST, Wu TC, Hung YC, Hsu CY, Chen HJ, Hsu SF, Kuo CE, Hu WL. Chinese Herbal Products for Non-Motor Symptoms of Parkinson's Disease in Taiwan: A Population-Based Study. Front Pharmacol 2021; 11:615657. [PMID: 33584294 PMCID: PMC7873047 DOI: 10.3389/fphar.2020.615657] [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: 10/09/2020] [Accepted: 12/23/2020] [Indexed: 11/20/2022] Open
Abstract
Objective: Combinations of Chinese herbal products (CHPs) are widely used for Parkinson’s disease (PD) in Taiwan. Thereby, we investigated the use of CHPs in patients with PD. Methods: This study was a population-based cohort study that analyzed the data of patients with PD from the National Health Insurance Research Database. A total of 9,117 patients were selected from a random sample of one million individuals included in this database. We used multiple logistic regression models to estimate the adjusted odds ratios of the demographic factors and analyzed the formula and single CHPs commonly used for PD. Results: Traditional Chinese medicine users were more commonly female, younger, of white-collar status, and residents of Central Taiwan. Chaihu-Jia-Longgu-Muli-Tang was the most commonly used formula, followed by Ma-Zi-Ren-Wan and then Shao-Yao-Gan-Cao-Tang. The most commonly used single herb was Uncaria tomentosa (Willd. ex Schult.) DC., followed by Gastrodia elata Blume and then Radix et Rhizoma Rhei (Rheum palmatum L., Rheum tanguticum Maxim. ex Balf., and Rheum officinale Baill.). Chaihu-Jia-Longgu-Muli-Tang and U. tomentosa (Willd. ex Schult.) DC. have shown neuroprotective effects in previous studies, and they have been used for managing non-motor symptoms of PD. Conclusion: Chaihu-Jia-Longgu-Muli-Tang and U. tomentosa (Willd. ex Schult.) DC. are the most commonly used CHPs for PD in Taiwan. Our results revealed the preferences in medication prescriptions for PD. Further studies are warranted to determine the effectiveness of these CHPs for ameliorating the various symptoms of PD, their adverse effects, and the mechanisms underlying their associated neuroprotective effects.
Collapse
Affiliation(s)
- Chien-Hung Lin
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsienhsueh Elley Chiu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Szu-Ying Wu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Ting Tseng
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tzu-Chan Wu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Feng Hsu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taipei, Taiwan
| | - Chun-En Kuo
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan.,Fooyin University College of Nursing, Kaohsiung, Taiwan
| |
Collapse
|
5
|
Mishra P, Greenfield SM, Harris T, Hamer M, Lewis SA, Singh K, Nair R, Mukherjee S, Krishnamurthy Manjunath N, Harper DR, Tandon N, Kinra S, Prabhakaran D, Chattopadhyay K. Yoga Program for Type 2 Diabetes Prevention (YOGA-DP) Among High-Risk People: Qualitative Study to Explore Reasons for Non-participation in a Feasibility Randomized Controlled Trial in India. Front Public Health 2021; 9:682203. [PMID: 34540780 PMCID: PMC8446204 DOI: 10.3389/fpubh.2021.682203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Yoga-based interventions can be effective in preventing type 2 diabetes mellitus (T2DM). We developed a Yoga program for T2DM prevention (YOGA-DP) among high-risk people and conducted a feasibility randomized controlled trial (RCT) in India. The objective of this study was to identify and explore why potential participants declined to participate in the feasibility RCT. Methods: An exploratory qualitative study, using semi-structured interviews, was conducted at a Yoga center in New Delhi, India. Fourteen people (10 women and four men) who declined to participate in the feasibility RCT were interviewed, and 13 of them completed the non-participant questionnaire, which captured their socio-demographics, diets, physical activities, and reasons for declining. Results: Three types of barriers were identified and explored which prevented participation in the feasibility RCT: (1) personal barriers, such as lack of time, perceived sufficiency of knowledge, preferences about self-management of health, and trust in other traditional and alternative therapies; (2) contextual barriers, such as social influences and lack of awareness about preventive care; and (3) study-related barriers, such as lack of study information, poor accessibility to the Yoga site, and lack of trust in the study methods and intervention. Conclusions: We identified and explored personal, contextual, and study-related barriers to participation in a feasibility RCT in India. The findings will help to address recruitment challenges in future Yoga and other RCTs. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: CTRI/2019/05/018893.
Collapse
Affiliation(s)
| | | | - Tess Harris
- Population Health Research Institute, St. George's University of London, London, United Kingdom
| | - Mark Hamer
- Institute Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Sarah Anne Lewis
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Kavita Singh
- Centre for Chronic Disease Control, New Delhi, India
| | - Rukamani Nair
- Bapu Nature Cure Hospital and Yogashram, New Delhi, India
| | | | | | | | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
- *Correspondence: Kaushik Chattopadhyay
| |
Collapse
|
6
|
Nutraceutical Use among Patients with Chronic Disease Attending Outpatient Clinics in a Tertiary Hospital. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9814815. [PMID: 33224262 PMCID: PMC7673927 DOI: 10.1155/2020/9814815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022]
Abstract
Food-drug interphase products, referring to nutraceuticals in this study, are a category of health products containing a combination of food ingredients with active substances for oral consumption. Many of these products are marketed as an alternative to prescription medicine to treat various ailments despite the lack of scientific evidence, influencing patients with chronic diseases to consume nutraceutical products. This study aimed to determine the prevalence and factors associated with knowledge, attitude, and practice of nutraceutical use among patients with chronic disease attending to the outpatient clinic. This is a cross-sectional study involving patients with chronic disease at the outpatient specialist clinic. Samples were recruited from the outpatient clinic using convenience sampling. Data was collected using a self-administered questionnaire, which was self-constructed and validated. We found that the use of nutraceuticals was prevalent among 17.9% of respondents. More than half (60.9%) of the respondents have poor knowledge of nutraceutical and 53.1% of respondents have a positive attitude towards nutraceutical. Gender and morbidities were the factors associated with the practice of nutraceutical usage. Female patients are more likely to have increased use of nutraceutical than male patients and patients with multiple morbidities have higher odds of using nutraceutical than patients with single morbidities. There is a high number of patients who consume nutraceutical products and public knowledge of nutraceutical needs to be improved further. The government should develop appropriate regulation and monitoring of nutraceutical products.
Collapse
|
7
|
Canaway R, Leach M, Hunter J. Setting an agenda for strengthening the evidence-base for traditional and complementary medicines: Perspectives from an expert forum in Australia. ADVANCES IN INTEGRATIVE MEDICINE 2018. [DOI: 10.1016/j.aimed.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
8
|
Zörgő S, Purebl G, Zana Á. A qualitative study of culturally embedded factors in complementary and alternative medicine use. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:25. [PMID: 29357855 PMCID: PMC5778786 DOI: 10.1186/s12906-018-2093-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/15/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Within the intercultural milieu of medical pluralism, a nexus of worldviews espousing distinct explanatory models of illness, our research aims at exploring factors leading to complementary and alternative medicine (CAM) use with special attention to their cultural context. METHODS The results are based on medical anthropological fieldwork (participant observation and in-depth interviews) spanning a period from January 2015 to May 2017 at four clinics of Traditional Chinese Medicine in Budapest, Hungary. Participant observation involved 105 patients (males N = 42); in-depth interviews were conducted with patients (N = 9) and practitioners (N = 9). The interviews were coded with Interpretative Phenomenological Analysis; all information was aggregated employing Atlas.ti software. RESULTS In order to avoid the dichotomization of "push and pull factors," results obtained from the fieldwork and interviews were structured along milestones of the patient journey. These points of reference include orientation among sources of information, biomedical diagnosis, patient expectations and the physician-patient relationship, the biomedical treatment trajectory and reasons for non-adherence, philosophical congruence, and alternate routes of entry into the world of CAM. All discussed points which are a departure from the strictly western therapy, entail an underlying socio-cultural disposition and must be scrutinized in this context. CONCLUSIONS The influence of one's culturally determined explanatory model is ubiquitous from the onset of the patient journey and exhibits a reciprocal relationship with subjective experience. Firsthand experience (or that of the Other) signifies the most reliable source of information in matters of illness and choice of therapy. Furthermore, the theme of (building and losing) trust is present throughout the patient journey, a determining factor in patient decision-making and dispositions toward both CAM and biomedicine.
Collapse
Affiliation(s)
- Szilvia Zörgő
- Semmelweis University, Institute of Behavioural Sciences, 4 Nagyvárad tér, Budapest, 1089 Hungary
| | - György Purebl
- Semmelweis University, Institute of Behavioural Sciences, 4 Nagyvárad tér, Budapest, 1089 Hungary
| | - Ágnes Zana
- Semmelweis University, Institute of Behavioural Sciences, 4 Nagyvárad tér, Budapest, 1089 Hungary
| |
Collapse
|
9
|
Traditional herbal medicine use among people living with HIV/AIDS in Gondar, Ethiopia: Do their health care providers know? Complement Ther Med 2017; 35:14-19. [PMID: 29154059 DOI: 10.1016/j.ctim.2017.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/26/2017] [Accepted: 08/28/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND People living with HIV/AIDS (PLWHA) are increasingly using herbal remedies due to the chronic nature of the disease, the complexities of treatment modalities and the difficulty in adhering to the therapeutic regimens. Yet, research on herbal medicine use in this patient population is scarce in Ethiopia. The present study aimed at investigating the prevalence and factors associated with the use of traditional herbal medicine among PLWHA in Gondar, Ethiopia. METHODS A cross sectional survey was conducted on 360 PLWHA attending the outpatient clinic of University of Gondar referral and teaching hospital from September 1 to 30, 2016. A questionnaire about the socio-demographic, disease characteristics as well as traditional herbal medicine use was filled by the respondents. Descriptive statistics, univariate and multivariate logistic regression analyses were performed to determine prevalence and correlates of herbal medicine use. RESULTS Out of 360 respondents, 255 (70.8%) used traditional herbal medicine. The most common herbal preparations used by PLWHA were Ginger (Zingiber officinale) (47%), Garlic (Allium sativum L.) (40.8%) and Moringa (Moringa stenopetala) (31.4%). Majority of herbal medicine users rarely disclose their use of herbal medicines to their health care providers (61.2%). Only lower educational status was found to be strong predictors of herbal medicine use in the multivariate logistic regression. CONCLUSIONS The use of herbal medicine among PLWHA is a routine practice and associated with a lower educational status. Patients also rarely disclose their use of herbal medicines to their health care providers. From the stand point of high prevalence and low disclosure rate, health care providers should often consult patients regarding herbal medicine use.
Collapse
|
10
|
Abou-Rizk J, Alameddine M, Naja F. Prevalence and Characteristics of CAM Use among People Living with HIV and AIDS in Lebanon: Implications for Patient Care. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:5013132. [PMID: 28050191 PMCID: PMC5168459 DOI: 10.1155/2016/5013132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/07/2016] [Indexed: 01/25/2023]
Abstract
This study aimed to assess the prevalence and determinants of Complementary and Alternative Medicine (CAM) use among People Living with HIV and AIDS (PLWHA) in Lebanon and to identify related issues that may affect patient care. A cross-sectional survey design was used to interview 116 PLWHA in Beirut. The questionnaire addressed sociodemographic and disease characteristics as well as CAM use. The main outcome of the study was CAM use since diagnosis. Data analysis included descriptive statistics and logistic regression analyses. Overall, 46.6% of participants reported using one or more CAM therapies, with herbs and herbal products being the most commonly used (63%). A higher education level was associated with a 3-fold increase in the odds of CAM use. Among users, 20% used CAM as alternative to conventional treatment, 48% were not aware of CAM-drug interactions, 89% relied on nonhealth care sources for their choice of CAM, and 44% did not disclose CAM use to their physician. CAM use is prevalent among Lebanese PLWHA. Findings of this study highlighted the need to educate health care practitioners to have an open communication and a patient-centered approach discussing CAM use during routine care and to enhance awareness of PLWHA on safe use of CAM.
Collapse
Affiliation(s)
- Joana Abou-Rizk
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Mohamad Alameddine
- Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14, Dubai Healthcare City, P.O. Box 505055, Dubai, UAE
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| |
Collapse
|
11
|
Syed IA, Sulaiman SAS, Hassali MA, Thiruchelvam K, Syed SH, Lee CK. Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.09.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
12
|
Medagama AB, Widanapahirana H, Prasanga T. The availability and validity of safety information of over the counter herbal products for use in diabetes in Sri Lanka: A cross sectional study. JOURNAL OF COMPLEMENTARY MEDICINE RESEARCH 2015; 4:264-9. [PMID: 26649230 PMCID: PMC4665020 DOI: 10.5455/jice.20151104093108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/26/2015] [Indexed: 11/21/2022]
Abstract
AIMS There is an increase of over-the-counter (OTC) herbal products for use in diabetes mellitus. The aim of this study is to evaluate the safety information provided with OTC herbal remedies intended for diabetic patients in Sri Lanka and to assess the completeness of the information provided. METHODS Inclusion criteria consisted of OTC herbal remedies meant for use in diabetes. They were bought from local Sri Lankan supermarkets and non-ayurvedic pharmacies and product information regarding the risk of hypoglycemia, precautions for use, adverse events, dose, and interactions were assessed using a scoring system. The accuracy of the information was then compared against published data. RESULTS 11 products fulfilled the inclusion criteria. Five products contained a single constituent and five contained more than one. None had complete and accurate safety information according to our criteria. None specifically warned against the risk of hypoglycemia. 9 out of 11 products (81.8%) carried ≤3 items of the five essential factual information we expected. Hypoglycemic coma, gastrointestinal symptoms, hepatotoxicity, carcinogenesis, and interactions causing elevated drug levels of Carbamazepine were some of the safety information that was missing. CONCLUSIONS Key safety information was absent in most products. Regulation of sale, provision of key safety information and adverse event reporting should be a priority.
Collapse
Affiliation(s)
| | | | - Tharindu Prasanga
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| |
Collapse
|
13
|
Muñoz FA, Servin AE, Kozo J, Lam M, Zúñiga ML. A binational comparison of HIV provider attitudes towards the use of complementary and alternative medicine among HIV-positive Latino patients receiving care in the US-Mexico border region. AIDS Care 2012; 25:990-7. [PMID: 23088506 DOI: 10.1080/09540121.2012.729806] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Use of complementary and alternative medicine (CAM) is common among Latinos living with HIV in the United States (US)-Mexico border region. Health providers may vary in their approach to communicating acceptance or non acceptance of CAM use, which can undermine patient confidence in disclosing CAM use. Patient-provider communication about CAM is important because certain types of CAM can affect antiretroviral therapy (ART) adherence. We undertook the present binational study to understand US and Mexican provider beliefs, and perceptions surrounding CAM use among Latino patients, and to learn if and how CAM communication occurs. Between July and December 2010, we conducted in-depth, qualitative interviews in Tijuana and San Diego. Analysis procedures drew upon principles of Grounded Theory. The sample was comprised of 19 HIV-health care providers, including 7 women and 12 men. Emerging CAM-related themes were: Provider's perceptions, attitudes and knowledge about CAM; CAM types and modalities; and patient-provider CAM communication. Many clinicians were uncomfortable supporting CAM use with their patients. San Diego providers reported more frequent instances of CAM use among Latino patients than Tijuana providers. Providers from both cities reported that patients infrequently disclose CAM use and almost half do not routinely ask patients about CAM practices. Most of the providers acknowledged that they lack information about CAM, and are concerned about the drug interaction as well as the effects of CAM on adherence. Our findings have important implications for understanding provider communication surrounding CAM use in a highly transnational population and context. Because CAM use may undermine ART adherence and is highly prevalent among Latinos, provider communication about CAM is critical to improved health outcomes among HIV-positive Latinos. Considering the significant growth of US Latinos, especially in the US-Mexico border region, assessment of Mexican and US provider training and communication needs surrounding Latino patient CAM use is warranted.
Collapse
Affiliation(s)
- Fátima A Muñoz
- Division of Global Public Health, Department of Medicine, University of California, San Diego, la Jolla, CA, USA
| | | | | | | | | |
Collapse
|
14
|
Farooqui M, Hassali MA, Abdul Shatar AK, Shafie AA, Farooqui MA, Saleem F, Aljadhey H. Complementary and alternative medicines (CAM) disclosure to the health care providers: a qualitative insight from Malaysian cancer patients. Complement Ther Clin Pract 2012; 18:252-6. [PMID: 23059441 DOI: 10.1016/j.ctcp.2012.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 06/20/2012] [Accepted: 06/20/2012] [Indexed: 11/17/2022]
Abstract
This study sought to evaluate Malaysian oncology patients CAM disclosure to the health care providers. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified three themes: reasons of CAM disclosure, reasons of CAM non-disclosure and preference of CAM discussion to health care providers. Patients agreed that CAM disclosure is important to avoid any interaction with the conventional medicines. Perceived lack of physicians' knowledge & interest in CAM, fear of termination of therapy by the physicians upon CAM disclosure, and perceived simplicity of some of the CAM therapies were among the reasons of non-disclosure. Given the option of oncologists, pharmacists or nurses, patients described oncologists as the most suitable person to discuss or disclose CAM use due to confidence in their clinical skills. Understanding the underlying beliefs of patients' reluctance to disclose CAM to health care providers is important especially when they are on an ongoing treatment for cancer.
Collapse
Affiliation(s)
- Maryam Farooqui
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Bertam Campus, 13200 Kepala Batas, Penang, Malaysia.
| | | | | | | | | | | | | |
Collapse
|
15
|
Hassali MA, Saleem F, Shafie AA, Al-Qazaz HK, Farooqui M, Aljadhey H, Atif M, Masood I. Assessment of general public perceptions toward traditional medicines used for aphrodisiac purpose in state of Penang, Malaysia. Complement Ther Clin Pract 2012; 18:257-60. [PMID: 23059442 DOI: 10.1016/j.ctcp.2012.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 06/06/2012] [Indexed: 10/28/2022]
Abstract
The study aims to evaluate general public perceptions regarding the use of Traditional and Complementary Medicines (TCM) for aphrodisiac purposes. A questionnaire based, cross-sectional study was undertaken. Respondents were selected in the state of Penang, Malaysia. A total of 392 respondents were included in the study. Descriptive statistics were used for data analysis. Chi Square/Fischer Exact tests were used where appropriate. Out of 392 respondents, 150 (38.26%) reported using specific Traditional medicines for aphrodisiac purposes. Most respondents (46.94%) agreed that aphrodisiac medicines were easily available t. Moreover, 40.31% of the respondents reported that traditional aphrodisiac medicines were cheaper than modern (prescription) medicines. This study highlights limited public knowledge regarding the use of traditional aphrodisiac medicine. Healthcare professionals should be aware of informal TCM usage when prescribing allopathic medicines.
Collapse
Affiliation(s)
- Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia.
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Owen-Smith A, McCarty F, Hankerson-Dyson D, Diclemente R. Prevalence and predictors of complementary and alternative medicine use in African-Americans with acquired immune deficiency syndrome. ACTA ACUST UNITED AC 2012; 17:33-42. [PMID: 22577340 DOI: 10.1111/j.2042-7166.2011.01140.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND: The use of complementary and alternative medicine (CAM) among Human Immunodeficiency Virus (HIV)-positive individuals is becoming increasingly widespread. Unfortunately, some CAM therapies may jeopardize the efficacy of conventional HIV medication, making it critical to understand CAM use among this population. OBJECTIVE: To investigate the prevalence and predictors of CAM use in a theory-driven, multidimensional manner. METHODS: African-American individuals who had received a diagnosis of acquired immune deficiency syndrome (AIDS) were recruited. The computer-administered survey asked questions about participants' CAM use and various psychosocial and socio-demographic characteristics. Participants' most recent CD4+ cell counts and HIV RNA levels were abstracted from medical records. Linear regression analyses, adjusted for potential confounders, were conducted to assess the independent contribution of various factors in explaining frequency of CAM use. RESULTS: One hundred and eighty two subjects participated in the survey. Results indicate that most (94%) participants used at least one type of CAM therapy. The majority of participants (79.7%) used CAM therapies as a complement (rather than an alternative) to their HIV medications though half had not discussed these therapies with their healthcare providers. Female sex, high yearly income, high health literacy and high HIV RNA levels were associated with a greater frequency of CAM use, while stronger emotional well-being was associated with a lower frequency of CAM use. CONCLUSIONS: The implications of these findings are discussed and suggestions for future research are provided.
Collapse
Affiliation(s)
- Ashli Owen-Smith
- Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road, Atlanta, GA 30322
| | | | | | | |
Collapse
|
17
|
Lubinga SJ, Kintu A, Atuhaire J, Asiimwe S. Concomitant herbal medicine and Antiretroviral Therapy (ART) use among HIV patients in Western Uganda: a cross-sectional analysis of magnitude and patterns of use, associated factors and impact on ART adherence. AIDS Care 2012; 24:1375-83. [PMID: 22292937 DOI: 10.1080/09540121.2011.648600] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Use of herbal medicines among patients receiving Anti-retroviral Therapy (ART) remains by far an uncharacterised phenomenon in Africa and Uganda specifically. We evaluated the use of herbal medicines among patients on ART at the HIV clinic of Mbarara Regional Referral Hospital (MRRH), examined factors associated with their concomitant use and their impact on ART adherence. This was a cross-sectional study among 334 systematically sampled patients receiving ART at the HIV clinic of MRRH from February to April 2010. We collected data on patient demographics, clinical characteristics, perceptions of quality of care received, self-perceived health status, information on ART received, herbal medicines use and ART adherence. Study outcomes were concomitant herbal medicine and ART use, and ART adherence. Descriptive analysis and logistic regression were conducted using Stata10.0. Close to half, 155 (46.4%) reported concomitant herbal medicines and ART use, with 133 (39.8%) using herbal medicines at least once daily. Most (71.6%) used herbal medicines to treat HIV-related symptoms. A majority (92.3%) reported that the doctors were unaware of their use of herbal medicines, 68.5% citing its minimal importance to the attending physician. Most frequently used herbs were Aloe vera (25%) and Vernonia amygdalina (21%). Time since start of ART (OR 1.14 95% CI: 1.01-1.28, for each one year increase), number of ART side effects reported (≥3 vs.≤1, OR 2.20 95% CI 1.13-4.26) and self-perceived health status (Good vs. Poor, OR 0.31 95% CI 0.12-0.79) were independently associated with concomitant herbal medicine and ART use. Concomitant herbal medicine and ART use was not associated with poor ART adherence (OR 0.85 95% CI 0.47-1.53). There is widespread concomitant herbal medicines and ART use among our patients, with no association to poor ART adherence. Patients appear to use these therapies to complement as opposed to substituting ART.
Collapse
Affiliation(s)
- S J Lubinga
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda.
| | | | | | | |
Collapse
|
18
|
Ellis WL. Perceived stress levels among HIV/AIDS-infected mothers: the role of over-the-counter products. SOCIAL WORK IN HEALTH CARE 2012; 51:850-867. [PMID: 23078015 DOI: 10.1080/00981389.2012.699022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to identify correlates of perceived stress levels among 49 HIV/AIDS-infected mothers enrolled in a social services agency that provides HIV/AIDS support services in North Carolina. The author found in an Ordinary Least Squares regression analysis that the CD4 t-cell count, receipt of advice or support from church pastor, annual household income, and employed were all negatively related to seropositive mothers' perceived stress scores. Conversely, the need to have borrowed money from family members or friends to help pay for over-the-counter products like nutritional drinks, vitamins, or minerals was found to be positively related to these scores. The accessibility of these over-the-counter products could not only help to lower seropositive mothers' perceived stress levels but also potentially improve the functioning of their body's immune system. Implications for the Medicaid Program's prescription drug policy that excludes these over-the-counter products and prescription drug representatives are discussed.
Collapse
Affiliation(s)
- Walter L Ellis
- Social Work Program, Livingstone College, Salisbury, North Carolina 28144, USA.
| |
Collapse
|