Use of complementary and alternative treatment for allergic contact dermatitis

The Prevalence of Complementary and Alternative Medications Use Among Dermatology Patients in Aseer Region, Saudi Arabia

Purpose

The utilization rate of complementary and alternative medication (CAM) is on the rise, especially for the general population. Despite the lack of scientific support, CAM has been used for decades and is more often used among chronic patients. This research examines the prevalence of CAM use in dermatology patients in the area of Aseer, Saudi Arabia.

Materials and Methods

This research was done using a descriptive hospital-based cross-sectional survey among adults who attended the dermatological clinics at the major hospitals in the Aseer area of Southern Saudi Arabia. The dermatology outpatients were approached individually and were asked to fill out a survey about their usage of CAM therapies in the preceding year. The questionnaire included questions on patients' socio-demographic data and clinical data on their dermatological condition, including duration and the effect on their daily life. The occurrence and pattern of CAM use and the type of CAM utilized were also examined.

Results

353 dermatological patients filled out the study questionnaire. Patients varied in age from 18 to above 60 years, with an average of 26.1 ± 12.9 years. 203 (57.5%) patients were females. 120 (34%) of the study patients reported using folk medicine with doctor medication for their dermatological disorder, 84 (23.8%) used folk medicine and stopped using medications prescribed by a doctor, while 149 (42.2%) never used folk medicine. The most used CAM was olive oil (22%), followed by sidr (21%), honey (19%), cactus (15%), henna (14%), and garlic (13%).

Conclusion

More than half of the participants in this study used CAM, with nearly 1 out of 5 patients not using the medications prescribed by their physicians. Females with long-lasting diseases were the main users who reported using a variety of CAMs. Satisfactory results were experienced by nearly half of the patients.

Community pharmacists' knowledge, attitude and practices towards the use of complementary and alternative medicines in Durban, South Africa

Background

Atopic eczema (AE) is a common skin disease with an increasing worldwide prevalence, which has almost doubled over the last decade in South Africa. Many patients commonly explore complementary and alternative medicines (CAM) for AE and often initially seek advice from their local pharmacists.

Aim

To explore the knowledge, attitude and practices amongst community pharmacists regarding CAM.

Setting

The study was conducted amongst pharmacists working in community pharmacies in Durban, South Africa.

Methods

During 2016, a cross-sectional study was conducted amongst 158 randomly selected pharmacists, of which 82 responded. Respondents were sent an email with a link to the questionnaire. Where logistically possible, questionnaires were hand-delivered.

Results

The majority of respondents were male (n = 46; 56%), aged between 31 and 40 years. Despite most pharmacists not being familiar with various CAMs for AE, many (43%) recommend them, and 50% were amenable to referring patients to CAM practitioners. Despite 51% reporting that patients do ask about CAM for AE, 54% are not confident discussing or initiating discussions with patients. More than half of the pharmacists (55%) had no CAM training but believed it is essential for inclusion in the undergraduate pharmacy curriculum. Most were interested in broadening their knowledge on CAM and felt it would better prepare them in counselling their patients.

Conclusions

The study demonstrated poor knowledge and communication about CAM for AE between pharmacists and patients, although pharmacists exhibited strong interests in learning more about CAM. There is a continuing need for education programmes and inclusion into undergraduate curricula that would assist pharmacists to advise patients on different types of CAMs.

Use of Complementary and Alternative Therapies in Outpatients with Atopic Dermatitis from a Dermatological University Department

Background: Treatment of atopic dermatitis (AD) may be challenging, therefore some patients seek complementary and alternative medications (CAM). We determined prevalence and predictors for CAM use in a hospital cohort of AD patients. Material and Methods: Between January 1, 2012, and December 31, 2017, AD patients referred to the dermatological outpatient clinic at Bispebjerg Hospital were included in the study. Information on CAM use, demographics and disease characteristics were obtained by questionnaire, and associations were determined by χ2 and t test separately for children (< 16 years) and adults (≥16 years). Results: In total 441 filled in the questionnaire on AD, and 433 patients responded to the questions about CAM use: 198 children and 235 adults. A total of 137 (31.6%) had used one or more CAM. CAM use in children was significantly associated with prior use of ≥2 conventional treatments (p = 0.047) and topical calcineurin inhibitors (p = 0.021), a higher number of affected eczema sites (p < 0.001) including more frequent affection of the face and extremities, a higher SCORAD score (p = 0.045), and low mean overall self-rated health (p = 0.003). CAM use in adults was significantly associated with lower age of onset of AD (p = 0.004), comorbid allergic rhinoconjunctivitis (p = 0.039), frequent use of moisturizing cream (p = 0.024), facial and neck eczema (p = 0.005) and high educational level (p = 0.043). Conclusion: CAM use is frequent in both children and adult AD patients. CAM users are characterized by long disease duration, a significant disease burden and by having a longer education. The high prevalence of CAM may indicate that patients’ expectations regarding treatment of AD are not redeemed in the conventional health care system.

Self-reported knowledge and approaches toward complementary and alternative medicine among physicians dealing with allergic diseases

Considering the popularity of Complementary and Alternative Medicine (CAM) in allergic patients, physicians involved in allergic patients' care need to be aware of CAM. To assess self-reported knowledge, attitude and approach to CAM of physicians who deal with allergic patients, a total of 500 structured questionnaires were distributed to physicians who participated in "Turkish National Society of Allergy and Clinical Immunology Congress-2009". For the questionnaires handed out, 242 (48.4%) physicians (median age 36.0 years, range 25-64 years) responded; 22.4% were fellows in training and 48.5% were residents. The main specialties were pediatrics (49.3%), and pulmonology (36.8%); half were either specialists or training in allergy and one-quarter (25.6%) referred patients to CAM. Asthma (42.1%) and chronic urticaria (28.9%) were the most common CAM referral diseases. Referred therapies were herbal (10.3%) and diet-based medicine (7.4%). The differences between physicians in terms of age, gender, experience in medicine, and specialty/allergy subspecialty were not statistically significant (p = 0.01). Affiliation to a university hospital was significantly associated with no CAM referral vs. affiliation in a state/private hospital or private practice. Academic degree and reported level of knowledge negatively/positively affected attitudes toward CAM, respectively. More than half of the respondents (68.8%) reported lack of or insufficient information about CAM, while 58.7% of physicians desired CAM education. This first report on physicians involved in allergic patients' care shows that they are reluctant to refer for CAM therapies. A minority believes that they have enough knowledge, and most are interested in continuing medical education on CAM. Considering physicians' interest and tendency to communicate significantly with their patients about CAM when they feel that they have sufficient knowledge and popularity of CAM among patients, training possibilities should be created to improve physicians' education in this field.

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.

Guidelines in dermatology--quo vadis?: Facts and controversies

Since their introduction in 1980s, medical guidelines have become a milestone in the modern medical practice and science. Being a key feature of modern evidence-based medicine, guidelines offer the opportunity for unification and standardization of diagnostic procedures, their use guarantees the equal access of patients to medical service, and they represent a scaffold for inexperienced physicians. The implementation of guidelines also can serve as a basis in malpractice issues and can contribute to the formation of national and international health care policies. In past decades, the process of development, update, and practical application of clinical guidelines has been seriously improved; however, certain limitations still exist, namely cost-effectiveness issues, editorial independence, applicability, accessibility, and external validity. This contribution discusses the advantages and the drawbacks in the use and the development of medical guidelines, emphasizing future perspectives and challenges in the development of clinical guidelines.

The prevalence of dietary-related complementary and alternative therapies and their perceived usefulness among cancer patients

BACKGROUND

The present study aimed to directly assess and compare the usage, benefits and side-effects of dietary-related complementary and alternative medicine (CAM) use among adult cancer patients and non-cancer adults in Norwich, UK.

METHODS

Self-administered questionnaires were completed by 98 cancer patients and 92 non-cancer adults to compare demographics, types of CAM usage with reasons, benefits, side-effects and CAM information sources. The groups were matched for gender, age, marital status, education and household income. The mean ages were 62.7 and 59.7 years, respectively, with slightly more female than male participants.

RESULTS

CAM use was high in both groups (47% in cancer and 53% in non-cancer respondents, P > 0.05). The most widely-used diet-related CAM among both groups was the large intake of fruit, vegetables and juice, multivitamins, fish oils and glucosamine. Fish oil intake was significantly higher in the non-cancer group (P < 0.05), whereas selenium and beta-carotene supplements were significantly higher in the cancer group (P < 0.01 and P = 0.02, respectively). The main reasons for using CAM were to boost the immune system and to improve quality of life (P > 0.05). Reported benefits included increased optimism and hope for the cancer group and increased optimism and pain relief for the non-cancer group.

CONCLUSIONS

Diet-related CAM is used frequently by both cancer patients and non-cancer adults, with many reported benefits and few reported side-effects. Significant differences between the groups included a higher prevalence of fish oil used by the non-cancer group, and a higher use of selenium and beta-carotene supplements in the cancer group.