Personal use of complementary and alternative medicine (CAM) by U.S. health care workers

Nonpharmacological pain management approaches among U.S. construction workers: A cross-sectional pilot study

BACKGROUND

U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers.

METHODS

A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled.

RESULTS

Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches.

CONCLUSION

This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.

Endorsement of alternative medicine and vaccine hesitancy among physicians: A cross-sectional study in four European countries

Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, we analyzed the relationship between endorsement of complementary and alternative medicine (CAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787). Our results suggest that, in all the participating countries, CAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average CAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal. These results constitute a call to consider health care professionals' attitudes toward CAM as a factor that could hinder the implementation of immunization campaigns.

Knowledge and practice and attitude toward cupping therapy among physicians in Sheikh Khalifa medical city

Background

Complementary medicine (CM) is gaining popularity worldwide. According to the 2019 World Health Organization global report on traditional and complementary medicine (T&CM), 80% of member states acknowledged practicing T&CM. In the United Arab Emirates, T&CM practice prevalence in 2012 was 20-39%. These trends highlight physicians' need for knowledge on CM, such as cupping therapy.

Objective

This study aims to assess knowledge, practice, and attitude toward cupping therapy (CT) among physicians in Sheikh Khalifa medical city (SKMC).

Methodology

A cross-sectional study was conducted from September 2020 to March 2021 among the physicians of SKMC. The survey was carried out using an online questionnaire. The questionnaire included four sections: socio-demographics, knowledge of physicians toward cupping therapy, physicians' attitude toward cupping therapy, and physicians' practice toward cupping therapy. SPSS version 28 was used for data analysis. Data were reported in frequencies and percentages. A P value of <0.05 is the level of statistical significance.

Results

The response rate was 83%. Among the 154 participants, 67.5% had adequate knowledge of CT, 66.9% showed a positive attitude, and 31.2% reported good practice toward CT. Individuals below 40 years reported significantly lesser knowledge than individuals over 40 years (p = 0.035, OR 0.49 [0.246-0.998]). Over 80% of physicians concur that cupping therapy can be used to treat and manage low back pain, joint discomfort, headache, migraine, and anxiety. The majority of physicians believe that education regarding cupping therapy is required.

Conclusions

Most physicians had adequate knowledge and a positive attitude toward cupping therapy.

Iranian healthcare professionals' knowledge, attitudes, and use of complementary and alternative medicine: a cross sectional study

Background

The present study aims to investigate the knowledge, attitude, and performance of Iranian Healthcare Professionals (HP) about Complementary and Alternative Medicine (CAM) modalities.

Methods

This cross-sectional study was carried out on 210 HP in 2019. Samples were selected from healthcare centers, clinics, and hospitals using census sampling. Data collection tools included demographic information, attitude, knowledge, and the amount of use of CAM modalities. Data analysis was performed using SPSS ver. 24.

Results

In this study, the response rate was 85.3% (n=209). A majority of respondents had a positive attitude toward CAM (n=166, 79%), but their level of knowledge was limited (n=154, 73.6%). The most commonly used CAM modalities were herbal medicine (93.2%), exercise therapy (75.4%), and hydrotherapy (75.2%), respectively, and the least commonly used ones were magnetic therapy (2.9%) and hypnosis (4.8%). The most important reasons for the use of CAM modalities by HP included fewer side effects than medical treatments (57.4%), its lowest cost than medical treatments (34.9%), non-serious disease with no need for referral to a clinic (32.1%), and its more convenient access than medical treatments (30.6%). The results showed that there was a significant relationship between the education level and the use of CAM modalities (p<0.05). There was also a significant relationship between the suggestion of CAM modalities and the amount of use of these modalities, and those who used these modalities would also have recommended them to their clients more frequently (p<0.05).

Conclusion

The results showed that most of HP used at least one of the CAM modalities and had a positive attitude towards CAM. As the level of knowledge was limited, training courses should be implemented to increase health practitioner’s level of knowledge on CAM.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-021-03421-z.

Knowledge and clinical dialogues about complementary health approaches among nurse practitioners specialized in geriatrics

BACKGROUND

In the United States, people over the age of 65 years will account for 20% of the population by 2030, and these elders are more likely to have chronic comorbid complex health problems. Sixty-three percent use complementary health approaches (CHAs) but less than half disclose their use to their health care providers. Nurse practitioners (NPs) are the fastest growing population of primary care health providers.

PURPOSE

This study identifies to what degree NPs with specialized training in geriatrics understand CHAs, use them themselves, encourage their patients to access them, and engage in CHA clinical dialogue.

METHODS

Cross-sectional online survey collecting quantitative and narrative data; US NPs with specialized training in geriatrics (n = 170, mean age 52 years, SD: 9.0, range: 29-73).

RESULTS

Although NPs are knowledgeable about some CHA and believe they are beneficial for older adults to use, they want more education to help understand the effects of a variety of CHA, be more aware of possible treatment interactions, and to integrate CHA into the current health care system. Patient factors (impaired cognitive function, acute health problems, and not open to CHA), provider factors (inadequate CHA knowledge, limited referral paths and resources), and system factors (limited accessibility and availability of CHA in in-patient setting, CHA not covered by insurance, and limited clinical time) disrupt NPs from assessing and discussing CHA with their patients.

IMPLICATIONS FOR PRACTICE

There is a need to develop and implement NP practice guidelines for CHA clinical management for older adults and provide educational opportunities to incorporate CHA into clinical practice.

Vaccination attitudes, beliefs and behaviours among primary health care workers in northern Croatia

Primary health care workers (HCWs) provide almost all vaccine services in Croatia, so they play an essential role in vaccine recommendations and uptake. The aim of this study was to determine the level of vaccine hesitancy among primary HCWs, to identify differences between nurses and physicians in attitudes, beliefs and behaviours towards vaccination, and to determine predictors of vaccine hesitancy among HCWs. We conducted a cross-sectional study from July to December in 2018 among physicians and nurses employed in the services of epidemiology, public health, school medicine, pediatrics and general practice/family medicine in Primorje-Gorski Kotar County, a primarily urban region with a population around 300 000 in the northern part of Croatia. The list of primary HCWs offices was obtained from the Croatian Health Insurance Fond website. We used a self-administered questionnaire on their attitudes, beliefs and behaviours relative to vaccination. Obtained response rate was 65.5% (324/495) of eligible primary HCWs; 64.1% (143/223) of physicians and 66.5% (181/272) of nurses. Seventeen percent of HCWs were identified as vaccine hesitant, and in univariate analysis, we observed an association between HCWs occupation and their own vaccination against flu (p = 0.001), measles (p = 0.016) and HPV (p = 0.025). Nurses and physicians differed (p < 0.001) in their general attitude, beliefs and behaviours towards vaccination, with a higher level of hesitancy among nurses. In multiple logistic regression, those more likely to be vaccine-hesitant were nurses (AOR = 5.73, 95%CI = 2.48-13.24), those who were uncertain or would never receive a vaccine against measles (AOR=11.13; 95%CI=5.37-23.10) and HPV (AOR=5.02; 95%CI=2.60-9.74), as well as those who had encountered a serious adverse event following immunization (AOR=7.55; 95%CI=3.13-19.18). As personal hesitancy may have a negative impact on vaccination education and recommendations, and therefore vaccine coverage, it is necessary to implement interventions to increase vaccination knowledge and confidence among primary health care workers, especially nurses.

A scoping review of network meta-analyses assessing the efficacy and safety of complementary and alternative medicine interventions

BACKGROUND

Network meta-analysis (NMA) has rapidly grown in use during the past decade for the comparison of healthcare interventions. While its general use in the comparison of conventional medicines has been studied previously, to our awareness, its use to assess complementary and alternative medicines (CAM) has not been studied. A scoping review of the literature was performed to identify systematic reviews incorporating NMAs involving one or more CAM interventions.

METHODS

An information specialist executed a multi-database search (e.g., MEDLINE, Embase, Cochrane), and two reviewers performed study selection and data collection. Information on publication characteristics, diseases studied, interventions compared, reporting transparency, outcomes assessed, and other parameters were extracted from each review.

RESULTS

A total of 89 SR/NMAs were included. The largest number of NMAs was conducted in China (39.3%), followed by the United Kingdom (12.4%) and the United States (9.0%). Reviews were published between 2010 and 2018, with the majority published between 2015 and 2018. More than 90 different CAM therapies appeared at least once, and the median number per NMA was 2 (IQR 1-4); 20.2% of reviews consisted of only CAM therapies. Dietary supplements (51.1%) and vitamins and minerals (42.2%) were the most commonly studied therapies, followed by electrical stimulation (31.1%), herbal medicines (24.4%), and acupuncture and related treatments (22.2%). A diverse set of conditions was identified, the most common being various forms of cancer (11.1%), osteoarthritis of the hip/knee (7.8%), and depression (5.9%). Most reviews adequately addressed a majority of the PRISMA NMA extension items; however, there were limitations in indication of an existing review protocol, exploration of network geometry, and exploration of risk of bias across studies, such as publication bias.

CONCLUSION

The use of NMA to assess the effectiveness of CAM interventions is growing rapidly. Efforts to identify priority topics for future CAM-related NMAs and to enhance methods for CAM comparisons with conventional medicine are needed. SYSTEMATIC REVIEW REGISTRATION: https://ruor.uottawa.ca/handle/10393/35658.

U.S. Physician Recommendations to Their Patients About the Use of Complementary Health Approaches

Objective: There are no nationally representative studies using a probability sample that have been published examining whether physicians recommend complementary health approaches (CHAs) to their patients, as previous research has focused only on selected medical specialties or a particular U.S. region. This article fills a void in the current literature for robust data on recommendations for CHAs by office-based physicians in the United States. Design: Descriptive statistics and multivariable regression analyses of physician-level data were from the 2012 Physician Induction Interview of the National Ambulatory Medical Care Survey (NAMCS PII), a nationally representative survey of office-based physicians. Weighted response rate among eligible physicians sampled for the 2012 NAMCS PII was 59.7%. Setting/Location: United States. Outcome measures: Recommendations by physicians to their patients for any CHA, and individual CHAs: massage therapy, herbs/nonvitamin supplements, chiropractic/osteopathic manipulation, yoga, acupuncture, and mind-body therapies. Differences in recommendations by physician demographic characteristics were identified. Results: Massage therapy was the most commonly recommended CHA (30.4%), followed by chiropractic/osteopathic manipulation (27.1%), herbs/nonvitamin supplements (26.5%), yoga (25.6%), and acupuncture (22.4%). The most commonly recommended CHAs by general/family practice physicians were chiropractic/osteopathic manipulation (54.0%) and massage therapy (52.6%). Of all U.S. physicians, 53.1% recommended at least one CHA to patients during the previous 12 months. Multivariable analyses found physician's sex, race, specialty, and U.S. region to be significant predictors of CHA recommendations. Female physicians were more likely than male physicians to recommend massage therapy (adjusted odds ratio [aOR] = 1.76, 95% confidence interval [CI] = 1.40-2.20), herbs/nonvitamin supplements (aOR = 1.85, 95% CI = 1.46-2.35), yoga (aOR = 2.16, 95% CI = 1.70-2.75), acupuncture (aOR = 1.65, 95% CI = 1.27-2.13), and mind-body therapies (aOR = 2.63, 95% CI = 2.02-3.41) to patients. Psychiatrists (aOR = 0.13, 95% CI = 0.07-0.23), OB/GYNs (aOR = 0.38, 95% CI = 0.24-0.60), and pediatricians (aOR = 0.26, 95% CI = 0.18-0.38) were all less likely to recommend chiropractic/osteopathic manipulation than general and family practitioners. Conclusions: Overall, more than half of office-based physicians recommended at least one CHA to their patients. Female physicians recommended every individual CHA at a higher rate than male physicians except for chiropractic and osteopathic manipulation. These findings may enable consumers, physicians, and medical schools to better understand potential differences in use of CHAs with patients.

Integrative Medicine as a Vital Component of Patient Care

The landscape of medicine in the United States has been slowly progressing toward a more holistic and individualized approach to healing. Part of this progress has been the integration between western and alternative forms of medicine, a concept that has been described as “integrative medicine.” This approach to healthcare incorporates a patient’s mind, spirituality, and sense of community into the healing process. Integrative medicine has been typically well received and the demand has been steadily increasing in primary US hospitals. Here we cover a number of topics that include the definition of integrative medicine, its potential benefits, current examples of successful implementations, and potential barriers to its expansion. The aim was to give a primary on integrative medicine and its current state for healthcare providers.

Pediatric Nurses' Usage and Experience Toward Complementary Health Approaches

OBJECTIVES

The usage of Complementary Health Approaches (CHA) and its popularity have been increasing among both children and pediatric nurses. The aims of this study were to (1) determine the knowledge and usage levels of pediatric nurses about CHA, (2) describe the experiences of nurses about CHA, and (3) evaluate the attitudes of nurses toward CHA.

METHODS

This was multicenter study. A total of 1,450 pediatric nurses who are working at the pediatric departments of different hospitals in Turkey participated in the study between June 2013 and February 2014. Around 1,303 female and 147 male pediatric nurses, in total 1,450, were included in the study. The semi-structured questionnaire had three sections. The first section composed of 14 questions about sociodemographic characteristics. The second section contained seven questions about the nurses' professional practices with respect to CHA. The third section contained eight questions about the nurses' attitudes to CHA.

RESULTS

The study revealed that 90.6% of the nurses used CHA, and primarily made use of praying (82.3%), massage (76.6%), and vitamins (60.2%), respectively. Most of the nurses used CHA for relaxation. Approximately half of the nurses did not asked the families of their CHA usage. More than half of the nurses (58.8%) stated that nurses were not responsible for informing patients about CHA. It was found that the nurses had negative experiences with CHA such as allergies, pain, and being upset. The most frequently indicated positive experience was "feeling better both physically and psychologically."

CONCLUSIONS

It is extremely important that nurses have knowledge about CHA. Nurses should question parents' use of CHA and inform parents about CHA' benefits and potential risks. Considering the personal/professional experiences, it is necessary to evaluate the positive/negative effects of CHA. Research may contribute to increased awareness of the potentially important role of nurses in the delivery of CHA.

Complementary Health Practitioners in the Acute and Critical Care Setting: Nursing Considerations

In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant. Previous articles in this column of Critical Care Nurse provided an overview of complementary health approaches that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses, as well as important legal, ethical, safety, quality, and financial implications that acute and critical care nurses should consider when integrating complementary health approaches with conventional care. This column provides the acute and critical care nurse with key information about validation of credentials, experience, and competence of nurses and volunteers providing complementary health approaches, as well as about institutional policies and scope of practice.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users

OBJECTIVE

This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users.

METHODS AND MATERIALS

Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data.

RESULTS

Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM.

CONCLUSION

This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person.

Knowledge, attitudes, and practices among health care providers regarding complementary and alternative medicine in Trinidad and Tobago

Background

Health care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use. We explored the knowledge, attitudes, and practices of health care providers regarding CAM.

Methods

This cross-sectional study was conducted between March 1 and July 31, 2015 among health care providers working mainly in the public sector in Trinidad and Tobago. A 34-item questionnaire was distributed and used for data collection. Questionnaire data were analysed using inferential and binary logistic regression models.

Results

Response rate was 60.3% (362/600). Responders were 172 nurses, 77 doctors, 30 pharmacists, and 83 other health care providers of unnamed categories (mainly nursing assistants). Responders were predominantly female (69.1%), Indo-Trinidadian (55.8%), Christian (47.5%), self-claimed “very religious” (48.3%), and had <5 years of working experience (40.6%). The prevalence of CAM use was 92.4% for nurses, 64.9% for doctors, 83.3% for pharmacists, and 77.1% for other health care providers. The majority (50–75%) reported fair knowledge of herbal, spiritual, alternative, and physical types of CAM, but had no knowledge of energy therapy and therapeutic methods. Sex, ethnicity, and type of health care provider were associated with both personal use and recommendation for the use of CAM. Predictors of CAM use were sex, religion, and type of health care provider; predictors of recommendation for the use of CAM were sex and type of health care provider. About half of health care providers (51.4%) and doctors (52%) were likely to ask their patients about CAM and <15% were likely to refer patients to a CAM practitioner. However, health care providers expressed interest in being educated on the subject. Doctors (51.9%) and pharmacists (63.3%) said that combination therapy is superior to conventional medicine alone. Less than 10% said conventional medicine should be used alone.

Conclusion

Knowledge about CAM is low among health care providers. The majority engages in using CAM but is reluctant to recommend it. Predictors of CAM use were sex, religion, and profession; predictors of recommendation for the use of CAM were sex and profession. Health care providers feel the future lies in integrative medicine.

Experiences and Attitudes of Nurses Regarding Complementary Health Approaches Used by Themselves and Their Patients

Nurses' attitudes and experiences may affect the level of patient exposure to complementary health approaches (CHA), both now and in the future. The purpose of this study was to describe nurses' experience of CHA and their personal and professional attitudes to the use of CHA. The sample consisted of 220 nurses working at a university hospital in Antalya, Turkey. Data were collected using a questionnaire developed by the researchers. Nurses had a positive attitude toward CHA and reported mixed experiences of CHA for allergies, pain, and stress. This study may contribute to increased awareness of the potentially important role of nurses in delivery of CHAs. Hospital nurses should receive more training on CHA. Nurses should discuss the potential benefits and risks of CHA with patients.

Do consumers perceive their doctors as influenced by pharmaceutical marketing communications?

Purpose

– This paper aims to explore whether and how consumers perceive the impact of pharmaceutical marketing on their own doctor’s prescribing behaviors, and subsequent responses toward their doctor’s advice.

Design/methodology/approach

– Three experimental studies were conducted. Studies 1 and 2 are based on text-based manipulations and undergraduate student research participants. Study 3 uses image-based manipulations and average adult consumers.

Findings

– Study 1 demonstrates that consumers can be quite skeptical about their doctor’s motives for prescribing certain brand-name drugs; in particular, consumers can construe doctors as agents of persuasion for prescribed brands. Study 2 shows that this can result not only in choosing generic drugs over prescribed brands but also in opting out of pharmaceuticals altogether by choosing alternatives like natural remedies. Study 3 further demonstrates that these effects can be easily triggered by visual cues in a non-student sample.

Originality/value

– This research builds on the existing literature on pharmaceutical marketing communications, and extends the theory of persuasion knowledge into healthcare settings.

Introduction to complementary, alternative, and traditional therapies

The use of complementary, alternative, and traditional therapies is increasing in the United States, and patients and their families are bringing these practices into the acute care setting. Acute and critical care nurses are in a unique and trusted position to advocate for their patients and to promote safe incorporation of complementary, alternative, and traditional therapies into the plan of care.

Use of complementary and alternative medicine within Norwegian hospitals

Background

Over the recent decades complementary and alternative medicine (CAM) use within and outside of the public health care system in Norway has increased. The aim of this study is to describe to what extent CAM is offered in Norwegian hospitals in 2013 and investigate possible changes since 2008.

Methods

In January 2013 a one-page questionnaire was sent to the medical director of all included hospitals (n = 80). He/she was asked to report whether or not one or more specific CAM therapies were offered in the hospital. Fifty-nine (73.8 %) hospitals responded and form the basis for the analyses.

Results

CAM was offered in 64.4 % of the responding hospitals. No major differences were found between public and private, or between somatic and psychiatric, hospitals. Acupuncture was the most frequent CAM method offered, followed by art- and expression therapy and massage.

The proportion of hospitals offering CAM has increased from 50.5 % in 2008 to 64.4 % in 2013 (p = 0.089). The largest increase was found in psychiatric hospitals where 76.5 % of hospitals offered CAM in 2013 compared to 28.6 % in 2008 (p = 0.003). A small decrease was found in the proportion of hospitals offering acupuncture between 2008 (41.4 %) and 2013 (37.3 %).

Conclusions

A majority of Norwegian hospitals offer some sort of CAM. The largest increase since 2008 was found in psychiatric hospitals. Psychiatric hospitals seem to have established a practice of offering CAM to their patients similar to the practice in somatic hospitals. This could indicate a shift in the attitude with regard to CAM in psychiatric hospitals.

Factors associated with pediatrician attitudes over the use of complementary and traditional medicine on children in Muscat, Oman

This study aimed to evaluate the attitude of pediatricians toward the use of complementary and Traditional Medicine (TM) on children in Muscat, Oman. A cross-sectional survey was performed using a self-completed questionnaire during the year 2012. A total of 67 pediatricians, comprising of 30 males (44.8%) and 37 females (55.2%) participated in the study. The majority of the studied group (83.5%) was of the opinion that most types of complementary and TM are not safe for children, except spiritual healing, to which 53.7% considered as safe. About one third (29.9%) of the participants reported that they might recommend complementary and TM for sick children in the future. Almost half the participants (52.2%) acknowledged personal use of complementary and TM in the past and 67.2% reported that their family members used these medicines. Herbal therapy was found to be the most commonly used method (38.9%) followed by spiritual (33.9%), cautery (20.2%) and Curucoma (15.7%). Other methods, which include; acupuncture, bone healing and Chinese healing were also found to be in use but in rare manner. Knowledge level of TM and complementary medicine of most of the doctors was found to be low but one third of them acknowledged that they may recommend these treatments to their patients in future. Therefore, training pediatricians on the types, benefits and side effects of complementary and TM is recommended.

Changes in the use of complementary and alternative medicine in Taiwan: a comparison study of 2007 and 2011

OBJECTIVE

In this study, we explored the differences in the use of complementary and alternative medicine (CAM) based on data from 2007 and 2011 national surveys in Taiwan.

RESEARCH DESIGN

Two cross-sectional, community-based epidemiological surveys were conducted in Taiwan. Participants 18 years and older were interviewed regarding their CAM use in the previous 12 months. Nationally representative random-household telephone surveys using a sampling method with a probability proportional to size were conducted in 2007 and 2011. The data were analysed to compare the results between surveys.

RESULTS

We obtained a total of 1260 and 2266 valid responses in 2007 and 2011, respectively. The use of at least one or more CAM therapies during the previous year decreased from 48.9% in 2007 to 37.8% in 2011 (p < .001). In both surveys, the most common CAM therapies used were Chinese medicinal herbs followed by health supplement products and tuina. We observed the greatest relative increase in CAM use between 2007 and 2011 in health supplement products (12.8% vs. 16.0%) and massage (1.3% vs. 2.9%), whereas the largest relative decrease occurred for tuina (24.4-13.4%) and Chinese medicinal herbs (31.6-25.4%).

CONCLUSION

Widespread CAM use reflects a more personal orientation towards maintaining health and selecting health care support services. Thus, a set of standards should be established for the safety and effectiveness of therapies, and consensus building is required to overcome the differences among practitioners from various backgrounds and traditions.