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Lotfi R, Chikhaoui M, Elmourid A, Chigr F. The Use of Traditional and Complementary Medicine Among Patients With Multiple Sclerosis in Morocco. Int J MS Care 2024; 26:140-143. [PMID: 38872996 PMCID: PMC11168297 DOI: 10.7224/1537-2073.2022-116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is an acquired chronic, autoimmune, and neurodegenerative disease of the central nervous system. In addition to conventional MS therapy, patients are interested in traditional and complementary medicine (T&CM). Our study aims to describe the use of T&CM in a cohort of Moroccan patients with MS. METHODS A quantitative descriptive study was adopted to study this subject. For data collection, we opted for an anonymous questionnaire for 98 patients with MS. We gathered data via an electronic survey, using multivariable analysis to examine the effect of specific factors on T&CM use. Data collection took place from March 2022 to June 2022. RESULTS The results show that 52% of patients use T&CM. Of those, 29.6% use cupping, 23.5% recite the Holy Quran, 15.3% use phytotherapy, 13.2% use apitherapy, and 10.2% use acupuncture. In addition, 66.3% of the surveyed respondents stated that alternative medicine positively affects their health. Finally, 49.1% of surveyed patients who use alternative medicine are between 30 and 40 years old. The results also show that the rate of T&CM use is higher in patients with progressive MS (OR = 2.540) and patients without financial access to disease-modifying therapy (OR = 2.100). CONCLUSIONS This study invites us to consider societal, cultural, and economic factors when studying the use of T&CM among people with MS. Further research is needed to understand the motivations for using T&CM.
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Affiliation(s)
- Rachid Lotfi
- From the Biological Engineering Laboratory, Faculty of Sciences and Techniques, University Sultan Moulay Slimane, Bèni Mellal, Morocco
| | - Mourad Chikhaoui
- Laboratory of Ecology and Environment, Faculty of Sciences Ben M’Sik, Hassan II University of Casablanca, Casablanca, Morocco
| | - Abdessamad Elmourid
- Polyvalent Team in Research and Development, Department of Biology and Geology, Polydisciplinary Faculty, Sultan Moulay Slimane University, Bèni Mellal, Morocco
| | - Fatiha Chigr
- From the Biological Engineering Laboratory, Faculty of Sciences and Techniques, University Sultan Moulay Slimane, Bèni Mellal, Morocco
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Lotfi R, El Kardoudi A, Chigr F. Multiple sclerosis in Morocco: Epidemiological, clinical, and therapeutic profile. Mult Scler Relat Disord 2024; 81:105347. [PMID: 38061315 DOI: 10.1016/j.msard.2023.105347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE This study aims to describe the clinical, therapeutic, and epidemiological profiles of MS patients in Morocco. METHODS This descriptive study involved 170 patients representing four Morocco regions. We collected the data using an electronic survey. RESULTS The results show female dominance in patients with MS. Besides, most patients present with relapsing-remitting MS (RRMS). The main clinical symptoms reported by patients are fatigue, cognitive issues, spasticity, bowel or bladder complaints, and visual issues. Furthermore, the findings show that almost half of the patients use Interferon bêta-1a and azathioprine as disease-modifying therapies; 60.5 % use traditional and complementary medicine, of which 30.6 % use cupping, 30 % recite the Holy Quran, and 28.2 % use apitherapy. The findings show that there is a statistically significant relationship between specific MS factors such as professional activity (p = 0.0071), degree of satisfaction with treatment (p = 0.005), stress (p = 0.014), and the frequency of relapses. CONCLUSIONS In addition to DMT, patients also use traditional and complementary medicine. There is also a relationship between some epidemiological characteristics and the frequency of relapses in patients with MS.
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Affiliation(s)
- Rachid Lotfi
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco.
| | - Abdeslam El Kardoudi
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Fatiha Chigr
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
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Storr Krogh C, Skovgard L, Lynning M, Steenberg JL. Reasons for Engaging in Complementary and Alternative Medicine Among Highly Educated Women With Multiple Sclerosis. Int J MS Care 2023; 25:104-110. [PMID: 37250196 PMCID: PMC10211353 DOI: 10.7224/1537-2073.2021-133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND Previous research has shown that users of complementary and alternative medicine (CAM) among persons with multiple sclerosis are more likely to be women and to have a higher level of education compared with nonusers. This qualitative study was performed to explore the motivations linked to CAM use among highly educated women with multiple sclerosis. METHODS The study was based on a phenomenological approach, and 8 semistructured, in-depth qualitative interviews were performed. Data were transcribed verbatim and analyzed through meaning condensation and identification of recurring themes. RESULTS Regarding the informants' motivations for CAM use, 3 main themes emerged: (1) Self-reliance is essential in disease management, (2) conventional health care lacks a holistic approach, and (3) personal experience is the primary guide. CONCLUSIONS The interviewees wanted approaches to health care that supported their desire to actively participate in the management of their disease. They were critical of the conventional health care system, and they emphasized the importance of letting their own personal experiences, as well as those of others, guide their decisions.
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Affiliation(s)
| | - Lasse Skovgard
- From the Danish MS Society, Valby, Denmark (CSK, LS, ML, JLS)
| | - Marie Lynning
- From the Danish MS Society, Valby, Denmark (CSK, LS, ML, JLS)
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Soto-Lara M, Silva-Loredo M, Monroy-Córdoba JR, Flores-Ordoñez P, Cervera-Delgadillo NG, Carrillo-Mora P. Alternative medicine therapies in neurological disorders: Prevalence, reasons and associated factors. A systematic review. Complement Ther Med 2023; 73:102932. [PMID: 36805318 DOI: 10.1016/j.ctim.2023.102932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/16/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE This systematic review aimed to identify the prevalence of CAM use in patients with neurological disorders, and also to know most frequent types of CAM used. METHODS Five databases: PubMed, Science Direct, EBSCO, Latindex and Scielo (in English and Spanish) were searched from January 2010 to May 2021. Only original cross-sectional, retrospective and cohort studies were included, whose primary objective was to describe the frequency of CAM use in neurological disorders and/or the related factors to its use in adults. Based on the data, a descriptive analysis was performed, covering the characteristics of studies, measuring methods, prevalence, types and related factors. To control the risk of bias, a quality assessment of each study was performed using STROBE checklist. RESULTS For the final analysis, 40 studies were included. Most common pathologies observed in the studies were multiple sclerosis, headache, stroke, Parkinson and epilepsy. The STROBE score of studies ranged from 13 to 22 points, with an average of 18.2. Prevalence of CAM use was highly variable from one study to another (16% in stroke patients, to 100% in amyotrophic lateral sclerosis or spinal cord injury patients). Biological therapies (dietary supplements and herbal medicine) were the most commonly CAM types used. The associated factors identified were female sex, an age between 40 and 50 years, and higher socioeconomic level. Not all studies investigated about the results of CAMs but these ranged from 35% to more than 80% of reporting positive effects. CONCLUSIONS The prevalence of CAM use in neurological diseases is highly variable (16%-100%); the most used type of CAM was biological therapies and the associated factors were female sex, age between 40 and 50 years old and high socioeconomic level.
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Affiliation(s)
- María Soto-Lara
- Facultad de Medicina, Universidad Nacional Autónoma de México, Cuidad de México, Mexico
| | - Melissa Silva-Loredo
- Facultad de Medicina, Universidad Nacional Autónoma de México, Cuidad de México, Mexico
| | | | - Paola Flores-Ordoñez
- Facultad de Medicina, Universidad Nacional Autónoma de México, Cuidad de México, Mexico
| | | | - Paul Carrillo-Mora
- División de Neurociencias Clínicas, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Ciudad de México, México.
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Mutombo CS, Bakari SA, Ntabaza VN, Nachtergael A, Lumbu JBS, Duez P, Kahumba JB. Perceptions and use of traditional African medicine in Lubumbashi, Haut-Katanga province (DR Congo): A cross-sectional study. PLoS One 2022; 17:e0276325. [PMID: 36256659 PMCID: PMC9578634 DOI: 10.1371/journal.pone.0276325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In the Democratic Republic of Congo, the desire of the Ministry of Health to integrate Traditional African Medicine into the Official Health System remains limited by the lack of reliable data on several aspects of this medicine. This study aims to determine the perceptions of the Lubumbashi population towards Traditional African Medicine and the contexts of recourse to these therapeutic modalities. We conducted semi-structured interviews of population samples in each of the 7 Lubumbashi municipalities, which were semi-randomly selected in proportions to each population size, from January to June 2017 and from February to July 2018. A total of 4278 people (average age, 32.1 ± 10.4 years; 36.5% of women) have been surveyed. Among them, 75.8% define "Traditional African Medicine" as "herbal-based treatments"; 79.4% have resorted to traditional medicine, for several pathologies and social problems. This medicine was preferred for efficiency, speed of healing and low cost, as well as the presence of the diseases against which it would be the only one used. Most, (52.1%) have started with Conventional Medicine, then resorted to Traditional African Medicine, 34.7% started directly with Traditional African Medicine, while 13.2% combined these two medicines. From those who have resorted to Traditional African Medicine (n = 3396), 55% declare no concern towards traditional medicine, while 42.5% fear looseness, overdose, intoxication, and lack of hygiene; from those who have not resorted to Traditional African Medicine (n = 882), 78% are fearful of fear looseness, witchcraft, and fetishism. Traditional African Medicine remains an important health care resource for the Lubumbashi people. It is essential that decision-makers consider the importance of this health sector for the population, but also the reported fears and hindrances, and work towards the regulation, sanitization, and control of this medicine to ensure its safe use.
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Affiliation(s)
- Cedrick S Mutombo
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
- Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | - Salvius A Bakari
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
| | - Vianney N Ntabaza
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
| | - Amandine Nachtergael
- Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | - Jean-Baptiste S Lumbu
- Service de Chimie Organique, Département de Chimie, Faculté des Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
| | - Pierre Duez
- Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | - Joh B Kahumba
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
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The effects of a 12-week yoga intervention on body awareness in people with multiple sclerosis: A non-controlled pilot study. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Weld‐Blundell IV, Grech L, Learmonth YC, Marck CH. Lifestyle and complementary therapies in multiple sclerosis guidelines: Systematic review. Acta Neurol Scand 2022; 145:379-392. [PMID: 35037722 DOI: 10.1111/ane.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/14/2021] [Indexed: 11/28/2022]
Abstract
Management of multiple sclerosis (MS) may comprise clinical interventions and self-management strategies, including complementary therapies and modifiable lifestyle factors such as exercise and smoking cessation. Lifestyle modifications and complementary therapies with proven safety and efficacy are essential as part of best-practice MS management, especially when faced with limited access to healthcare services. However, it is unclear to what extent MS clinical practice guidelines and consensus statements address these strategies. A systematic review was conducted, wherein MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, guideline databases and developer sites were searched for guidelines and consensus statements that addressed lifestyle modifications and complementary therapies of interest. Two researchers independently screened articles, extracted data and assessed guideline quality using the Appraisal of Guidelines for Research and Evaluation version II. Thirty-one guidelines and consensus statements were included. Quality was high for 'clarity of presentation' (77%) and 'scope and purpose' (73%), moderate for 'stakeholder development' (56%), 'rigour of development' (48%) and 'editorial independence' (47%), and low for 'applicability' (29%). Two guidelines, related to physical activity and exercise, mindfulness, smoking cessation, and vitamin D and polyunsaturated fatty acid supplementation, scored high in all domains. These guidelines were two of only four guidelines intended for use by people with MS. High-quality guidelines and consensus statements to guide lifestyle modifications and complementary therapies in MS management are limited. Our findings indicate the need for more guidelines intended for use by people with MS, and a further focus on implementation resources.
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Affiliation(s)
- Isabelle V. Weld‐Blundell
- Disability and Health Unit Centre for Health Equity Melbourne School of Population and Global Health The University of Melbourne Melbourne Victoria Australia
| | - Lisa Grech
- School of Health Sciences Swinburne University of Technology Melbourne Victoria Australia
- Melbourne School of Psychological Sciences The University of Melbourne Melbourne Victoria Australia
- School of Clinical Sciences at Monash Health Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia
- Department of Cancer Experiences Research Peter MacCallum Cancer Centre Melbourne Victoria Australia
| | - Yvonne C. Learmonth
- Discipline of Exercise Science Murdoch University Perth WA Australia
- Perron Institute for Neurological and Translational Science Perth WA Australia
- Centre for Molecular Medicine and Innovative Therapeutics Healthy Futures Institute Murdoch University Perth WA Australia
- Centre for Health Ageing Healthy Futures Institute Murdoch University Perth WA Australia
| | - Claudia H. Marck
- Disability and Health Unit Centre for Health Equity Melbourne School of Population and Global Health The University of Melbourne Melbourne Victoria Australia
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Arji G, Rezaeizadeh H, Moghadasi AN, Sahraian MA, Karimi M, Alizadeh M. Complementary and alternative therapies in multiple sclerosis: a systematic literature classification and analysis. Acta Neurol Belg 2022; 122:281-303. [PMID: 35060096 DOI: 10.1007/s13760-021-01847-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIM Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive utilization of Complementary and Alternative Medicine (CAM) in MS, there is a need to have comprehensive evidence regarding their application in the management of MS symptoms. This manuscript is a Systematic Literature Review and classification (SLR) of CAM therapies for the management of MS symptoms based on the International Classification of Functioning Disability and Health (ICF) model. METHOD Studies published between 1990 and 2020 IN PubMed, Science Direct, Scopus, Pro-Quest, and Google Scholar using CAM therapies for the management of MS symptoms were analyzed. RESULTS Thirty-one papers on the subject were analyzed and classified. The findings of this review clearly show that mindfulness, yoga, and reflexology were frequently used for managing MS symptoms. Moreover, most of the papers used mindfulness and yoga as a CAM therapy for the management of MS symptoms, which mostly devoted to mental functions such as fatigue, depression, cognition, neuromuscular functions such as gait, muscle strength, and spasticity, and sensory function such as balance, in addition to, reflexology is vastly used to management of mental functions of MS patients. CONCLUSION Evidence suggested that CAM therapies in patients with MS have the potential to target and enhancement numerous elements outlined in the ICF model. Although the use of CAM therapies in MS symptom management is promising, there is a need for strict clinical trials. Future research direction should concentrate on methodologically powerful studies to find out the potential efficacy of CAM intervention.
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Affiliation(s)
- Goli Arji
- School of Nursing and Midwifery, Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran
| | - Hossein Rezaeizadeh
- Department of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Abdolrreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Department of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mojtaba Alizadeh
- Department of Computer Engineering, Lorestan University, Khorramabad, Iran.
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Lynning M, Svane C, Westergaard K, Bergien S, Gunnersen S, Skovgaard L. Tension and trauma releasing exercises for people with multiple sclerosis - An exploratory pilot study. J Tradit Complement Med 2021; 11:383-389. [PMID: 34522632 PMCID: PMC8427467 DOI: 10.1016/j.jtcme.2021.02.003] [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: 07/18/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND AND AIM Multiple sclerosis (MS) is characterized by increasing symptom burden leading many people with MS to use complementary treatments. TRE (Tension and Trauma Releasing Exercises) is a mind-body therapeutic method aiming to release muscle tension and stress. People with MS (PwMS) have reported benefits from TRE, but no scientific studies have investigated the effects of TRE on PwMS. Aim: To test a TRE program for PwMS and thereby explore outcome measures to be applied in future randomized studies. EXPERIMENTAL PROCEDURE A nine-week TRE program was completed by nine participants: Five were women, age ranged from 44 to 66 years, and time since diagnosis ranged from 2 to 21 years. Outcome measures included self-reported day-to-day levels of nine different symptoms as well as sleep quality and stress level. Modified Fatigue Impact Scale (MFIS) fatigue score and spasticity level of the ankle plantar flexors, assessed using a Portable Spasticity Assessment Device (PSAD), were measured pre and post intervention. RESULTS Decreases were seen in the mean scores of all nine self-reported day-to-day symptoms as well as stress level, while sleep quality mean score increased. LME analyses showed that all changes were statistically significant except one (bowel dysfunction). Mean MFIS-measured fatigue level decreased significantly from a score of 43.7 (SD = 13.6) to a score of 22.0 (SD = 12.3). No significant change was reported in PSAD-measured spasticity level. CONCLUSION The study indicates possible effects of TRE on PwMS on several self-reported outcome measures. Larger, randomized studies should be carried out to explore the findings further.
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Affiliation(s)
| | - C. Svane
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
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Grace-Farfaglia P. Self-Reported Diet and Health Outcomes of Participants of the CCSVI-Tracking Survey Study. Nutrients 2021; 13:nu13061891. [PMID: 34072860 PMCID: PMC8230225 DOI: 10.3390/nu13061891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Of the 1575 participants of the CCSVI-Tracking Survey, 475 patients recorded their quality of life and EDSS outcomes for at least 2 months. Self-reported use of complementary and conventional therapies included diet, use of drug therapy, symptoms, quality of life, and mobility. Analysis included comparing outcomes related to different diets within and between groups. Adherence to the MS diet was not associated with a greater quality of life, less disability, a lower Symptom Score, or faster walking speed compared to other diets. Alternately, the participants from the Mediterranean diet region as a whole (µ = 32.65 (SD = 11.37, SEM = 2.37, p = 0.05) had a significantly greater QoL (µ = 60, p = 0.05) and a lower MS symptom score, µ = 32.65 (11.37), p = 0.0029. A decline of symptoms was observed in all diet groups over 3 months with the most dramatic decline observed in participants from the Eastern Mediterranean diet region. The main effect for the within-subjects factor was significant, F(3, 1056) = 55.95, p < 0.001, indicating that there were significant differences between the groups.
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Affiliation(s)
- Patricia Grace-Farfaglia
- Department of Health Science, Rocky Mountain University of Health Professions, Provo, UT 84606, USA;
- Department of Health Science, College of Health Professions, Sacred Heart University, Fairfield, CT 06825, USA
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11
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Ashtiani AR, Seied Amirhossein L, Jadidi A, Ghasami K, Khanmohamadi Hezave A, Aghae Pour SM, Malekhosseni S, Kamalinejad M, Alimoradian A, Salehi M. The effect of novel simple saffron syrup on fatigue reduction in patients with multiple sclerosis. J Basic Clin Physiol Pharmacol 2020; 31:jbcpp-2020-0063. [PMID: 32716906 DOI: 10.1515/jbcpp-2020-0063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/25/2020] [Indexed: 11/15/2022]
Abstract
Objectives Multiple sclerosis (MS) is a progressive and often debilitating neurological disorder. This chronic disease has a high prevalence in the world and also in Iran. Fatigue is a common symptom of the disease, which causes serious mental and psychological discomfort. Simple saffron syrup, contains some compounds that can be effective in relieving the symptom. The object of this study is to investigate the effect of simple saffron syrup on fatigue in patients with MS. Methods This study is a pre-post study which evaluates the fatigue rate of MS patients (30 participants) according to the FSS scale. The participants were given a saffron simple syrup to consume a tablespoon (7.5 cc) every 8 h for two months. After 60 days of prescribing, patients are assessed for fatigue based on fatigue severity scale (FSS) criteria. Results One-way ANOVA showed that there was a notable difference between the mean score of fatigue in MS patients before and after the intervention (p<0.001). So, the fatigue severity of the subjects after saffron syrup consumption dropped dramatically for two months. (p<00.01). Conclusions According to the outcomes of this study, simple saffron syrup can be effective as an adjunct therapy for fatigue reduction in patients with MS due to effectiveness besides no significant side effects.
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Affiliation(s)
| | - Latifi Seied Amirhossein
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Ali Jadidi
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadam, Iran.,Faculty of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Keyvan Ghasami
- Department of Neurology, Vali-E-Asr.Medical Center, Arak Medical University, Arak, Iran
| | | | | | - Shema Malekhosseni
- Department of Pharmacology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Kamalinejad
- School of Pharmacy, Shaheed Beheshti University of Medical Sciences and Health Services, Tehran, Iran
| | - Abbas Alimoradian
- Department of Pharmacology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mehdi Salehi
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
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12
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Bergien SO, Petersen CM, Lynning M, Kristiansen M, Skovgaard L. Use of natural medicine and dietary supplements concomitant with conventional medicine among people with Multiple Sclerosis. Mult Scler Relat Disord 2020; 44:102197. [PMID: 32531752 DOI: 10.1016/j.msard.2020.102197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) are widespread among people with Multiple Sclerosis (PwMS) and are often used concomitant with conventional treatment. Natural medicine and dietary supplements (NADS) are the most frequently used CAM modality and among other patient groups use of NADS concomitant with conventional medicine has been reported as a potential risk to patients' safety due to risk of drug interactions. The use of NADS concomitant with conventional medicine has, however, not been investigated among PwMS. This study's aim was to investigate the prevalence of NADS and conventional MS-related medicine use among PwMS, specific types of NADS and conventional MS-related medicine used, the prevalence of NADS used concomitant with conventional MS-related medicine, and to characterize PwMS who use NADS and PwMS who use NADS concomitant with conventional MS-related medicine in a Danish context. METHODS The study was a cross-sectional study conducted as an interviewer-administered survey via phone in April 2019. The questionnaire includes questions about the use of NADS and conventional MS medicine as well as sociodemographic and health-related factors. In total 384 PwMS answered the questionnaire. Both descriptive and logistic analyses were used to analyze the data. RESULTS The results show that the majority of PwMS use conventional MS-related medicine. In total, 85 % (n=322) had used at least one NADS within the last 12 months including vitamin D. When excluding vitamin D, the use of NADS within the last 12 months was 78.4% (n=298). Beside vitamin D the most reported types of NADS used were fatty acids (37%), Multivitamins (37%), and Calcium (35%). A total of 75.8% (n=288) reported using NADS concomitant with conventional MS medicine, and the products most often combined with conventional MS medicine were Vitamin D, Multivitamin, Calcium, Magnesium, and fatty acids. The results suggest that PwMS using NADS concomitant with conventional MS-related medicine are characterized by a high prevalence of young and newly diagnosed patients with a high education level. CONCLUSION The study contributes to a better understanding of NADS used among PwMS. The study shows that the majority of PwMS use NADS and that they use it concomitant with conventional MS-medicine. Furthermore, the detailed mapping of the specific types of NADS used gives a nuanced insight into the specific products of NADS used among PwMS, including different kinds of vitamins, minerals, and herbal remedies.
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Affiliation(s)
- S O Bergien
- The Danish Multiple Sclerosis Society, Valby, Denmark.
| | - C M Petersen
- The Danish Multiple Sclerosis Society, Valby, Denmark
| | - M Lynning
- The Danish Multiple Sclerosis Society, Valby, Denmark
| | - M Kristiansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - L Skovgaard
- The Danish Multiple Sclerosis Society, Valby, Denmark
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13
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Shariff EM, Al-Shammrani FJ, Nazish S, Zafar AS, Shahid RM, Khuda IE, Zeeshan MA, Alabdali MA, Al-Bakr AI, Aljaafari DT, Balharith IO, Alahmed AA, Alsalman SA, Almajed AM, Alkhamis FA. Is non-traditional therapy for multiple sclerosis overwhelming in Saudi Arabia. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2019; 24:192-198. [PMID: 31380818 PMCID: PMC8015515 DOI: 10.17712/nsj.2019.3.20180010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives: To describe the prevalence, knowledge and attitudes about complementary and alternative medicine (CAM) use and the proportion that seek advice from their physician about CAM use. Methods: This cross-sectional observational study was performed in multiple sclerosis (MS) clinic of King Fahd Hospital of Universityin Alkhobar, Kingdom of Saudi Arabia from January-June 2017. A total of 133 patients have completed the survey. Results: The mean age of patients was 32.3±7.6 years and 84 (63.2 %) were female. Approximately 83.5% of the patients reported the use of CAM. Among all the reported forms of CAM, vitamins were the most prevalent form, followed by cupping, special prayers and meditation. The majority of patients (62%) obtained knowledge of CAM through social media. A significant number of patients (75.6%) did not disclose the use of CAM to their physician. There was a trend for using CAM more in highly educated, older age, and female patients. The most commonly reported rationale to use CAM was overall improvement in health status. Conclusion: The use of CAM among Saudi patients with MS is highly prevalent, without disclosure of its use to physicians. These factors should be taken into account in the doctor-patient consultation to avoid adverse events.
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Affiliation(s)
- Erum M Shariff
- Department of Neurology, King Fahd Hospital, Imam AbdulRahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia. E-mail:
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Barnard E, Brown CR, Weiland TJ, Jelinek GA, Marck CH. Understanding barriers, enablers, and long-term adherence to a health behavior intervention in people with multiple sclerosis. Disabil Rehabil 2018; 42:822-832. [PMID: 30375258 DOI: 10.1080/09638288.2018.1510550] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: The optimal management strategy for multiple sclerosis (MS), and many other chronic diseases, likely involves health behavior modification. Multimodal behavioral interventions may be most effective, but little is known about long-term adherence in people with MS.Methods: This qualitative study assessed barriers and enablers to long-term adherence by people with MS who self-selected for a 5-day health behavior intervention 3-5 years prior. Thirteen women and five men participated in semi-structured phone interviews, which were transcribed and thematically analyzed.Results: The experience was described as useful for information gathering, decision making, and practical strategies regarding health behaviors. The majority still followed supplementation and dietary recommendations most of the time, although consuming non-recommended food while eating out was common. Support at home, ability and enjoyment in food preparation, and ability to resist unhealthy foods were both barriers and enablers. Adherence to "time-consuming" exercise and meditation recommendations were less common and episodic. Many reported competing interests on time from work and family; and barriers including injuries and symptoms, weather, financial or geographical barriers, and lack of person-centred support and motivation. Increased fitness and mobility, weight loss, and a sense of accomplishment and control were advantages and motivators. Practical and attitudinal strategies employed included planning, tailoring activities to ability and preference, and self-monitoring.Conclusion: While most people attempted to engage with all components of the intervention initially, only some still engaged with all components, and none to the recommended levels. These data can inform future quantitative studies and health behavior interventions.Implications for rehabilitationA multimodal group lifestyle intervention may be useful to assist people with multiple sclerosis in information gathering, decision making, attitudinal changes, and practical strategies regarding health behaviors; as well as providing a sense of hope for the future and control over wellbeing.While participants are unlikely to engage with all components of a multimodal intervention to the recommended level, they are likely to make improvements to one or more health behaviors.Experiential learning, including going through recipes and ingredient lists, and practicing meditation and physical exercises, is helpful to instigate behavior change.The initiation and maintenance of behavior change was assisted by support from family, friends, and health practitioners; and practical strategies employed by participants, including planning, self-monitoring, and tailoring activities to ability and preference.
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Affiliation(s)
- Emma Barnard
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Chelsea R Brown
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Tracey J Weiland
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - George A Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Claudia H Marck
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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15
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Rommer PS, König N, Sühnel A, Zettl UK. Coping behavior in multiple sclerosis-complementary and alternative medicine: A cross-sectional study. CNS Neurosci Ther 2018; 24:784-789. [PMID: 29635832 PMCID: PMC6120478 DOI: 10.1111/cns.12857] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/12/2018] [Accepted: 03/13/2018] [Indexed: 12/13/2022] Open
Abstract
Main Problem Treatment options for multiple sclerosis (MS) have enlarged tremendously over the last years. Nonetheless, lots of patients look for alternative treatment options. The use of complementary and alternative medicine (CAM) is widespread in MS, however, its scientific investigation is limited so far. The aim of the study is to analyse clinical and demographical differences of MS patients in dependency of their CAM utilization as coping strategy. Methods A total of 254 patients with a clinically definite MS were examined in a semistructured interview. Additional standardized questionnaires were used to measure different aspects of coping with illness. All patients underwent neurological examination. Results About 206 of all enrolled patients are CAM users (81.1%). They have a longer disease duration (8.3 years vs 7.3 years, P = 0.028) and show higher disability (median EDSS 4.0 vs 2.0, P < 0.001) than nonusers. CAM users differed significantly from nonusers in their coping behavior (P = 0.035). Users are brooding more heavily over the disease, looking for more information about MS, and are looking for a sense of their disease in religion more often than nonusers. CAM users are at a higher risk of depression. Almost two‐thirds of CAM users (57.6%) reported positive effects on the well‐being of their state of health. Conclusion Coping behavior differs significantly between CAM users and nonusers. CAM utilization is associated with higher disability and depression. More than 80% of our cohort has used alternative or complementary methods. CAM utilization may mirror unmet needs in the treatment of MS.
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Affiliation(s)
- Paulus S Rommer
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany.,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - Annett Sühnel
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
| | - Uwe K Zettl
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
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Huybregts E, Betz W, Devroey D. The use of traditional and complementary medicine among patients with multiple sclerosis in Belgium. J Med Life 2018; 11:128-136. [PMID: 30140319 PMCID: PMC6101689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction. Conventional treatment of multiple sclerosis (MS) is often disappointing. As a result, some of these patients seek salvation in traditional and complementary medicine (T&CM). The aim of this study is to describe how many patients with MS use T&CM and what their motives and expectations are in doing so. Methods. Ninety-nine patients with diagnosed MS, attending the service of ambulatory revalidation of the National Clinic for Multiple Sclerosis in Melsbroek (Belgium) were included in February 2004 in this retrospective study. All patients had MS resulting in motoric or psychosocial symptoms. The disability was not quantified for this study. Participants were interviewed by means of a structured questionnaire on their current treatment of MS including T&CM. Results. In total 44% of the participants had experiences with T&CM. The most frequently used T&CM were homeopathy and acupuncture. Participants using conventional treatment were more satisfied with the support (p=0.006) and the treatment outcome (0.018) than T&CM users. The use of T&CM was not related to gender, education, living conditions, causal treatment such as disease modifying-therapy (DMT), grade of disability or subtype of the disease. Conclusion. Patients diagnosed with MS seek hope in T&CM such as homeopathy or acupuncture. The results of this study suggest that MS patients need more professional support in their personal search for alternative therapies. Key point. 50% of patients diagnosed with multiple sclerosis search relief in traditional and complementary medicine such as homeopathy or acupuncture. These patients often feel compelled to try every opportunity to heal, often stimulated or urged on by friends or relatives. Multiple sclerosis patients are more satisfied with their conventional treatment than with the traditional and complementary medicine.
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Affiliation(s)
- E Huybregts
- Department of Family Medicine & Chronic Care, Vrije Universiteit Brussel, Belgium
| | - W Betz
- Department of Family Medicine & Chronic Care, Vrije Universiteit Brussel, Belgium
| | - D Devroey
- Department of Family Medicine & Chronic Care, Vrije Universiteit Brussel, Belgium
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Salamonsen A, Ahlzén R. Epistemological challenges in contemporary Western healthcare systems exemplified by people's widespread use of complementary and alternative medicine. Health (London) 2017; 22:356-371. [PMID: 28401813 DOI: 10.1177/1363459317693408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Modern Western public healthcare systems offer predominantly publicly subsidized healthcare traditionally based on biomedicine as the most important basis to cure persons who suffer from disorders of somatic or psychiatric nature. To which extent this epistemological position is suitable for this purpose is under scientific debate and challenged by some people's personal understandings of health and illness, their individual illness experiences and their decision-making. Current studies show decreasing levels of patient trust in Western public healthcare and a widespread patient-initiated use of complementary and alternative medicine which is often linked to unmet patient-defined healthcare needs. Patients'/complementary and alternative medicine users' understandings of their afflictions are often based on elements of biomedical knowledge as well as embodied and experience-based knowledge. We believe this points to the need for a phenomenologically and socially based understanding of health and illness. In this article, we analyze challenges in contemporary healthcare systems, exemplified by people's widespread use of complementary and alternative medicine and based on three ways of understanding and relating to unhealth: disease (the biomedical perspective), illness (the phenomenological perspective), and sickness (the social perspective). In public healthcare systems aiming at involving patients in treatment processes, acknowledging the coexistence of differing epistemologies may be of great importance to define and reach goals of treatment and compliance.
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Affiliation(s)
- Anita Salamonsen
- UiT the Arctic University of Norway, Norway.,Karlstad Hospital, Sweden.,University Hospital of Örebro, Sweden
| | - Rolf Ahlzén
- Karlstad Hospital, Sweden.,University Hospital of Örebro, Sweden
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Pedersen IK, Hansen VH, Grünenberg K. The emergence of trust in clinics of alternative medicine. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:43-57. [PMID: 26403077 DOI: 10.1111/1467-9566.12338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Demands for alternative medicine have increased since the 1970s in nations in which western scientific evidence has become the basis for health care. This paradox has been the impetus to examine how trust emerges in clinics of alternative medicine. Alternative practitioners are self-regulated and the clients pay out of their own pockets to attend non-authorised treatments with very limited scientific evidence of their effects. Trust is a key issue in this context. However, only a few studies have dealt with the ways in which alternative practitioners win their clients' trust. Drawing on three qualitative studies and informing the empirical findings with a sociological concept of trust, this article provides new empirical insights on how trust emerges in Danish clinics of acupuncture, reflexology and homeopathy. The analysis demonstrates how trust is situational and emerges through both clients' susceptibility and practitioners' individual skill development and strategies, as well as from objects, place and space. Trust is developed on relational and bodily as well as material grounds. It is argued that the dynamics and elements of trust identified do not only minimalise uncertainties but sometimes convert these uncertainties into productive new ways for clients to address their ailments, life circumstances and perspectives.
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19
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Salamonsen A. Use of complementary and alternative medicine in patients with cancer or multiple sclerosis: possible public health implications. Eur J Public Health 2015; 26:225-9. [PMID: 26450914 DOI: 10.1093/eurpub/ckv184] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) among Scandinavian patients with cancer or multiple sclerosis (MS) may be perceived as closely connected to their experiences from conventional care and thus contextualized by Scandinavian public healthcare systems. This study aimed at providing more insight into such patients' widespread, complex, self-initiated and unregulated use of CAM, analysed from a public health perspective. METHODS Twenty-nine qualitative in-depth interviews with 31 CAM users diagnosed with cancer or MS were conducted. Qualitative content analysis was used to interpret the data. RESULTS The participants were 'active patients' because they initiated their use of CAM and wanted to take part in decision-making and contribute to positive health outcomes. They moved in and out of CAM and public healthcare contexts as 'boundary walkers'. Experience-based knowledge such as bodily experiences as well as scientific knowledge was perceived as relevant sources of knowledge in decision-making. CAM treatments were in general perceived as safe and conventional treatments as being potentially risky. CONCLUSION Boundary walkers often challenge the understandings of illness behaviour, evidence and treatment traditionally incorporated in Scandinavian public healthcare systems. CAM may be perceived as a healthcare system that acknowledges experience-based knowledge and patient involvement in treatment processes. Patient-centeredness is an important goal in current European public health programmes, but is often not recognized by CAM users in clinical practice. Thus, studies of CAM users' healthcare needs and their strategies to meet them may provide crucial knowledge to future development of patient-centred public health and medical education programmes.
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Affiliation(s)
- Anita Salamonsen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Ploughman M, Manning OJ, Beaulieu S, Harris C, Hogan SH, Mayo N, Fisk JD, Sadovnick AD, O'Connor P, Morrow SA, Metz LM, Smyth P, Allderdice PW, Scott S, Marrie RA, Stefanelli M, Godwin M. Predictors of chronic cerebrospinal venous insufficiency procedure use among older people with multiple sclerosis: a national case-control study. BMC Health Serv Res 2015; 15:161. [PMID: 25881078 PMCID: PMC4424567 DOI: 10.1186/s12913-015-0835-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/06/2015] [Indexed: 11/17/2022] Open
Abstract
Background Following the initial reports of Chronic Cerebrospinal Venous Insufficiency (CCSVI) and the purported curative potential of venoplasty, (coined the ‘liberation’ procedure) Canadians living with multiple sclerosis (MS) began to travel abroad to receive the unregulated procedure, often placing them at odds with their health providers. The purpose of this study was to determine the factors influencing older MS patients’ decision to undergo the procedure in order to develop more specific and targeted health information. Methods We performed secondary analysis of data collected as part of the ‘Canadian Survey of Health Lifestyle and Aging with MS’ from people over the age of 55 years with MS symptoms for 20 or more years. The survey consisted of self-reported information on impairments, disability, participation, demographics, personal and environmental factors. In order to compare respondents who underwent the procedure to those who did not and to develop a predictive model, we created a comparison group using a case–control algorithm, controlling for age, gender and education, and matching procedure cases to controls 1:3. We used multivariate stepwise least likelihood regression of ‘a priori’ variables to determine predictive factors. Results The prevalence of the ‘liberation’ procedure in our sample was 12.8% (95/743), substantially lower than reported in previous studies of complementary/alternative treatments in MS. The predictive model contained five factors; living alone (Odds ratio 0.24, 95%CI 0.09-0.63), diagnosis of anxiety (Odds ratio 0.29, 95%CI 0.10 - 0.84), rating of neurologist’s helpfulness (Odds ratio 0.56, 95%CI 0.44 -0 .71), Body Mass Index (Odds ratio 0.93, 95%CI, 0.89 - 0.98) and perceived physical impact of MS (Odds ratio 1.02, 95%CI 1.01 - 1.04). Conclusions Predictive factors differed from previous studies of complementary/alternative treatment use likely due to both the invasiveness of the procedure and the advanced age of our study cohort. Our findings suggest that health professionals should target information on the risks and benefits of unregulated procedures to those patients who feel dissatisfied with their neurologist and they should include family members in discussions since they may be providing the logistical support to travel abroad and undergo the ‘liberation’ procedure. Our findings may be applicable to others with chronic disabling conditions who contemplate the user-pay unregulated invasive procedures available to them. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-0835-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle Ploughman
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, Rm 400, L.A. Miller Centre, 100 Forest Rd, St. John's, NL, Canada.
| | - Olivia J Manning
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, Rm 400, L.A. Miller Centre, 100 Forest Rd, St. John's, NL, Canada.
| | | | - Chelsea Harris
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, Rm 400, L.A. Miller Centre, 100 Forest Rd, St. John's, NL, Canada.
| | - Stephen H Hogan
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, Rm 400, L.A. Miller Centre, 100 Forest Rd, St. John's, NL, Canada.
| | - Nancy Mayo
- Clinical Epidemiology, McGill University, Montreal, QC, Canada.
| | - John D Fisk
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - A Dessa Sadovnick
- Department of Medical Genetics and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Paul O'Connor
- Department of Neurology, St. Michaels Regional Hospital, Toronto, ON, Canada.
| | | | - Luanne M Metz
- Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
| | - Penelope Smyth
- Department of Neurology, University of Alberta, Edmonton, AB, Canada.
| | - Penelope W Allderdice
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, Rm 400, L.A. Miller Centre, 100 Forest Rd, St. John's, NL, Canada.
| | - Susan Scott
- Clinical Epidemiology, McGill University, Montreal, QC, Canada.
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Mark Stefanelli
- Department of Neurology, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
| | - Marshall Godwin
- Primary Health Care Research Unit, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
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González-González L, Pérez-Cortéz JG, Flores-Aldana M, Macías-Morales N, Hernández-Girón C. [Antioxidant use as dietary therapy in patients with multiple sclerosis]. Medwave 2015; 15:e6065. [PMID: 25629306 DOI: 10.5867/medwave.2015.01.6065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 12/22/2014] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Multiple sclerosis is an immune-mediated disease that produces chronic inflammation and neural degeneration. The disease progresses with acute attacks that result in myelin inflammation. This in turn increases oxidative stress and favors the appearance of reactive oxygen species. Reactive oxygen species damage neural cells causing apoptosis. The etiology of multiple sclerosis remains unknown and current therapy is aggressive and expensive. Recently, complementary and alternative medicine therapies have been proposed to control pathogenesis and symptoms of this disease. It is believed that these therapies help slow the progression of multiple sclerosis and improve survival. METHODS We conducted a MEDLINE/PubMed search using the following MeSH terms: diet, multiple sclerosis, antioxidants. We selected the main articles containing multiple sclerosis and diet. RESULTS We analyzed three case control studies that evaluated different dietary approaches in multiple sclerosis. For this review, we also included five experimental studies that studied the efficacy of lipoic acid in humans and rodents in diseases like multiple sclerosis, experimental autoimmune encephalomyelitis, and breast cancer.
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Affiliation(s)
- Laura González-González
- Escuela de Nutrición, Universidad Latinoamericana, Cuernavaca, México. Address: Av. Universidad N°. 655, CP 62100, Cuernavaca, Morelos, México.
| | | | - Mario Flores-Aldana
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Nayeli Macías-Morales
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Carlos Hernández-Girón
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Skovgaard L, Pedersen IK, Verhoef M. Exclusive use of alternative medicine as a positive choice: a qualitative study of treatment assumptions among people with multiple sclerosis in denmark. Int J MS Care 2014; 16:124-31. [PMID: 25337054 DOI: 10.7224/1537-2073.2013-010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND A survey of members of the Danish MS Society revealed that a minority of MS patients choose to forgo all types of conventional treatment and use complementary and alternative medicine (CAM) exclusively. A qualitative follow-up study was performed to elucidate the choice of exclusive CAM use by exploring treatment assumptions among a group of exclusive CAM users. METHODS The study was based on a phenomenological approach. Semistructured in-depth qualitative interviews were conducted with 17 participants, using program theory as an analytical tool, and emerging themes were extracted from the data through meaning condensation. RESULTS Four themes characterized the participants' treatment assumptions: 1) conventional medicine contains chemical substances that affect the body in negative ways; 2) CAM treatments can strengthen the organism and make it more capable of resisting the impact of MS; 3) the patient's active participation is an important component of the healing process; 4) bodily sensations can be used to guide treatment selection. CONCLUSIONS Exclusive use of CAM by MS patients may reflect embracing CAM rather than a rejection of conventional medicine. Health-care practitioners, patient organizations, and health authorities within the MS field should be aware of possible changes in patients' attitudes toward both CAM and conventional treatment interventions.
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Affiliation(s)
- Lasse Skovgaard
- Danish MS Society, Valby, Denmark, and the Department of Public Health, University of Copenhagen, Copenhagen, Denmark (LS); the Department of Sociology, University of Copenhagen, Copenhagen, Denmark (IKP); and NAFKAM, University of Tromsø, Tromsø, Norway (MV)
| | - Inge Kryger Pedersen
- Danish MS Society, Valby, Denmark, and the Department of Public Health, University of Copenhagen, Copenhagen, Denmark (LS); the Department of Sociology, University of Copenhagen, Copenhagen, Denmark (IKP); and NAFKAM, University of Tromsø, Tromsø, Norway (MV)
| | - Marja Verhoef
- Danish MS Society, Valby, Denmark, and the Department of Public Health, University of Copenhagen, Copenhagen, Denmark (LS); the Department of Sociology, University of Copenhagen, Copenhagen, Denmark (IKP); and NAFKAM, University of Tromsø, Tromsø, Norway (MV)
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Skovgaard L, Pedersen IK, Verhoef M. Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis' views on risks of negative interactions between herbal medicine and conventional drug therapies. Altern Ther Health Med 2014; 14:59. [PMID: 24533750 PMCID: PMC3942187 DOI: 10.1186/1472-6882-14-59] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 01/12/2014] [Indexed: 12/01/2022]
Abstract
Background Most users of complementary and alternative medicine (CAM) combine it with conventional medicine. Recent risk assessment studies have shown risks of negative interactions between CAM and conventional medicine, particularly when combining herbal medicine and conventional drug therapies (CDT). Little is known about the way users consider such risks. The present paper aims to gain knowledge about this issue by exploring views on risks of negative interactions when combining herbal medicine and CDT among people with multiple sclerosis (MS). Methods This paper draws on a qualitative follow-up study on a survey among members of the Danish MS Society. Semi-structured, in-depth qualitative interviews were conducted with a strategic selection from the survey respondents. The study was inspired by a phenomenological approach and emerging themes were extracted from the data through meaning condensation. Results Four themes characterized the informants’ views on risks of negative interactions when combining herbal medicine and CDT: 1) ‘naturalness’ in herbal medicine; 2) ‘bodily sensations’ as guidelines; 3) trust in the CAM practitioner; 4) lack of dialogue with medical doctor. Conclusions Generally, the combination of herbal medicine and CDT was considered by the informants to be safe. In particular, they emphasized the ‘non-chemical’ nature of herbal medicine and of their own bodily sensations as warrants of safety. A trustful relation to the CAM practitioner furthermore made some of them feel safe in their use of herbal medicine and CDT in combination. The informants’ use of bodily sensations as a non-discursive risk assessment may be a relevant element in understanding these issues.
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Opheim R, Fagermoen MS, Bernklev T, Jelsness-Jorgensen LP, Moum B. Fatigue interference with daily living among patients with inflammatory bowel disease. Qual Life Res 2013; 23:707-17. [PMID: 23975381 DOI: 10.1007/s11136-013-0508-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of the study was to examine fatigue interference with daily living in patients with inflammatory bowel disease (IBD) and to explore relationships between severe fatigue interference and socio-demographic and clinical variables, including use of complementary and alternative medicine (CAM). METHODS Data were collected using self-report questionnaires from adult IBD outpatients. Fatigue interference was assessed with the 5-item Fatigue Severity Scale, and scores ≥ 5 were defined as severe fatigue interference. CAM use was assessed with the International CAM Questionnaire. Multivariate logistic regression analysis was used to examine associations between severe fatigue interference and socio-demographic factors, clinical factors, and CAM use. RESULTS In total, 428 patients had evaluable questionnaires (response rate 93 %). Severe fatigue interference was reported by 39 % of the total sample. Patients with Crohn's disease (CD) (n = 238) were more likely than patients with ulcerative colitis (UC) (n = 190) to report severe fatigue interference (43 and 33 %, respectively, p = 0.003). In addition, patients reporting severe fatigue interference were more likely to have active disease than patients without severe fatigue interference (p < 0.001 for both diagnoses). Patients with inactive disease had scores comparable to the general population. Factors independently associated with severe fatigue interference in UC included disease activity and CAM use, while in CD they included disease activity and current smoking. CONCLUSIONS Severe fatigue interference is common among IBD patients with active disease. Among patients with UC, but not CD, CAM use was associated with severe fatigue interference. The relationship between fatigue interference and personal factors should be considered further in subsequent studies.
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Affiliation(s)
- Randi Opheim
- Division of Medicine, Department of Gastroenterology, Oslo University Hospital, Nydalen, P.O. Box 4956, 0424, Oslo, Norway,
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Methodology of an International Study of People with Multiple Sclerosis Recruited through Web 2.0 Platforms: Demographics, Lifestyle, and Disease Characteristics. Neurol Res Int 2013; 2013:580596. [PMID: 23691313 PMCID: PMC3649686 DOI: 10.1155/2013/580596] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/27/2013] [Accepted: 03/20/2013] [Indexed: 11/21/2022] Open
Abstract
Background. Despite evidence of the potential importance of the role of health and lifestyle behaviours in multiple sclerosis (MS) outcomes, there has not been a significant focus on this area of research. Aim. We aimed to recruit an international sample of people with MS at baseline and over a five-year timeframe, examine their health and lifestyle behaviours, and determine the relationship of these behaviours to self-reported disability, disease activity, and quality of life. Methods. People with MS were recruited through web 2.0 platforms including interactive websites, social media, blogs, and forums and completed a comprehensive, multifaceted online questionnaire incorporating validated and researcher-derived tools. Results. 2519 participants met inclusion criteria for this study. This paper describes the study methodology in detail and provides an overview of baseline participant demographics, clinical characteristics, summary outcome variables, and health and lifestyle behaviours. The sample described is unique due to the nature of recruitment through online media and due to the engagement of the group, which appears to be well informed and proactive in lifestyle modification. Conclusion. This sample provides a sound platform to undertake novel exploratory analyses of the association between a variety of lifestyle factors and MS outcomes.
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