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El Toum Y, Costa T, El Toum E, Haddad T, Salameh P, El Karak F, Ghosn M, Nasr F, Chahine G, Kattan J, Kourie HR. Supplement use and its impact on daily life of cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:172. [PMID: 38379082 DOI: 10.1007/s00520-024-08380-y] [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: 09/02/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life. METHODS Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables. RESULTS A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety. CONCLUSION This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients.
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Affiliation(s)
- Youssef El Toum
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Tarek Costa
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elissa El Toum
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Tina Haddad
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Fady El Karak
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Nasr
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Georges Chahine
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Hijazi MA, Shatila H, Abu Qiyas S, Aboul-Ela M, El-Lakany A, Naja F. Complementary and alternative medicine use during the COVID-19 pandemic: Community pharmacists' knowledge, attitudes, and practices. Res Social Adm Pharm 2023; 19:502-509. [PMID: 36371308 PMCID: PMC9617642 DOI: 10.1016/j.sapharm.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The challenges in COVID-19 treatment have driven patients to seek Complementary and Alternative Medicine (CAM) for the prevention and/or treatment of the disease. Pharmacists are uniquely positioned to promote the effective and safe use of CAM. OBJECTIVE Assess the beliefs, practices, and knowledge of community pharmacists in Lebanon about existing evidence for the use of CAM for the prevention and/or treatment of COVID-19. METHODS A national cross-sectional survey was conducted among community pharmacists during the COVID-19 pandemic in Lebanon (n = 310 respondents). Participants completed an online questionnaire addressing, in addition to the socio-demographic characteristics; the beliefs, practices, and knowledge of pharmacists regarding the existing evidence of CAM use for COVID-19 prevention and/or treatment. RESULTS Pharmacists (70%) received frequent inquiries about CAM for COVID-19 prevention or treatment. Only 25.5% of the pharmacists reported having enough time to get information about CAM and COVID-19. Almost all participants believed that pharmacists have a major role in the fight against COVID-19 (98%) and that they have enough information to counsel patients in that regard (75%). For practices, the majority of pharmacists reported counseling their patients on proper use (98%) and possible adverse reactions (93%) of CAM, but only 51% reported toxic or undesirable effects. Regarding knowledge, although most pharmacists answered correctly the questions on the role of CAM in preventing COVID-19, few knew about its role in treating the infection. Pharmacists who trust the WHO website as a credible source had a higher knowledge score (β = 0.52, 95%CI: 0.05-0.986). CONCLUSIONS The positive beliefs and practices of pharmacists towards CAM during the pandemic were coupled with a few gaps, especially in their knowledge about existing evidence for CAM use. Concerted efforts ought to be dedicated to supporting pharmacists in playing a more prominent role during health crises such as the COVID-19 pandemic.
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Affiliation(s)
- Mohamad Ali Hijazi
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Hibeh Shatila
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Salma Abu Qiyas
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Maha Aboul-Ela
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Abdalla El-Lakany
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,Research Institute of Medical and Health Sciences (RIHMS), University of Sharjah, Sharjah, United Arab Emirates,Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences American, University of Beirut, Beirut, Lebanon,Corresponding author. Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Dehghan M, Rad MM, Lari LA, Ghorbani-nejad B, Mohebi-Rad M. The relationship between use of complementary and alternative medicine and health literacy in chronically ill outpatient cases: a cross-sectional study in southeastern Iran. Front Public Health 2023; 11:988388. [PMID: 37181699 PMCID: PMC10173769 DOI: 10.3389/fpubh.2023.988388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 03/24/2023] [Indexed: 05/16/2023] Open
Abstract
Background Chronically ill outpatient cases use a variety of complementary and alternative medicines due to their diseases and therapeutic complications. Chronic condition, quality of life, and health literacy all affect the use of complementary medicine among chronically ill outpatient cases. Health literacy helps patients make fully informed decisions about the use of complementary and alternative medicine. This study aimed to investigate the relationship between complementary and alternative medicine and health literacy in chronically ill outpatient cases. Method This cross-sectional analytical-descriptive study was conducted on 400 chronically ill outpatient cases referred to medical centers affiliated to Kerman University of Medical Sciences. Convenience sampling was used. Research tools included the complementary and alternative medicine questionnaire and the health literacy questionnaire. SPSS25 was used to analyze data. Results The mean use of complementary and alternative medicine in a recent year was 16.75 ± 7.89, which was lower than the mid-point of the questionnaire (84). Prayer, medicinal plants, vitamin supplements, music therapy, and art therapy were the mostly used complementary and alternative medicine methods. The most common reasons for using complementary medicine were to reduce physical complications and improve anxiety and stress. The mean satisfaction with the use of complementary and alternative medicine was 34.96 ± 6.69. The mean health literacy score was 67.13 ± 19.90. Decision-making and the use of health information had the highest mean score among the dimensions of health literacy, whereas reading skills received the lowest mean score. We found a significant and direct relationship between the use of complementary and alternative medicine, health literacy, and all its dimensions. Conclusion The study results showed that health literacy predicted the use of complementary and alternative medicine. Health education and promotion programs may be useful for improvement of health literacy in the community.
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Affiliation(s)
- Mahlagha Dehghan
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
- *Correspondence: Mahlagha Dehghan, ;
| | - Mahla Mohebi Rad
- Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Leyla Ahmadi Lari
- Department of Anesthesiology, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
| | - Behnam Ghorbani-nejad
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Milad Mohebi-Rad
- School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Jaafar Z, Ayoub J, Hamadeh R, Baydoun S, Honein-AbouHaidar G, Banna J, Alameddine M, Naja F. A triangulated perspective for understanding CAM use in Lebanon: a qualitative study. BMC Complement Med Ther 2022; 22:204. [PMID: 35918687 PMCID: PMC9347103 DOI: 10.1186/s12906-022-03685-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
Background Existing evidence marked a prevalent use of Complementary and Alternative Medicine (CAM) therapies in Lebanon that is concomitant with low rates of disclosure to health care providers and limited knowledge among the general public of safety and side effects of CAM use. Objectives To examine the perspectives of Lebanese CAM users, CAM providers, and health care providers (HCPs) regarding their understanding of CAM and of the Push and Pull factors that drive its use. Methods A qualitative research study was conducted using in-depth interviews, targeting Lebanese adults (CAM users; 18-65 years) (n=14), CAM providers such as yoga instructors, owners of CAM product outlets, herbalists, and religious figures (n=13); and HCPs including physicians, nurses, dietitians, and pharmacists (n=14). The topic guide covered, in addition to the understanding of CAM, the Push and Pull factors driving CAM use. The adults were recruited by convenient sampling, and CAM providers and HCPs using a purposive sampling approach. Interviews were audiotaped, transcribed, and translated into English. Analysis was performed using a qualitative thematic approach. Similarities and differences in the perceptions of the participants with regards to factors that influence CAM use were charted and contrasted, using a triangulated approach. Results The three study groups exhibited a similar understanding of CAM, referring to non-conventional therapies used to prevent/treat diseases or to enhance wellbeing. CAM users and CAM providers identified “distrust in HCPs”, “lack of patient-centered care in CM”, and “limitations and side effects of CM” as important Push factors. All study groups highlighted the limited CAM knowledge of HCPs as a main reason for the lack of patient-centered care. All three groups also underscored the affordability and the social and cultural support for CAM as main enablers of its prevalent use. Unlike HCPs who were skeptical about the safety and effectiveness of CAM, CAM users and CAM providers indicated that most of CAM therapies are safe and efficient. Conclusions The triangulation of perspectives (CAM users, CAM providers, and HCPs) in this study allowed a comprehensive appraisal of CAM use and its drivers. Improving the HCPs’ CAM-related knowledge, promoting patient-centered care and fostering an open dialogue between HCPs and CAM providers are among the recommendations of the study. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03685-z.
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Kim D, Sung SH, Shin S, Park M. The effect of cancer on traditional, complementary and alternative medicine utilization in Korea: a fixed effect analysis using Korea Health Panel data. BMC Complement Med Ther 2022; 22:137. [PMID: 35585580 PMCID: PMC9118572 DOI: 10.1186/s12906-022-03614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer-related incidence and mortality rates are rapidly increasing worldwide. However, no studies have examined the effect of cancer as a single factor on the use of traditional, complementary, and alternative medicine (T&CAM). We aimed to determine the effect of cancer occurrence on T&CAM utilization using Korea Health Panel (KHP) data. METHODS We analyzed longitudinal data (49,380 observations) derived from 12,975 Korean adult participants with complete KHP data from 2011 to 2014 and 2016, and divided them into two groups based on cancer diagnosis. A panel multinomial logit model was used to assess whether the participants used T&CAM or conventional medicine or both in outpatient settings. Additionally, a negative binomial regression model was used to examine the effect of cancer on the number of outpatient visits for T&CAM. RESULTS In total, 25.54% of the study participants in the cancer group used T&CAM, which was higher than that in the non-cancer group (18.37%, p < 0.0001). A panel multinomial logistic regression analysis using KHP data showed that cancer occurrence was significantly more likely to be associated with 'Using both Korean medicine and conventional medicine' (Coef. = 0.80, p = 0.017) and 'Not using Korean medicine but using conventional medicine' (Coef. = 0.85, p = 0.008) than 'Not using Korean medicine and conventional medicine.' A panel negative binomial regression showed a significant effect of cancer on increasing the number of T&CAM outpatient visits (Coef. = 0.11, p = 0.040). CONCLUSIONS Our findings showed that cancer occurrence within an individual led to the simultaneous use of conventional medicine and T&CAM. In addition, the occurrence of cancer significantly increased the number of T&CAM outpatient visits among participants already using T&CAM. It was also found that T&CAM has been utilized more often by the most vulnerable people, such as medical beneficiaries and those with a low level of education.
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Affiliation(s)
- Dongsu Kim
- College of Oriental Medicine, Dongshin University, Naju, Jeollanam-do, 58245, South Korea
| | - Soo-Hyun Sung
- Department of Policy Development, National Institute of Korean Medicine Development, Junggu, Seoul, 04561, South Korea
| | - Seungwon Shin
- National Agency for Korean Medicine Innovative Technologies Development, National Institute of Korean Medicine Development, Junggu, Seoul, 04561, South Korea
| | - Minjung Park
- National Agency for Korean Medicine Innovative Technologies Development, National Institute of Korean Medicine Development, Junggu, Seoul, 04561, South Korea.
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Nur S, Aisyah AN, Lukitaningsih E, Rumiyati R, Fadri A, Marwati M. Cytotoxic Effect of the Paku Atai Merah (Angiopteris ferox Copel) Fraction on MCF-7 and HeLa Cells and its Compound Profile by GC-MS. BORNEO JOURNAL OF PHARMACY 2022. [DOI: 10.33084/bjop.v5i1.2943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cancer is a condition of abnormal cell proliferation of tissue cells in the body that becomes malignant. It can attack other parts of the body and affect the normal function of the body organs. The sample used in this study was tubers of paku atai merah (Angiopteris ferox Copel), then extracted using 96% ethanol eluent to obtain a thick extract. The ethanolic extract of A. ferox was fractionated using column chromatography to get the active fraction to characterize the compound using thin-layer chromatography and gas chromatography-mass spectroscopy (GC-MS) and tested its cytotoxic effectiveness on MCF-7 and HeLa cancer cells. The results of this study were obtained from fractionation using the column chromatography method to get sub-fraction C and the results of compound characterization using GC-MS and obtained variations in the class of compounds contained in the sample: amino acids, glucosinolates, alkaloids, flavonoids, and terpenoids. Based on the cytotoxic effect test of sub-fraction C on MCF-7 cells, the results obtained moderate cytotoxic effects with an IC50 value of 61.027 µg/mL, and HeLa cells had an IC50 value of 521.03 µg/mL, which was categorized as having a weak cytotoxic effect. Based on the results obtained from this study, it can be concluded that sub-fraction C of A. ferox tubers has a cytotoxic effect on MCF-7 cells to be used as a reference for tracing pure compounds from A. ferox tuber.
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Ho EY, Bylund CL, Wollney E, Peterson EB, Wong HN, Koenig CJ. A systematic review of communication about Complementary and Integrative Health (CIH) in global biomedical settings. PATIENT EDUCATION AND COUNSELING 2021; 104:2900-2911. [PMID: 34030929 DOI: 10.1016/j.pec.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES A systematic review to analyze communication rates of complementary and integrative health (CIH) and analyze how communication terms, such as "disclosure," are measured and operationalized. METHODS We searched seven databases for studies published between 2010 and 2018 with quantitative measurements of patients' communication of CIH to a biomedical clinician. We analyzed communication terms used to describe patients reporting CIH usage. We also examined the conceptual and operational definitions of CIH provided and whether those terms were explicitly operationalized. We aggregated the percentage, rate, or ratio of CIH users that communicated about CIH with their clinicians by disease type and geographical region. RESULTS 7882 studies were screened and 89 included in the review. Studies used a wide range of conceptual and operational definitions for CIH, as well as 23 different terms to report communication related to reporting CIH usage. Usage varied by disease type and geographical region. CONCLUSIONS Studies of CIH and CIH communication may measure different kinds of social and communicative phenomena, which makes comparison across international studies challenging. PRACTICE IMPLICATIONS Future studies should employ standardized, replicable measures for defining CIH and for reporting CIH communication. Clinicians can incorporate questions about prior, current, and future CIH use during the medical visit.
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Affiliation(s)
- Evelyn Y Ho
- Department of Communication Studies, University of San Francisco, San Francisco, USA; Asian American Research Center on Health, San Francisco, USA.
| | - Carma L Bylund
- College of Journalism and Communications, University of Florida, Gainesville, USA
| | - Easton Wollney
- College of Journalism and Communications, University of Florida, Gainesville, USA
| | - Emily B Peterson
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, USA
| | - Hong-Nei Wong
- Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, Stanford, Palo Alto, USA
| | - Christopher J Koenig
- Department of Communication Studies, San Francisco State University, San Francisco, USA; Medical Cultures Lab, University of California, San Francisco, San Francisco, USA
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Illahi AN, Hendrati LY. Alternative Medicine-Seeking Behavior among Cancer Patients at The Indonesian Cancer Foundation. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i32021.284-292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: A large proportion of cancer deaths are caused by patient delay in accessing hospital treatment. One of the causes of such delays is the use of alternative medicine. Purpose: This research is conducted to determine the characteristics and factors related to the behavior of seeking treatment in the form of alternative medicine among cancer patients at the Indonesian Cancer Foundation (Yayasan Kanker Indonesia). Methods: This research is a quantitative descriptive research with a cross-sectional study design. The target of the research is all patients who temporarily stayed at the Yayasan Kanker Indonesia from February–April 2020, a total of 45 patients aged ≥ 17 years who had been diagnosed with cancer. The data was obtained via questionnaires and interviews. The variables examined are the predisposition factors (sex, age, education, occupation, stage of cancer, time ranges for accessing health services after symptom onset, prior illness, family history), enabling factors (distance to health services, income, health insurance), and reinforcing factors (family support and information resources). Analysis of research data was conducted using frequency tables and Chi-Square or Fisher's Exact test. Results: The factors related to the behavior of seeking treatment via alternative medicine in cancer patients at Yayasan Kanker Indonesia are the stage of cancer (p=0.04), the time span between symptom onset and checking into health services (p=0.02), and length of illness (p=0.03). Conclusion: Alternative treatment search behavior is influenced by several factors, namely the stage of cancer, the time span between symptom onset and checking into health services, and the length of illness.
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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9963038. [PMID: 34055029 PMCID: PMC8149249 DOI: 10.1155/2021/9963038] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 05/08/2021] [Indexed: 12/24/2022]
Abstract
Background Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.
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Hijazi MA, Shatila H, Omeich Z, El-Lakany A, Ela MA, Naja F. The role of pharmacists in complementary and alternative medicine in Lebanon: users' perspectives. BMC Complement Med Ther 2021; 21:81. [PMID: 33691698 PMCID: PMC7944898 DOI: 10.1186/s12906-021-03256-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Customers’ expectations and satisfaction are critical to ensure a more effective role of the community pharmacists in promoting the safe use of Complementary and Alternative Medicine (CAM). The aim of this study is to examine the perceptions and practices of customers buying their CAM products from pharmacies and explore their satisfaction with CAM-related services offered by the community pharmacists in Lebanon. Methods A national cross-sectional study was conducted among users of CAM (age > =18 years) who obtained their CAM from community pharmacies in Lebanon (n = 832). Within the proximity of the pharmacy, subjects were invited to complete a multi-component questionnaire. The latter consisted of four sections related to CAM: general beliefs, perception of pharmacists’ role, practices, satisfaction with services offered by the pharmacists. In addition, the questionnaire included questions about sociodemographic characteristics of participants. Results The majority of participants agreed to an active role of the pharmacists’ in guiding CAM use, however over half of the participants (61.3%) did not agree that the pharmacist is more knowledgeable in this field than other healthcare providers. As for practices, one in two surveyed customers (47%) did not always give feedback to their pharmacists about the outcomes after using CAM, 20% did not often ask the pharmacists about the safe and effective mode of use of the products and 28.1% did not discuss their medical history. For services offered by the pharmacist, the majority of participants reported receiving good education about the CAM product (87.1%), its side effects (87.1%) and mode of use (93.4%), while significant proportions of participants reported that pharmacists were not asking questions about their medical history before dispensing CAM products (22%) nor were they providing information on CAM-drug interactions (30%). Conclusions The results of this study highlighted important gaps between the perceptions of customers and the services they received from the pharmacists about CAM use. These findings could be used by concerned stakeholders, including public health authorities and educational bodies, to develop evidence-based interventions aimed at promoting the role of pharmacists in ensuring a safe and effective CAM use Lebanon. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03256-8.
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Affiliation(s)
- Mohamad Ali Hijazi
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Hibeh Shatila
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Zeina Omeich
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Abdalla El-Lakany
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Maha Aboul Ela
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates. .,Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
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The Effect of Art Therapy and Music Therapy on Breast Cancer Patients: What We Know and What We Need to Find Out—A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020. [DOI: 10.1155/2020/7390321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective. To systematically review the evidence available on the effects of art therapy and music therapy interventions in patients with breast cancer.Design. Systematic search was conducted in PubMed, EBSCO, and Cochrane Central databases. Articles were scanned using the following keywords: “art therapy” or “music therapy” and “breast cancer” or “breast neoplasms,” “breast carcinoma,” “breast tumor,” and “mammary cancer.” Only RCTs published in English, with a control group and experimental group, and presenting pre-/post-therapy results were included. PRISMA guidelines for this systematic review were followed.Results. Twenty randomized controlled trials matched the eligibility criteria. Nine studies evaluated the effect of art therapy, and eleven evaluated the effect of music therapy. Improvements were measured in stress, anxiety, depression reduction, pain, fatigue, or other cancer-related somatic symptoms’ management. Overall, the results show that art therapy was oriented towards the effects on quality of life and emotional symptoms while music therapy is the most often applied for anxiety reduction purposes during or before surgeries or chemotherapy sessions.Conclusion. Art and music therapies show effective opportunities for breast cancer patients to reduce negative emotional state and improve the quality of life and seem to be promising nonmedicated treatment options in breast oncology. However, more detailed and highly descriptive single therapy and primary mental health outcome measuring RCTs are necessary to draw an evidence-based advise for the use of art and music therapies.
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Shawahna R, Abdelhaq I. Important knowledge items with regard to the benefits of exercise for patients with epilepsy: Findings of a qualitative study from Palestine. Epilepsy Behav 2020; 108:107099. [PMID: 32335502 DOI: 10.1016/j.yebeh.2020.107099] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/07/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Physicians and complementary alternative medicine (CAM) specialists are not formally educated/trained on the benefits of exercises for people living with epilepsy (PWE). This study was performed to develop a consensus-based knowledge items on the benefits of exercises for PWE that physicians and CAM specialists need to know. METHODS Knowledge items were collected after an extensive review of the scientific literature and from in-depth interviews with key contacts in the domain (6 primary healthcare providers, 4 neurologists, 4 exercise and medicine specialists, 4 CAM practitioners, 4 researchers who did studies on the benefits of exercise for PWE, and 4 PWE). Items collected were reviewed by 12 researchers who did studies on exercise for PWE. A Delphi technique was followed among a panel of 50 members to develop the consensus-based core list. RESULTS The final consensus-based core list contained 64 items that were grouped into the following categories: 1) general items recommending exercise for PWE, 2) benefits of exercise on prevention of seizures, 3) benefits of exercise on antiepileptic therapy, 4) benefits of exercise in preventing comorbidities associated with epilepsy, 5) benefits of exercise in improving quality of life of PWE, and 6) psychosocial benefits of exercise for PWE. CONCLUSION This consensus-based core list might guide educators, trainers, or authorities while designing educational or training courses to increase knowledge of physicians in primary healthcare and CAM specialists with regard to the benefits of exercise for PWE. Further investigations are needed to determine if such consensus-based core list might improve care and wellbeing of PWE.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Imad Abdelhaq
- Department of Physical Education, Faculty of Educational Sciences and Teachers' Training, An-Najah National University, Nablus, Palestine
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Ng JY, Nault H, Nazir Z. Complementary and integrative medicine mention and recommendations: A systematic review and quality assessment of lung cancer clinical practice guidelines. Integr Med Res 2020; 10:100452. [PMID: 32904205 PMCID: PMC7452189 DOI: 10.1016/j.imr.2020.100452] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/28/2020] [Accepted: 06/11/2020] [Indexed: 02/06/2023] Open
Abstract
Background Complementary and integrative medicine (CIM) use is widely sought by those diagnosed with cancer, with up to 50% of lung cancer patients seeking these therapies in the United States. The purpose of this study was to identify the quantity and assess the quality of CIM recommendations in clinical practice guidelines (CPGs) for the treatment and/or management of lung cancer. Methods A systematic review was conducted to identify lung cancer CPGs. MEDLINE, EMBASE and CINAHL were searched from 2008 to 2018, along with the Guidelines International Network and the National Center for Complementary and Integrative Health websites. Eligible guidelines containing recommendations for the treatment and/or management of lung cancer were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Results From 589 unique search results, 4 guidelines mentioned CIM, of which 3 guidelines made CIM recommendations. Scaled domain percentages from highest to lowest were: scope and purpose (82.4% overall, 76.9% CIM), clarity and presentation (96.3% overall, 63.0% CIM), editorial independence (61.1% overall, 61.1% CIM), rigour of development (62.5% overall, 54.9% CIM), stakeholder involvement (66.7% overall, 42.6% CIM) and applicability (29.9% overall, 18.8% CIM). Quality varied within and across guidelines. Conclusion Guidelines that scored well could serve as a framework for discussion between patients and healthcare professionals regarding use of CIM therapies in the context of lung cancer. Guidelines that scored lower could be improved according to the AGREE II instrument, with insight from other guidelines development resources.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Hayley Nault
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Zainib Nazir
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Yeh MH, Wu HC, Lin NW, Hsieh JJ, Yeh JW, Chiu HP, Wu MC, Tsai TY, Yeh CC, Li TM. Long-term use of combined conventional medicine and Chinese herbal medicine decreases the mortality risk of patients with lung cancer. Complement Ther Med 2020; 52:102427. [PMID: 32951705 DOI: 10.1016/j.ctim.2020.102427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/21/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We explored the effect of Chinese herbal medicine (CHM) on the long-term survival of lung cancer patients and hazard ratio (HR) and to analyse CHM herbs and formulas for lung cancer treatment. METHODS We conducted a retrospective cohort study on diagnosed lung cancer patients in 2003-2016 from Taipei and Dalin Tzu Chi General Hospital Cancer Registry Database and from outpatient database from Chinese Medicine and Conventional Medicine Department. We categorised the patients into CHM user and CHM nonuser groups according to the CHM consumption time. After passing the proportional hazard assumption, we used the Cox PH model to calculate the groups' survival hazard ratio (HR) and examine the statistical difference and effect of CHM on lung cancer survival. RESULTS We classified 2557 lung cancer patients into 1643 CHM nonusers and 228 CHM users. The CHM users had lower mortality than the CHM nonusers. With the multivariable Cox model, we observed that the CHM use was associated with 35% lower risk of mortality (adjusted HR: 0.65; 95% confidence interval: 0.51-0.76). Continuous CHM use of >180 days may further lessen the mortality risk by 64%. Finally, eight herbs and two formulas could significantly lower the mortality. After pairing the eight herbs for analysis, seven combinations could reduce the mortality better than only using one herb. CONCLUSION CHM users had significantly lower mortality than CHM nonusers. The longer the CHM use, the more the mortality HR declined. Glehnia littoralisF. Schmidt ex Miq., Polyporus umbellatus(Pers.) Fries and Trichosanthes kirilowii Maxim. possess a highly substantial anticancer activity compared with other herbs.
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Affiliation(s)
- Ming-Hsien Yeh
- Graduate Institute of Chinese Medicine, China Medical University, Taichung City, 40402, Taiwan; Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, 62247, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien City, Hualien, 97004, Taiwan
| | - Hsien-Chang Wu
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, 23142, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien City, Hualien, 97004, Taiwan
| | - Nai-Wei Lin
- Department of Computer Science and Information Engineering, National Chung Cheng University, Minxiong, Chiayi, 621, Taiwan
| | - Jin-Jian Hsieh
- Department of Mathematics, National Chung Cheng University, Minxiong, Chiayi, 621, Taiwan
| | - Jin-Wen Yeh
- Department of Computer Science and Information Engineering, National Chung Cheng University, Minxiong, Chiayi, 621, Taiwan
| | - Hung-Pin Chiu
- Department of Information Management, Nanhua University, Dalin, Chiayi, 62249, Taiwan
| | - Mei-Chun Wu
- Department of Information Management, Nanhua University, Dalin, Chiayi, 62249, Taiwan
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan; Department of Medical Research, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan; Department of Nursing, Tzu Chi University of Science and Technology, 880 Chien-Kuo Road Section 2, Hualien, 62247, Taiwan.
| | - Chia-Chou Yeh
- Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, 62247, Taiwan; Department of Medical Research, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien City, Hualien, 97004, Taiwan.
| | - Te-Mao Li
- Graduate Institute of Chinese Medicine, China Medical University, Taichung City, 40402, Taiwan.
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What Do Primary Healthcare Providers and Complementary and Alternative Medicine Practitioners in Palestine Need to Know about Exercise for Cancer Patients and Survivors: A Consensual Study Using the Delphi Technique. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7695818. [PMID: 31118968 PMCID: PMC6500610 DOI: 10.1155/2019/7695818] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/22/2019] [Accepted: 04/14/2019] [Indexed: 12/24/2022]
Abstract
Background Exercise has physiologic and psychological benefits for cancer patients and survivors. Today, various exercises are recommended as adjunct to therapies for cancer patients and survivors. This study was conducted to develop a consensual core list of important knowledge items that primary healthcare providers and complementary and alternative medicine (CAM) practitioners need to know on the role of exercises and physical activities in stimulating anticancer immunity. Methods Knowledge items were collected following interviews with key contact experts (4 oncologists, 3 exercise and medicine specialists, 2 researchers, 2 cancer patients, and 3 survivors) and extensive literature review. The collected knowledge items were rated by 9 researchers who conducted research on exercise and cancer. A modified two-iterative Delphi technique was employed among a panel (n = 65) of healthcare providers and CAM practitioners to develop the consensual core list of knowledge items. Results Of the 49 knowledge items, consensus was achieved on 45 (91.8%) items in 6 categories. Of those, 9 (20.0%) were general items on recommending moderate to vigorous habitual exercises and physical activities. The rest of items were related to the effects of habitual exercises and physical activities on the functions of immune system and exposure to carcinogens 16 (35.6%), anticancer therapies 12 (26.7%), metastasis of cancer 3 (6.7%), metabolism within tumors 3 (6.7%), and myokines release 2 (4.4%). Conclusion Formal consensus was achieved for the first time on a core list of knowledge items on how exercises and physical activities might stimulate anticancer immunity. This core list might be considered at the time of developing training/educational interventions and/or continuing education for primary healthcare providers and CAM practitioners. Future studies are still needed to investigate if such consensual lists might improve congruence in cancer care continuum and improve survival rates and wellbeing of cancer patients and survivors.
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Hijazi MA, Shatila H, El-Lakany A, Aboul Ela M, Kharroubi S, Alameddine M, Naja F. Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon. BMJ Open 2019; 9:e025074. [PMID: 30852542 PMCID: PMC6429928 DOI: 10.1136/bmjopen-2018-025074] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Pharmacists are uniquely positioned to provide patients with evidence-based information in order to ensure effective and safe use of Complementary and alternative medicine (CAM) products. OBJECTIVE Assess beliefs, practices and knowledge related to CAM products among community pharmacists in Lebanon. DESIGN, METHODS AND SETTING Using stratified random sampling, a nationally representative survey was conducted among community pharmacists in Lebanon. Through face-to-face interviews, pharmacists completed a multicomponent questionnaire consisting of four sections: (1) sociodemographic characteristics; (2) beliefs related to regulation of CAM products, role of media in promoting their safe use, availability of resources and continuing education; (3) practices including selling CAM products, providing advice for patients and reporting adverse effects and (4) knowledge about specific CAM products, their uses, side effects and interactions. RESULTS A total of 341 pharmacists agreed to participate (response rate: 86%). Only pharmacists with complete data were included in this study (n=310). Pharmacists agreed that CAM products are effective (63.8%) and that they should be exclusively sold in pharmacies (80.3%), but disagreed that commercially marketed CAM products are well regulated (63.5%) and that media plays a positive role in educating users about these products (55.8%). As for practices, 64.5% of pharmacists were always or often advising patients on safe use; however, 74.2% of participants rarely or never reported adverse effects. Regarding knowledge, although the majority of pharmacists were aware of the uses of CAM products, fewer knew about their side effects and their interactions with drugs. After adjustment for covariates, receiving education/training on CAM products during university was the sole predictor of higher knowledge score (ß=0.68, 95% CI 0.29 to 1.07). CONCLUSIONS This study revealed positive beliefs of pharmacists in Lebanon towards CAM products and indicated important gaps in their practice and knowledge. Deliberate efforts to enhance the education of pharmacists are warranted to ensure the safe integration and use of CAM products in Lebanon.
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Affiliation(s)
- Mohamad Ali Hijazi
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Hibeh Shatila
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Abdalla El-Lakany
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Maha Aboul Ela
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohamad Alameddine
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Strategy & Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences College of Medicine, Dubai, Dubai, United Arab Emirates
| | - Farah Naja
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
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