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Goel AR, Henderson CR, Reid MC. Do Palliative Care Providers Use Complementary and Integrative Medicine? A Nationwide Survey. J Pain Symptom Manage 2022; 63:599-609. [PMID: 34788656 PMCID: PMC9121789 DOI: 10.1016/j.jpainsymman.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 11/20/2022]
Abstract
CONTEXT Given the high prevalence of burdensome symptoms in palliative care (PC) and increasing use of complementary and integrative medicine (CIM) therapies, research is needed to determine how often and what types of CIM therapies providers recommend to manage symptoms in PC. OBJECTIVES To document recommendation rates of CIM for target symptoms and assess if, CIM use varies by provider characteristics. METHODS Nationwide survey's of physicians (MD and DO), physician assistants, and nurse practitioners in PC. RESULTS Participants (N = 404) were mostly female (71.3%), physicians (74.9%), and cared for adults (90.4%). Providers recommended CIM an average of 6.82 times per-month (95% CI: 6.04-7.60) and used an average of 5.13 (95% CI: 4.90-5.36) out of 10 CIM modalities. Respondents recommended mind-body medicines (e.g., meditation, biofeedback) most, followed by massage, and acupuncture and/or acupressure. The most targeted symptoms included pain; followed by anxiety, mood disturbance, and distress. Recommendation frequencies for specific modality-for-symptom combinations ranged from little use (e.g., aromatherapy for constipation) to occasional use (e.g., mind-body interventions for psychiatric symptoms). Finally, recommendation rates increased as a function of pediatric practice, noninpatient practice setting, provider age, and proportion of effort spent delivering palliative care. CONCLUSION To the best of our knowledge, this is the first national survey to characterize PC providers' CIM recommendation behaviors and assess specific therapies and common target symptoms. Providers recommended a broad range of CIM but do so less frequently than patients report using CIM. These findings should be of interest to any provider caring for patients with serious illness.
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Affiliation(s)
- Anurag Ratan Goel
- Departments of Medicine and Pediatrics (A.R.G.), Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Charles R Henderson
- Department of Human Development (C.R.H.), Cornell University, Ithaca, New York, USA
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Phutrakool P, Pongpirul K. Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis. Syst Rev 2022; 11:10. [PMID: 35027078 PMCID: PMC8759198 DOI: 10.1186/s13643-021-01882-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 12/27/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. METHODS We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. RESULTS Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42-62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37-54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. CONCLUSION Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019125628.
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Affiliation(s)
- Phanupong Phutrakool
- School of Global Health and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Patumwan, Bangkok, 10330, Thailand
| | - Krit Pongpirul
- School of Global Health and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Patumwan, Bangkok, 10330, Thailand. .,Department of International Health and Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,Bumrungrad International Hospital, Bangkok, Thailand.
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Handayani K, Susilawati D, Sutaryo, Mulatsih S, Kaspers GJL, Mostert S, Sitaresmi M. Health-care providers’ perception and communication about traditional and complementary medicine in childhood cancer in Indonesia. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2022. [DOI: 10.1016/j.phoj.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Michlig JR, Stelter AJ, Czarnecki ML, Norton A, Korom N, Hainsworth K. Pediatric healthcare professionals' perceptions, knowledge, and use of essential oils. Complement Ther Clin Pract 2021; 45:101474. [PMID: 34388559 DOI: 10.1016/j.ctcp.2021.101474] [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: 12/15/2020] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Complementary and Integrative Medicines (CIM) are widely used by adults and children. Despite this, studies have shown that Healthcare Professionals' (HCPs) views about CIM vary. Because underlying knowledge, perceptions and biases may influence HCPs' acceptance of a new aromatherapy program, the investigators sought to assess HCPs' views regarding aromatherapy before implementing an aromatherapy program in a pediatric hospital. DESIGNS AND MEASURES A convenience sample of HCPs at an academic pediatric hospital in the United States completed an investigator developed online questionnaire about their perceptions, knowledge, and use of essential oils. RESULTS The sample included 987 respondents, of which: 62.0% were nurses. Overall, 94.2% of HCPs indicated that they "rarely, never, or seldomly" discussed essential oil use with patients. Most indicated a willingness to incorporate essential oils into their patient care with appropriate education. Furthermore, 47.4% of HCPs reported positive views about the use of essential oils, 4.9% reported negative views and opinions, and 45% raised specific concerns about safety, education and/or evidence. CONCLUSION Overall, this study suggests that HCPs have limited knowledge regarding essential oils, are open to learning more about them, and would like more evidence specifically regarding the efficacy and safety of using essential oils in pediatrics. Additionally, most HCPs are not currently discussing essential oils with pediatric patients. However, they are open to incorporating them into their patients' care if they receive proper education, and are open to our organization implementing an aromatherapy program if appropriate education and safety measures are provided.
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Affiliation(s)
- Johanna R Michlig
- Children's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, 53226, USA; Medical College of Wisconsin, 8701 W Watertown Plank Rd, Wauwatosa, WI, 53226, USA.
| | - Ashley J Stelter
- Children's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, 53226, USA
| | | | - Anita Norton
- Children's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, 53226, USA
| | - Nancy Korom
- Children's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, 53226, USA
| | - Keri Hainsworth
- Children's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, 53226, USA; Medical College of Wisconsin, 8701 W Watertown Plank Rd, Wauwatosa, WI, 53226, USA
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Fetz K, Längler A, Schwermer M, Carvalho-Hilje C, Vagedes J, Zuzak TJ, Ostermann T. Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments. BMC Health Serv Res 2020; 20:939. [PMID: 33046108 PMCID: PMC7552368 DOI: 10.1186/s12913-020-05782-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients' health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic Medicine (AM) is an IM approach frequently used in children in Germany. From both public health and health economic perspectives, it is relevant to investigate whether there are differences in the resource utilization between integrative pediatric departments (IPD) and the entirety of all pediatric departments. METHODS Standard ward documentation data from all German integrative anthroposophic pediatric departments (2005-2016; N = 29,956) is investigated and systematically compared to data of the entirety of all pediatric departments in Germany derived from the Institute for the Hospital Reimbursement System (2005-2016, N = 8,645,173). The analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major Diagnosis Categories (MDC), and effective Case Mix Index (CMI). RESULTS The length of stay in the IPD (M = 5.38 ± 7.31) was significantly shorter than the DRG defined length of stay (M = 5.8 ± 4.71; p < .001; d = - 0.07) and did not exceed or undercut the DRG covered length of stay. Compared to the entirety of all pediatric departments (M = 4.74 ± 6.23) the length of stay was significantly longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC differed between IPD and all pediatric departments, with higher frequencies of DRGs and MDCs associated with chronic and severe illnesses in the IPD. CONCLUSIONS Treatment within integrative anthroposophic pediatric departments fits well in terms of the DRG defined conditions concerning length of stay, even though integrative pediatric patients has an increased length of stay of averagely 1 day, which is most likely associated to time consuming, complex integrative treatment approaches and to a certain extend to higher amount of chronic and severe diseases.
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Affiliation(s)
- Katharina Fetz
- Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Melanie Schwermer
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Clara Carvalho-Hilje
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Jan Vagedes
- ARCIM Academic Research in Complementary and Integrative Medicine, Filderstadt, Germany.,Department of Neonatology, University Hospital Tuebingen, Calwerstraße 7, 72076, Tübingen, Germany
| | - Tycho Jan Zuzak
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Department of Pediatric Oncology and Hematology, University Hospital Essen, Hufelandstr.55, 45147, Essen, Germany
| | - Thomas Ostermann
- Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
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Communication about Traditional Complementary and Alternative Medicine (TCAM) in childhood cancer: A comparison between Dutch and Indonesian health-care providers at academic hospitals. ADVANCES IN INTEGRATIVE MEDICINE 2020. [DOI: 10.1016/j.aimed.2019.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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7
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Fetz K, Ostermann T, Schwermer M, Appelbaum S, Vagedes J, Zuzak TJ, Längler A. Do patients of integrative anthroposophic pediatric inpatient departments differ? Comparative analysis to all pediatric inpatients in Germany considering demographic and clinical characteristics. BMC Public Health 2019; 19:1623. [PMID: 31795983 PMCID: PMC6889203 DOI: 10.1186/s12889-019-7972-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/19/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Integrative medicine (IM) is a patient-centered, evidence-based, therapeutic paradigm which combines conventional and complementary approaches. The use of IM in pediatrics has increased in the past two decades and parents' demand for it is growing. An IM whole systems approach is anthroposophic medicine. Considering the growing demand for integrative approaches in children, it is relevant from a public health perspective to find out which kind of children use IM in Germany and whether they differ from the entirety of pediatric inpatients in Germany. Moreover, it would be interesting to known, whether these patients are willing to travel a longer distance to gain integrative treatment. METHODS The present study investigates the standard ward documentation datasets of 29,956 patients of all German integrative anthroposophic pediatric inpatient wards from 2005 to 2016 and compares them systematically to collect data of the entirety of all pediatric inpatient wards in Germany. Apart from patients' age and gender, and the ICD-10 admission diagnoses, the geographical catchment area of the hospitals were analyzed. RESULTS Sociodemographic characteristics of pediatric inpatients in the integrative anthroposophic departments (IAH) did not differ from the entirety of all pediatric inpatients. Regarding clinical characteristics, higher frequencies were found for endocrine, nutritional and metabolic diseases (IAH: 7.24% vs. 2.98%); mental, behavioral, and neurodevelopmental disorders (IAH: 9.83% vs. 3.78%) and nervous diseases (IAH: 8.82% vs. 5.16%) and lower frequencies for general pediatric diseases such as respiratory diseases (IAH: 17.06% vs. 19.83%), digestive diseases (IAH: 3.90% vs. 6.25%), and infectious and parasitic diseases (IAH: 12.88% vs. 14.82%) in comparison to the entirety of all pediatric inpatients in Germany. The IAH showed a broad catchment area, with most patients being from former, Western federal republic of Germany. Large catchment areas (> 100 km) for the IAH are merely covered by severe and chronic diseases. CONCLUSION Pediatric inpatients of IAH do not differ from the entirety of pediatric inpatients in Germany regarding sociodemographic characteristics but show differences regarding clinical characteristics. Parents are willing to travel further distance to get specialized integrative anthroposophic medical care for children with severe and chronic diseases.
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Affiliation(s)
- Katharina Fetz
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Melanie Schwermer
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
| | - Sebastian Appelbaum
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Jan Vagedes
- ARCIM Institute Academic Research in Complementary and Integrative Medicine, Filderstadt, Germany
- Department of Neonatology, University Hospital Tuebingen, Calwerstraße 7, 72076 Tübingen, Germany
| | - Tycho Jan Zuzak
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
- Department of Pediatric Oncology and Hematology, University Hospital Essen, Hufelandstr.55, 45147 Essen, Germany
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
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Stussman BJ, Nahin RR, Barnes PM, Ward BW. U.S. Physician Recommendations to Their Patients About the Use of Complementary Health Approaches. J Altern Complement Med 2019; 26:25-33. [PMID: 31763927 DOI: 10.1089/acm.2019.0303] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: There are no nationally representative studies using a probability sample that have been published examining whether physicians recommend complementary health approaches (CHAs) to their patients, as previous research has focused only on selected medical specialties or a particular U.S. region. This article fills a void in the current literature for robust data on recommendations for CHAs by office-based physicians in the United States. Design: Descriptive statistics and multivariable regression analyses of physician-level data were from the 2012 Physician Induction Interview of the National Ambulatory Medical Care Survey (NAMCS PII), a nationally representative survey of office-based physicians. Weighted response rate among eligible physicians sampled for the 2012 NAMCS PII was 59.7%. Setting/Location: United States. Outcome measures: Recommendations by physicians to their patients for any CHA, and individual CHAs: massage therapy, herbs/nonvitamin supplements, chiropractic/osteopathic manipulation, yoga, acupuncture, and mind-body therapies. Differences in recommendations by physician demographic characteristics were identified. Results: Massage therapy was the most commonly recommended CHA (30.4%), followed by chiropractic/osteopathic manipulation (27.1%), herbs/nonvitamin supplements (26.5%), yoga (25.6%), and acupuncture (22.4%). The most commonly recommended CHAs by general/family practice physicians were chiropractic/osteopathic manipulation (54.0%) and massage therapy (52.6%). Of all U.S. physicians, 53.1% recommended at least one CHA to patients during the previous 12 months. Multivariable analyses found physician's sex, race, specialty, and U.S. region to be significant predictors of CHA recommendations. Female physicians were more likely than male physicians to recommend massage therapy (adjusted odds ratio [aOR] = 1.76, 95% confidence interval [CI] = 1.40-2.20), herbs/nonvitamin supplements (aOR = 1.85, 95% CI = 1.46-2.35), yoga (aOR = 2.16, 95% CI = 1.70-2.75), acupuncture (aOR = 1.65, 95% CI = 1.27-2.13), and mind-body therapies (aOR = 2.63, 95% CI = 2.02-3.41) to patients. Psychiatrists (aOR = 0.13, 95% CI = 0.07-0.23), OB/GYNs (aOR = 0.38, 95% CI = 0.24-0.60), and pediatricians (aOR = 0.26, 95% CI = 0.18-0.38) were all less likely to recommend chiropractic/osteopathic manipulation than general and family practitioners. Conclusions: Overall, more than half of office-based physicians recommended at least one CHA to their patients. Female physicians recommended every individual CHA at a higher rate than male physicians except for chiropractic and osteopathic manipulation. These findings may enable consumers, physicians, and medical schools to better understand potential differences in use of CHAs with patients.
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Affiliation(s)
- Barbara J Stussman
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, Maryland
| | - Richard R Nahin
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, Maryland
| | | | - Brian W Ward
- National Center for Health Statistics, Hyattsville, Maryland
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Olbara G, Parigger J, Njuguna F, Skiles J, Sitaresmi MN, Gordijn S, van de Ven P, Kaspers G, Mostert S. Health-care providers' perspectives on traditional and complementary alternative medicine of childhood cancer in Kenya. Pediatr Blood Cancer 2018; 65:e27309. [PMID: 30051647 DOI: 10.1002/pbc.27309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 05/22/2018] [Accepted: 06/07/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Traditional and complementary alternative medicine (TCAM) use is rising globally. In many African countries, TCAM has been a way of life as the first and last resort remedy for many ailments, including cancer. Health-care providers (HCP) should address this need properly. This study explores HCP perspectives on TCAM in Kenya. METHODS This cross-sectional study used questionnaires. HCP involved in the care of children with cancer at a Kenyan academic hospital were interviewed. RESULTS In total, 155 HCP (response rate 79%) participated. Only 18% of HCP were positive about TCAM use. However, most HCP (85%) use TCAM themselves. More doctors (90%) than other HCP (56%) think that chemotherapy can cure cancer (P < 0.001).Thirty-three percent of HCP believe a combination of TCAM and chemotherapy is the best way to cure cancer, while 56% think that usefulness of TCAM is underestimated in conventional medicine. Self-prayer is regarded as most effective (58%) and safe (76%). Most harmful is witchcraft (80%). Most HCP (71%) think their knowledge about safety and efficacy of TCAM is inadequate. HCP think that their cancer patients use TCAM (97%) and that it is important that parents inform them about this (97%). However, only 5% of HCP always openly discuss TCAM with parents. CONCLUSIONS HCP need to improve their knowledge of TCAM and facilitate open communication about TCAM with families so parents feel safe to discuss their interest in it.
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Affiliation(s)
- Gilbert Olbara
- Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Josta Parigger
- Department of Pediatric Oncology-Hematology and Doctor 2 Doctor program, VU University Medical Center, Amsterdam, the Netherlands
| | - Festus Njuguna
- Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Jodi Skiles
- Department of Pediatrics, Division of Hemato-Oncology, Indiana University School of Medicine, Indianapolis
| | | | - Suzanne Gordijn
- Department of Pediatric Oncology-Hematology and Doctor 2 Doctor program, VU University Medical Center, Amsterdam, the Netherlands
| | - Peter van de Ven
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Gertjan Kaspers
- Department of Pediatric Oncology-Hematology and Doctor 2 Doctor program, VU University Medical Center, Amsterdam, the Netherlands
| | - Saskia Mostert
- Department of Pediatric Oncology-Hematology and Doctor 2 Doctor program, VU University Medical Center, Amsterdam, the Netherlands
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When, why, and how osteopaths and physicians communicate: Lessons learned from the results of a mixed methods study. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2017.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Morin C, Desrosiers J, Gaboury I. Descriptive study of interprofessional collaboration between physicians and osteopaths for the pediatric population in Quebec, Canada. BMC Health Serv Res 2017; 17:726. [PMID: 29137632 PMCID: PMC5686955 DOI: 10.1186/s12913-017-2717-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 11/09/2017] [Indexed: 11/10/2022] Open
Abstract
Background Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC) between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients. Methods A self-administered questionnaire was sent to osteopaths, family physicians, and pediatricians involved with pediatric patients in the province of Quebec. The postal questionnaire captured general knowledge about osteopathy and its practice parameters and role, sources of information, communication aspects including having a professional relationship and referrals, and influence of the upcoming government regulation. Quantitative data from the questionnaires were analyzed using descriptive statistics. Logistic regression model for factors associated with osteopathic referrals and multiple linear regression analyses for the number of correct answers about general osteopathic practice parameters were performed. Results A total of 274 physicians (155 family physicians (response rate 13%) and 119 pediatricians (17%)) and 297 osteopaths (42%) completed the survey. According to physicians, osteopathy was most appropriate for musculoskeletal pain (241; 91%) and plagiocephaly (235; 88%). Osteopathic referral was positively associated with having a professional relationship (odds ratio [OR] 4.10 (95% confidence interval [CI] 2.12; 7.95), p < 0.001), personal consultation (OR 2.58 (95% CI 1.35; 4.93), p = 0.004), community-based practice (OR 1.89 (95% CI 1.03; 3.47), p = 0.040), and belief in the active role of osteopathy for pediatric conditions (OR 1.22 (95% CI 1.01; 1.47), p = 0.042). The majority of physicians (72%) and osteopaths (62%) considered the upcoming government regulation of osteopathy a positive factor for collaboration. Conclusion Some collaboration already exists among these practitioners, including mutual referrals, but optimizing this collaboration still poses some challenges.
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Affiliation(s)
- Chantal Morin
- Department of Family Medicine and Emergency Medicine and School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
| | - Johanne Desrosiers
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine and School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Groenewald CB, Beals-Erickson SE, Ralston-Wilson J, Rabbitts JA, Palermo TM. Complementary and Alternative Medicine Use by Children With Pain in the United States. Acad Pediatr 2017; 17:785-793. [PMID: 28232257 PMCID: PMC5598558 DOI: 10.1016/j.acap.2017.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/08/2017] [Accepted: 02/14/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Chronic pain is reported by 15% to 25% of children. Growing evidence from clinical samples suggests that complementary and alternative medicine (CAM) therapies are desired by families and may benefit some children with pain conditions. The objective of this study was to provide estimates of CAM use by children with pain in the United States. METHODS We analyzed data from the 2012 National Health Interview Survey (NHIS) to estimate patterns, predictors, and perceived benefits of CAM use among children 4 to 17 years of age with and without painful conditions in the United States. We used chi-square tests to compare the prevalence rates of CAM use among children with pain to CAM use among children without pain. Multivariable logistic regression was used to examine factors associated with CAM use within the group of children with pain conditions. RESULTS Parents reported that 26.6% of children had pain conditions (eg, headache, abdominal, musculoskeletal pain) in the past year; of these children, 21.3% used CAM. In contrast, only 8.1% of children without pain conditions used CAM (χ2, P < .001). CAM use among children with pain was associated with female sex (adjusted odds ratio [aOR] = 1.49, P = .005), higher income (aOR = 1.61, P = .027), and presence of 4+ comorbidities (aOR = 2.01, P = .013). Among children with pain who used CAM, the 2 most commonly used CAM modalities were biology-based therapies (47.3%) (eg, special diets and herbal supplements) and manipulative or body-based therapies (46.3%) (eg, chiropractic and massage). CONCLUSIONS CAM is frequently used by children with pain in the United States, and many parents report benefits for their child's symptoms.
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Affiliation(s)
- Cornelius B Groenewald
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash.
| | - Sarah E Beals-Erickson
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash
| | - Jaime Ralston-Wilson
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash
| | - Jennifer A Rabbitts
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash; Department of Psychiatry, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash
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13
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Schlefman A, Rappaport DI, Adams-Gerdts W, Stubblefield SC. Brief Report: Healing Touch Consults at a Tertiary Care Children's Hospital. Hosp Pediatr 2016; 6:114-8. [PMID: 26822561 DOI: 10.1542/hpeds.2015-0203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Components of complementary and alternative medicine are increasingly being implemented at academic medical centers. These approaches include therapeutic touch or healing touch (HT), an energy-based therapy using light touch on or near the body. Limited data exist regarding complementary and alternative medicine use at children's hospitals. The aim of this study was to evaluate patterns and clinical characteristics of HT consultations among children hospitalized at Nemours/A.I. duPont Hospital for Children. METHODS We conducted a retrospective chart review of all patients hospitalized from January 2012 through December 2013, comparing patients who received HT consultations with those who did not. RESULTS There were 25,396 admissions during the study period; 882 (4%) of these, representing 593 individual patients, received an HT consultation. As compared with those without an HT consultation, patients receiving HT were older (median 12 years vs 5 years, P<.001), female (58% vs 46%, P<.001), and more likely to be admitted to the hematology/oncology or blood/bone marrow transplant units (P<.001). Patients with HT consultations had longer hospitalizations (median 121 hours vs 38 hours, P<.001) and more medical problems (median 12 vs 4, P<.001). Six attending physicians were responsible for placing the majority of HT consultations. Of the 593 patients receiving an HT consultation, 21% received ≥2 consultations during the study period. CONCLUSIONS Certain patients, such as those with longer hospitalizations and more medical problems, were more likely to receive HT consultations. Many patients received multiple consultations, suggesting that HT may be an important aspect of ongoing care for hospitalized children.
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14
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Chen X, Ung COL, Hu H, Liu X, Zhao J, Hu Y, Li P, Yang Q. Community Pharmacists' Perceptions about Pharmaceutical Care of Traditional Medicine Products: A Questionnaire-Based Cross-Sectional Study in Guangzhou, China. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:7801637. [PMID: 27066101 PMCID: PMC4811086 DOI: 10.1155/2016/7801637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/26/2016] [Accepted: 02/21/2016] [Indexed: 01/20/2023]
Abstract
This study aimed to investigate community pharmacists' perceived responsibility, practice behaviors, knowledge, perceived barriers, and improvement measures towards provision of pharmaceutical care in relation to traditional medicine (TM) products in Guangzhou, China. A self-completion questionnaire was used to survey licensed pharmacists working at community pharmacies. This study found that the community pharmacists in Guangzhou, China, were involved in the provision of TM products during their daily practice but only provided pharmaceutical care in this area with a passive attitude. Extrinsic barriers such as lack of scientific evidence for the safety and efficacy of TM products and unclear definition of their roles and responsibilities were highlighted while intrinsic factors such as insufficient TM knowledge were identified.
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Affiliation(s)
- Xi Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
- State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610000, China
| | - Xiaodan Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Jing Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Yuanjia Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Peng Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Qing Yang
- State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610000, China
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15
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Tassone RF. Elements for Developing an Academic Medical Acupuncture Practice: One Approach. Med Acupunct 2015. [DOI: 10.1089/acu.2015.1114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Jenkins BN, Vincent N, Fortier MA. Differences in referral and use of complementary and alternative medicine between pediatric providers and patients. Complement Ther Med 2015; 23:462-8. [DOI: 10.1016/j.ctim.2015.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/30/2015] [Accepted: 02/11/2015] [Indexed: 10/23/2022] Open
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Complementary and alternative medicine for Duchenne and Becker muscular dystrophies: characteristics of users and caregivers. Pediatr Neurol 2014; 51:71-7. [PMID: 24785967 PMCID: PMC4467767 DOI: 10.1016/j.pediatrneurol.2014.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/28/2014] [Accepted: 02/10/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Complementary and alternative medicine is frequently used in the management of chronic pediatric diseases, but little is known about its use by those with Duchenne or Becker muscular dystrophy. METHODS Complementary and alternative medicine use by male patients with Duchenne or Becker muscular dystrophy and associations with characteristics of male patients and their caregivers were examined through interviews with 362 primary caregivers identified from the Muscular Dystrophy Surveillance, Tracking, and Research Network. RESULTS Overall, 272 of the 362 (75.1%) primary caregivers reported that they had used any complementary and alternative medicine for the oldest Muscular Dystrophy Surveillance, Tracking, and Research Network male in their family. The most commonly reported therapies were from the mind-body medicine domain (61.0%) followed by those from the biologically based practice (39.2%), manipulative and body-based practice (29.3%), and whole medical system (6.9%) domains. Aquatherapy, prayer and/or blessing, special diet, and massage were the most frequently used therapies. Compared with nonusers, male patients who used any therapy were more likely to have an early onset of symptoms and use a wheel chair; their caregivers were more likely to be non-Hispanic white. Among domains, associations were observed with caregiver education and family income (mind-body medicines [excluding prayer and/or blessing only] and whole medical systems) and Muscular Dystrophy Surveillance, Tracking, and Research Network site (biologically based practices and mind-body medicines [excluding prayer and/or blessing only]). CONCLUSIONS Complementary and alternative medicine use was common in the management of Duchenne and Becker muscular dystrophies among Muscular Dystrophy Surveillance, Tracking, and Research Network males. This widespread use suggests further study to evaluate the efficacy of integrating complementary and alternative medicine into treatment regimens for Duchenne and Becker muscular dystrophies.
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Jong MC, van Vliet M, Huttenhuis S, van der Veer D, van den Heijkant S. Attitudes toward integrative paediatrics: a national survey among youth health are physicians in The Netherlands. Altern Ther Health Med 2012; 12:4. [PMID: 22244450 PMCID: PMC3293769 DOI: 10.1186/1472-6882-12-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 01/16/2012] [Indexed: 11/21/2022]
Abstract
Background Integrative Medicine (IM) is an emerging field in paediatrics, especially in the USA. The purpose of the present study was to assess the attitudes and beliefs of Youth Health Care (YHC) physicians in the Netherlands toward IM in paediatrics. Methods In October 2010, a link to an anonymous, self-reporting, 30-item web-based questionnaire was mailed to all members of the Dutch Organisation of YHC physicians. The questionnaire included questions on familiarity with IM, attitudes towards Integrative Paediatrics (IP), use and knowledge of Complementary and Alternative Medicine (CAM), demographic and practice characteristics. Results A total of 276 YHC physicians (response rate of 27%) responded to the survey. Of the respondents, 52% was familiar with IM and 56% had used some kind of CAM therapy during the past 2 years, of which self-medicated herbal and/or homeopathic remedies (61%) and supplements (50%) were most frequently mentioned. Most of the YHC physicians (62%) seldom asked parents of clients about CAM use. One third of the YHC physicians recommended CAM to their clients. In general, about 50% or more of the respondents had little knowledge of CAM therapies. Predictors for a positive attitude towards IP were familiarity with IM, own CAM use, asking their clients about CAM use and practising one or more forms of CAM therapy. Logistic regression analysis showed that the following factors were associated with a higher recommendation to CAM therapies: own CAM use (odds ratio (OR) = 3.8; 95% confidence interval (CI) = 2.1-6.9, p = 0.001) and practising CAM (OR 4.4; 95% CI = 1.6-11.7, p = 0.003). Conclusions In general Dutch YHC physicians have a relative positive attitude towards IP; more than half of the respondents used one or more forms of CAM and one third recommended CAM therapies. However, the majority of YHC physicians did not ask their clients about CAM use and seemed to have a lack of knowledge regarding CAM.
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