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Méril-Mamert V, Ponce-Mora A, Sylvestre M, Lawrence G, Bejarano E, Cebrián-Torrejón G. Antidiabetic Potential of Plants from the Caribbean Basin. PLANTS 2022; 11:plants11101360. [PMID: 35631785 PMCID: PMC9146409 DOI: 10.3390/plants11101360] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/27/2022]
Abstract
Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia, insulin insufficiency or insulin resistance, and many issues, including vascular complications, glycative stress and lipid metabolism dysregulation. Natural products from plants with antihyperglycemic, hypolipidemic, pancreatic protective, antioxidative, and insulin-like properties complement conventional treatments. Throughout this review, we summarize the current status of knowledge of plants from the Caribbean basin traditionally used to manage DM and treat its sequelae. Seven plants were chosen due to their use in Caribbean folk medicine. We summarize the antidiabetic properties of each species, exploring the pharmacological mechanisms related to their antidiabetic effect reported in vitro and in vivo. We propose the Caribbean flora as a source of innovative bioactive phytocompounds to treat and prevent DM and DM-associated complications.
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Affiliation(s)
- Vanessa Méril-Mamert
- Laboratoire COVACHIM-M2E EA 3592, Université des Antilles, CEDEX, 97157 Pointe-à-Pitre, France; (V.M.-M.); (M.S.); (G.L.)
| | - Alejandro Ponce-Mora
- Department of Biomedical Sciences, School of Health Sciences and Veterinary, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Moncada, Spain;
| | - Muriel Sylvestre
- Laboratoire COVACHIM-M2E EA 3592, Université des Antilles, CEDEX, 97157 Pointe-à-Pitre, France; (V.M.-M.); (M.S.); (G.L.)
| | - Genica Lawrence
- Laboratoire COVACHIM-M2E EA 3592, Université des Antilles, CEDEX, 97157 Pointe-à-Pitre, France; (V.M.-M.); (M.S.); (G.L.)
| | - Eloy Bejarano
- Department of Biomedical Sciences, School of Health Sciences and Veterinary, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Moncada, Spain;
- Correspondence: (E.B.); (G.C.-T.); Tel.: +96-136-90-00 (ext. 64541) (E.B.); +96-136-90-00 (ext. 64315) (G.C.-T.)
| | - Gerardo Cebrián-Torrejón
- Laboratoire COVACHIM-M2E EA 3592, Université des Antilles, CEDEX, 97157 Pointe-à-Pitre, France; (V.M.-M.); (M.S.); (G.L.)
- Correspondence: (E.B.); (G.C.-T.); Tel.: +96-136-90-00 (ext. 64541) (E.B.); +96-136-90-00 (ext. 64315) (G.C.-T.)
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Rafi MA, Azad DT, Bhattacharjee M, Rahman N, Mubin KA, Rahman MA, Hossain MG. A hospital-based study on complementary and alternative medicine use among diabetes patients in Rajshahi, Bangladesh. BMC Complement Med Ther 2020; 20:219. [PMID: 32660539 PMCID: PMC7359228 DOI: 10.1186/s12906-020-03021-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/08/2020] [Indexed: 11/25/2022] Open
Abstract
Background The use of complementary and alternative medicine (CAM) among type 2 diabetes mellitus (T2DM) patients is increasing worldwide. It can affect optimum glycemic management. This study was to determine the rate and influencing factors of CAM use among diabetes patients as well as their effect on glycemic control. Methods This cross-sectional study was conducted among T2DM patients attending the outpatient department of Rajshahi Medical College Hospital. It is a tertiary hospital in the northern part of Bangladesh. A face-to-face interview with a pretested structured questionnaire was used for data collection. Chi-square (χ2) test and multivariate logistic regression model were used in this study for data analysis. Results Out of 244 T2DM patients, 86 (35.2%) used CAM. Multivariate logistic regression model showed that lower family income group (AOR = 8.7, 95% CI: 2.15–35.22, p-value 0.002), having no institutional education (AOR = 3.4, 95% CI: 1.17–9.87, p-value 0.025) and having diabetes for more than five years (AOR = 2.821, 95% CI: 1.34–5.94, p-value 0.006) were the most influential predictors of CAM use. The most commonly used CAMs were herbal products (67.4%) and homeopathic medicine (37.2%). Most of the CAM users (72%) were influenced by friends, neighbors, and family members. The most common reasons behind CAM use were reported to be the belief that CAM helped control diabetes better (44.2%) and easy availability and lower cost (27.9%). More than half of the users reported the efficacy of CAM as ‘nothing significant’, while others reported as somewhat good. 14% of CAM users experienced side-effects, especially gastrointestinal upset. It was observed that using CAM was associated with poor glycemic control (AOR = 2.25, 95% CI: 1.14–4.44, p-value 0.018). Conclusion Our study demonstrated that some modifiable factors are associated with the use of CAM, and it cannot maintain good glycemic control. So, patients should be made aware of the ineffectiveness and bad effects of CAM by enhancing educational and poverty-alleviating programs.
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Affiliation(s)
- Md Abdur Rafi
- Rajshahi Medical College, 6000, Rajshahi, Bangladesh
| | | | | | - Nikita Rahman
- Rajshahi Medical College, 6000, Rajshahi, Bangladesh
| | - Kazi Abdul Mubin
- Department of Pharmacy, University of Rajshahi, -6205, Rajshahi, Bangladesh
| | - Md Ajijur Rahman
- Department of Pharmacy, University of Rajshahi, -6205, Rajshahi, Bangladesh
| | - Md Golam Hossain
- Department of Statistics, University of Rajshahi, 6205, Rajshahi, Bangladesh.
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Radwan H, Hasan H, Hamadeh R, Hashim M, AbdulWahid Z, Hassanzadeh Gerashi M, Al Hilali M, Naja F. Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates. BMC Complement Med Ther 2020; 20:216. [PMID: 32650773 PMCID: PMC7350641 DOI: 10.1186/s12906-020-03011-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of Complementary and Alternative Medicine (CAM) among Type 2 Diabetes Mellitus (T2DM) patients is increasing to manage the complexities of their condition, enhance their health, and ease complications. The burden of T2DM in the United Arab Emirates (UAE) coupled with the high prevalence of CAM use and its associated risks among patients with T2DM necessitated the investigation of the use of CAM by this patients' population. The aim of this study is to examine the prevalence, types, and correlates of CAM use among T2DM patients in the UAE. METHODS Patients with T2DM attending the outpatient clinics in the two governmental hospitals in Dubai and Sharjah, UAE were invited to participate in a cross-sectional survey. Face-to-face interviews were conducted with participants to complete a multi-component questionnaire. The questionnaire comprised of three main sections: demographic data, diabetes-related information, and CAM use details. Data analysis employed descriptive statistics, univariate and multivariate logistic regression to assess the prevalence and correlates of CAM use. RESULTS Two hundred forty-four T2DM patients completed the questionnaire (response rate: 80%). A total of 39.3% of participants were CAM users since diagnosis. After adjustment; the logistic regression results showed that CAM use was significantly associated with age, sex, education, employment, and having health insurance. The most commonly used type of CAM by participants were folk foods and herbs followed by spiritual and natural healing and vitamins and minerals supplements. The majority of CAM users were referred or encouraged to use CAM by family (42.7%), friends (25%) or social media (17.7%). Only 13.5% of participants used CAM because it was suggested by health care practitioners. Only 1 in four of CAM users disclosed CAM use to their treating physician. CONCLUSION CAM use among T2DM patients in the UAE is considerably high. Health policy and decision-makers are encouraged to dedicate particular attention to facilitating proper regulation and integration of CAM within conventional medicine to protect the health and wellbeing of patients. A concerted effort by medical schools and public health authorities should be committed to educating health care providers and patients on the safe and effective use of CAM therapies.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Rena Hamadeh
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Zeenat AbdulWahid
- Endocrinology and Diabetes Department, Al Qassimi Hospital-Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Mahboobeh Hassanzadeh Gerashi
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Clinical Nutrition Department, Al Qassimi Hospital-Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - 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. .,Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Yıldırım Dİ, Marakoğlu K. Complementary and alternative medicine use amongst Turkish type 2 diabetic patients: A cross-sectional study. Complement Ther Med 2018; 41:41-46. [DOI: 10.1016/j.ctim.2018.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/19/2018] [Accepted: 08/20/2018] [Indexed: 01/18/2023] Open
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Lesson From Comparison of CAM Use by Women With Female-Specific Cancers to Others: It's Time to Focus on Interaction Risks With CAM Therapies. Integr Cancer Ther 2016; 6:313-44. [DOI: 10.1177/1534735407309257] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There has been no examination as to whether the prevalence of complementary and alternative medicine (CAM) use, as well as personal factors associated with CAM use and predictive of CAM use for women with female-specific cancers, is similar to those in other diagnostic groups. The purpose of this review is to compare CAM use and personal factors associated with and predictive of CAM use by women with female-specific cancers to samples of other diagnostic groups. If it is the case that CAM use is similar across various types of samples, then it may be unnecessary to continue to study detailed CAM use by those in separate diagnostic groups and instead focus energies on the examination of CAM therapies that may have risks for interaction with conventional therapies, such as biologically based therapies. The researcher concludes that we are now in an era in which we need to use our restricted time, human resources, and finances to examine biologically based CAM use that may carry high risks for interactions or toxicities for specific groups under examination, rather than examine global CAM use, unless the situation warrants such all-inclusive study.
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Devi K, Santhini E, Manikandan R, Prabhu NM. The prevalence, awareness and potential of complementary alternative medicine in type 2 diabetics living in Madurai, India. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Effoe VS, Suerken CK, Quandt SA, Bell RA, Arcury TA. The Association of Complementary Therapy Use With Prescription Medication Adherence Among Older Community-Dwelling Adults. J Appl Gerontol 2015; 36:1054-1069. [PMID: 26320147 DOI: 10.1177/0733464815602116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Medication adherence is a major health concern, particularly among older adults who have one or more chronic conditions. We examined the association between complementary therapy use and medication adherence among older community-dwelling adults. In a bi-ethnic sample of 165 adults aged 65 years and older, anthropometric variables, data on chronic medical conditions, and medication use were assessed. Medication adherence was modeled as a score (<50%, 50%-75%, and >75%) and complementary therapy use was categorized as a binary variable. Over half of the participants (50.3%) were female, and 47.3% were African American. Complementary therapy use was prevalent (87.9%) and did not differ by sex, ethnicity, income, and educational attainment. Medication adherence score was >75% in 84.8% of complementary therapy users and 80.0% of non-users ( p = .61). Despite a high use of complementary therapy in this population, there was no apparent association with low medication adherence.
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Affiliation(s)
- Valery S Effoe
- 1 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Sara A Quandt
- 1 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ronny A Bell
- 1 Wake Forest School of Medicine, Winston-Salem, NC, USA
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Fan PEM, Chan MF, Chan YL, Koh SLS. Patterns of complementary and alternative medicine use among a group of patients with type 2 diabetes receiving outpatient care in Singapore. Int J Nurs Pract 2014; 19 Suppl 3:44-55. [PMID: 24090297 DOI: 10.1111/ijn.12173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study aims to identify patterns and evaluate factors associated with complementary and alternative medicine (CAM) use among type 2 diabetes patients in Singapore. A cross-sectional descriptive study using a self-administered questionnaire was performed among type 2 diabetes patients at an outpatient diabetes centre, and participants' medical records were accessed for diabetes complications and conventional medicine for managing diabetes. Among 304 participants, 43.4% used CAM and 61.2% did not inform health-care professionals of their CAM use. Three most common CAM were nutritional supplements, Chinese herbal medicine and massage. Friends (44.2%), partner and family (38%) were top sources of information for CAM, whereas factors significantly associated with CAM use were gender (P = 0.049), total monthly household income (P = 0.048) and frequency of self-monitoring of blood glucose (P = 0.036). Results highlight a need for improved health-care professionals-patients communication and for health-care professionals to be educated on CAM to provide relevant education to patients.
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Nahin RL, Byrd-Clark D, Stussman BJ, Kalyanaraman N. Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 12:193. [PMID: 23088705 PMCID: PMC3528411 DOI: 10.1186/1472-6882-12-193] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 10/11/2012] [Indexed: 11/22/2022]
Abstract
Background The overall prevalence of complementary medicine (CM) use among adults in the United States with diabetes has been examined both in representative national samples and in more restricted populations. However, none of these earlier studies attempted to identify predictors of CM use to treat diabetes among the populations sampled, nor looked for a relationship between CM use and diabetes severity. Methods Combining data from the 2002 and 2007 National Health Interview Survey (NHIS), we constructed a nationally representative sample of 3,978 U.S. adults aged ≥18 years with self-reported diabetes. Both the 2002 and 2007 NHIS contained extensive questions on the use of CM. We used logistic regression to examine the association between diabetes severity and overall CM use, as well as the use of specific categories of CM. Results In adults with type-2 diabetes, 30.9% used CM for any reason, but only 3.4% used CM to treat or manage their type-2 diabetes versus 7.1% of those with type-1 diabetes. Among those using CM to treat/manage their type-2 diabetes, 77% used both CM and conventional prescription medicine for their diabetes. The most prevalent types of CM therapies used were diet-based interventions (35.19%, S.E. 5.11) and non-vitamin/non-mineral dietary supplements (33.74%, S.E. 5.07). After controlling for sociodemographic factors, we found that, based on a count of measures of diabetes severity, persons with the most severe diabetes had nearly twice the odds of using CM as those with less severe disease (OR=1.9, 95%CI 1.2-3.01). Persons who had diabetes 10 years or more (OR=1.66, 95%CI 1.04-3.66) and those that had a functional limitation resulting from their diabetes (OR=1.74, 95%CI 1.09-2.8) had greater odds of using CM than those not reporting these measures. No significant associations were observed between overall CM use and other individual measures of diabetes severity: use of diabetic medications, weak or failing kidneys, coronary heart disease, or severe vision problems. Conclusions Our results demonstrate that individuals with more severe diabetes are more likely to use CM independent of sociodemographic factors. Further studies are essential to determine if CM therapies actually improve clinical outcomes when used to treat/manage diabetes.
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Patterns and Determinants of Complementary and Alternative Medicine Practitioner Use among Adults with Diabetes in Queensland, Australia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:659419. [PMID: 22919416 PMCID: PMC3420145 DOI: 10.1155/2012/659419] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 06/15/2012] [Indexed: 12/26/2022]
Abstract
There is evidence that complementary and alternative medicine (CAM) use is common among people with diabetes. The role of CAM in the treatment or management of diabetes is an emerging health issue given the potential side effects and benefits associated with the use of this kind of medicine. This paper examined patterns and determinants of CAM practitioner use in Queensland, Australia, using a large population-based sample of people with type 1 and type 2 diabetes. The study found that within a 12-month period, 7.7% of people with diabetes used the services of CAM practitioners alongside or as a complement to conventional health care service. Younger age, female gender, a higher education, having private health insurance, and engagement in preventive health behaviours are significant predictors of individuals who are more likely to visit a CAM practitioner. There was no significant difference in CAM practitioner use between people with type 1, type 2 insulin requiring, or type 2 noninsulin requiring diabetes. The findings highlight the need for further research on the role of CAM in the prevention and management of diabetes.
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Bradley R, Sherman KJ, Catz S, Calabrese C, Oberg EB, Jordan L, Grothaus L, Cherkin D. Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year. Altern Ther Health Med 2012; 12:44. [PMID: 22512949 PMCID: PMC3403984 DOI: 10.1186/1472-6882-12-44] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 04/18/2012] [Indexed: 11/25/2022]
Abstract
Background Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC) in primary care patients with inadequately controlled type 2 diabetes. Methods Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year. Participants were required to have hemoglobin A1c (HbA1c) values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight). Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6- and 12-months after entry into the study. Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure) were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was pre-specified as the primary endpoint for outcome assessment. Results Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study. At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001), diet (P = 0.001), physical activity (P = 0.02), mood (P = 0.001), self-efficacy (P = 0.0001) and motivation to change lifestyle (P = 0.003). Improvements in glucose testing, mood, self-efficacy and motivation to change lifestyle persisted at 12-months (all P < 0.005). For clinical outcomes, mean HbA1c decreased by −0.90 % (P = 0.02) in the ANC cohort at 6-months, a −0.51 % mean difference compared to usual care (P = 0.07). Reductions at 12-months were not statistically significant (−0.34 % in the ANC cohort, P = 0.14; -0.37 % difference compared to the usual care cohort, P = 0.12). Conclusions Improvements were noted in self-monitoring of glucose, diet, self-efficacy, motivation and mood following initiation of ANC for patients with inadequately controlled type 2 diabetes. Study participants also experienced reductions in blood glucose that exceeded those for similar patients who did not receive ANC. Randomized clinical trials will be necessary to determine if ANC was responsible for these benefits.
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McLaughlin D, Lui CW, Adams J. Complementary and alternative medicine use among older Australian women--a qualitative analysis. Altern Ther Health Med 2012; 12:34. [PMID: 22471758 PMCID: PMC3342907 DOI: 10.1186/1472-6882-12-34] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 04/04/2012] [Indexed: 12/05/2022]
Abstract
Background The use of complementary and alternative medicines (CAM) among older adults is an emerging health issue, however little is known about older people's experiences of using CAM and the cultural, geographical and other determinants of CAM use in this population. This study used qualitative methods to explore older women's views of CAM and reasons for their use of CAM. Participants for the project were drawn from the Australian Longitudinal Study on Women's Health (ALSWH) 1921-1926 birth cohort. Women who responded positively to a question about CAM use in Survey 5 (2008) of the ALSWH were invited to participate in the study. A total of 13 rural and 12 urban women aged between 83 and 88 years agreed to be interviewed. Results The women expressed a range of views on CAM which fell into three broad themes: "push" factors such as dissatisfaction with conventional health services, "pull" factors which emphasised the positive aspects of choice and self-care in health matters, and barriers to CAM use. Overall, the "push' factors did not play a major role in the decision to use CAM, rather this was driven by "pull" factors related to health care self-responsibility and being able to source positive information about types of CAM. A number of barriers were identified such as access difficulties associated with increased age, limited mobility and restricted transport options, as well as financial constraints. Conclusions CAM use among older women was unlikely to be influenced by aspects of conventional health care ("push factors"), but rather was reflective of the personal beliefs of the women and members of their close social networks ("pull factors"). While it was also apparent that there were differences between the rural and urban women in their use of CAM, the reasons for this were mainly due to the difficulties inherent in accessing certain types of CAM in rural areas.
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Bradley R, Sherman KJ, Catz S, Calabrese C, Jordan L, Grothaus L, Cherkin DC. Survey of CAM interest, self-care, and satisfaction with health care for type 2 diabetes at group health cooperative. Altern Ther Health Med 2011; 11:121. [PMID: 22132687 PMCID: PMC3280939 DOI: 10.1186/1472-6882-11-121] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 12/01/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Very little research has explored the factors that influence interest in complementary and alternative medicine (CAM) treatments. We surveyed persons with sub-optimally controlled type 2 diabetes to evaluate potential relationships between interest in complementary and alternative medicine (CAM) treatments, current self-care practices, motivation to improve self-care practices and satisfaction with current health care for diabetes. METHODS 321 patients from a large integrated healthcare system with type 2 diabetes, who were not using insulin and had hemoglobin A1c values between 7.5-9.5%, were telephoned between 2009-2010 and asked about their self-care behaviors, motivation to change, satisfaction with current health care and interest in trying naturopathic (ND) care for their diabetes. Responses from patients most interested in trying ND care were compared with those from patients with less interest. RESULTS 219 (68.5%) patients completed the survey. Nearly half (48%) stated they would be very likely to try ND care for their diabetes if covered by their insurance. Interest in trying ND care was not related to patient demographics, health history, clinical status, or self-care behaviors. Patients with greater interest in trying ND care rated their current healthcare as less effective for controlling their blood sugar (mean response 5.9 +/- 1.9 vs. 6.6 +/- 1.5, p = 0.003), and were more determined to succeed in self-care (p = 0.007). Current CAM use for diabetes was also greater in ND interested patients. CONCLUSIONS Patients with sub-optimally controlled type 2 diabetes expressed a high level of interest in trying ND care. Those patients with the greatest interest were less satisfied with their diabetes care, more motivated to engage in self-care, and more likely to use other CAM therapies for their diabetes.
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McLaughlin D, Adams J, Sibbritt D, Lui CW. Sex differences in the use of complementary and alternative medicine in older men and women. Australas J Ageing 2011; 31:78-82. [DOI: 10.1111/j.1741-6612.2011.00554.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Adams J, Sibbritt D, Lui CW. The urban-rural divide in complementary and alternative medicine use: a longitudinal study of 10,638 women. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 11:2. [PMID: 21208458 PMCID: PMC3024269 DOI: 10.1186/1472-6882-11-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 01/06/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences women's CAM consumption across the urban/rural divide. This paper analyses 10,638 women's CAM use across urban and rural Australia. METHODS Data for this research comes from Survey 5 of the Australian Longitudinal Study on Women's Health conducted in 2007. The participants were aged 56-61 years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables. RESULTS Women who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005). CONCLUSIONS In contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas.
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Affiliation(s)
- Jon Adams
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
| | - David Sibbritt
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Chi-Wai Lui
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
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Wardle J, Lui CW, Adams J. Complementary and alternative medicine in rural communities: current research and future directions. J Rural Health 2010; 28:101-12. [PMID: 22236320 DOI: 10.1111/j.1748-0361.2010.00348.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED CONTEXTS: The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. PURPOSE This article presents the first review and synthesis of research findings on CAM use and practice in rural communities. METHODS A comprehensive search of literature from 1998 to 2010 in CINAHL, MEDLINE, AMED, and CSA Illumina (social sciences) was conducted. The search was confined to peer-reviewed articles published in English reporting empirical research findings on the use or practice of CAM in rural settings. FINDINGS Research findings are grouped and examined according to 3 key themes: "prevalence of CAM use and practice,""user profile and trends of CAM consumption," and "potential drivers and barriers to CAM use and practice." CONCLUSIONS Evidence from recent research illustrates the substantial prevalence and complexity of CAM use in rural regions. A number of potential gaps in our understanding of CAM use and practice in rural settings are also identified.
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Affiliation(s)
- Jon Wardle
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
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Wardle JL, Adams J, Lui CW. A qualitative study of naturopathy in rural practice: a focus upon naturopaths' experiences and perceptions of rural patients and demands for their services. BMC Health Serv Res 2010; 10:185. [PMID: 20584288 PMCID: PMC2908615 DOI: 10.1186/1472-6963-10-185] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 06/28/2010] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) use--of which naturopathy constitutes a significant proportion--accounts for approximately half of all health consultations and half of out-of-pocket expenditure in Australia. Data also suggest CAM use is highest amongst rural Australians. Unfortunately little is known about the grass-roots reality of naturopathy or other CAM use in rural regions. METHODS Semi-structured interviews were conducted with 20 naturopaths practising in the Darling Downs region of South-East Queensland to assess their perceptions and experiences of rural patients and demand for their services. RESULTS Naturopaths described strong demand in rural areas for their services and perceived much of this demand as attributable to cultural traits in rural communities that served as pull factors for their naturopathic services. Such perceived traits included a cultural affinity for holistic approaches to health and disease and the preventive philosophy of naturopathy and an appreciation of the core tenet of naturopathic practice to develop closer therapeutic relationships. However, cost and a rural culture of self-reliance were seen as major barriers to naturopathic practice in rural areas. CONCLUSIONS Demand for naturopathic services in rural areas may have strong underlying cultural and social drivers. Given the apparent affinity for and increasingly large role played by CAM services, including naturopathic medicine, in rural areas it is imperative that naturopathic medicine and the CAM sector more broadly become a core focus of rural health research.
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Affiliation(s)
- Jon L Wardle
- School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, 4006, Australia
- The Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, 4006, Australia
| | - Jon Adams
- School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, 4006, Australia
- The Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, 4006, Australia
| | - Chi-Wai Lui
- School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, 4006, Australia
- The Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, 4006, Australia
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Bell RA, Andrews JS, Arcury TA, Snively BM, Golden SL, Quandt SA. Depressive symptoms and diabetes self-management among rural older adults. Am J Health Behav 2010; 34:36-44. [PMID: 19663750 PMCID: PMC2726973 DOI: 10.5993/ajhb.34.1.5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To assess the association of depressive symptoms with diabetes self-management regimens among older adults with type 2 diabetes in a rural, ethnically diverse community. METHODS Data from 696 rural older African Americans, American Indians, and whites were used to assess depressive symptoms (modified CES-D) and diabetes self-management (physical activity, blood glucose self-monitoring, self foot checks, following a healthful eating plan, and medication adherence). RESULTS In bivariate analyses, high CES-D scores were associated with decreased adherence to a healthful eating plan and physical activity and increased foot checks; the latter 2 remained significant in multivariate analyses. CONCLUSIONS Older adults with diabetes and depression are less likely to adhere to self-management, increasing their risk of complications.
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Affiliation(s)
- Ronny A. Bell
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-9736 (phone), (336) 713-4300 (fax)
| | - Jeanette S. Andrews
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-0453 (phone), (336) 713-5308 (fax)
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, (336) 716-9438 (phone), (336) 716-3206 (fax)
| | - Beverly M. Snively
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 713-0030 (phone), (336) 713-5308 (fax)
| | - Shannon L. Golden
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-9714 (phone), (336) 713-4228 (fax)
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, (336) 716-6015 (phone), (336) 713-4157 (fax)
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Abstract
SummaryThe increasing prevalence of complementary and alternative medicine (CAM) use is a significant health care issue in contemporary societies and researchers have identified CAM as holding potential for treating and coping with chronic illness and other conditions experienced in later life. This paper focuses upon contemporary research literature to provide a critical review of the prevalence, correlates, conditions, perceptions and communication of CAM use in later life. Evidence from recent research illustrates the substantial prevalence and complexity of CAM use amongst older people and such ‘community’ use requires all providers, regardless of their experience or perception of the worth of CAM, to at least acknowledge and enquire with their older patients about the potential use of these other medicines.
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