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Resnick A, Zeliadt SB, Ganz DA, Moucheraud C, Chuang E, Yano EM, Taylor SL. Changes in Use of Complementary and Integrative Health Therapies at the Veterans Affairs: Findings from a Whole Health System Pilot Program. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:805-812. [PMID: 36927089 DOI: 10.1089/jicm.2022.0816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Introduction: The Department of Veterans Affairs (VA) launched a Whole Health System pilot program in 18 VA "Flagship" medical centers in 2018 in part to expand the provision of complementary and integrative health (CIH) therapies. Materials and methods: A longitudinal quasi-experimental design was used to examine Veterans' use of at least 1 of 12 CIH therapies 2 years after initiation of the Flagship pilot program compared with the year before the program started. The sample included Veterans with chronic musculoskeletal pain with at least one visit to a VA primary care, mental health care, or pain clinic in each of the 3 study years. A population-average logit model was used to measure changes in the percentage of Veterans using at least one the CIH therapies over time. Results: Among Veterans with chronic musculoskeletal pain receiving health care at Flagship sites, 9.7% used a CIH therapy before the Flagship program initiation, whereas 14.2% used a therapy in the second year of the program (46.0% increase). In comparison, CIH therapy use among Veterans at non-Flagship sites increased from 10.3% to 12.0% over the same period (16.5% increase). Results from the population-average logit model show that Veterans at Flagship sites were significantly more likely to be CIH therapy users in the first (p < 0.001) and second (p < 0.001) years of the implementation compared with non-Flagship sites. Discussion: The Flagship pilot program was successful in terms of increasing the use of CIH therapies among Veterans with chronic musculoskeletal pain compared with non-Flagship sites. Conclusions: The Whole Health System implementation that included financial incentives, education, and other support to 18 VA "Flagship" medical centers helped to increase the use of CIH therapies in the VA. Future research should examine which of these efforts were most effective in expanding CIH therapy provision.
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Affiliation(s)
- Adam Resnick
- Department of Veterans Affairs, Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA, USA
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Steven B Zeliadt
- Department of Veterans Affairs, Seattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, WA, USA
| | - David A Ganz
- Department of Veterans Affairs, Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Corrina Moucheraud
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Emmeline Chuang
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Elizabeth M Yano
- Department of Veterans Affairs, Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA, USA
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Stephanie L Taylor
- Department of Veterans Affairs, Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA, USA
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Gökkaya İ, Renda G, Coşkun H, Koçak M, Özgen U. A descriptive survey study in endocrinology clinic: evaluation of the use of natural products. Curr Med Res Opin 2023; 39:1439-1449. [PMID: 37830875 DOI: 10.1080/03007995.2023.2270898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/11/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE The use of herbal products/dietary supplements (HP/DS) in endocrinal chronic diseases is growing. However, no studies have evaluated their use in patients who present to endocrinology and metabolic diseases clinics. This descriptive study aims to investigate the rate of HP/DS use and the factors affecting this in patients who presented to Karadeniz Technical University (KTU) Farabi Hospital Endocrinology and Metabolic Diseases Clinic, Türkiye between 01.11.2021 and 01.05.2022. METHODS Five hundred six questionnaires with acceptable data quality were included this investigation. The data were analyzed on SPSS version 23.0 software. The factors with the greatest effect on the use of HP/DS were determined using binary logistic regression analysis. RESULTS Analysis showed that 49.4% of the participants used HP/DS. The main factors affecting the use of herbal products were age, diagnosis of the disease, and treatment compliance problems. The most frequently used products were lemon, cinnamon, black cumin, ginger, turmeric, and dill. The participants main sources of information about HP/DS were friends/relatives, the internet/social media, and television, respectively. 74.8% of the participants using HP/DS did not inform their physcisian/pharmacist about such use, although 81.8% of these nevertheless wished to receive information from these occupational groups. CONCLUSION Herbal product monitoring in patients should be performed in collaboration with pharmacists, herbal product use should be investigated, and counseling services should be made available in order to maintain and promote public health.
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Affiliation(s)
- İçim Gökkaya
- Faculty of Pharmacy, Department of Pharmacognosy, Karadeniz Technical University, Ortahisar, Trabzon, Turkey
| | - Gülin Renda
- Faculty of Pharmacy, Department of Pharmacognosy, Karadeniz Technical University, Ortahisar, Trabzon, Turkey
| | - Hülya Coşkun
- Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Karadeniz Technical University, Ortahisar, Trabzon, Turkey
| | - Mustafa Koçak
- Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Karadeniz Technical University, Ortahisar, Trabzon, Turkey
| | - Ufuk Özgen
- Faculty of Pharmacy, Department of Pharmacognosy, Karadeniz Technical University, Ortahisar, Trabzon, Turkey
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Varanasi R, Srivastava A, Kumar Rt S, Bala R. Practice, prescription habits, experience and perception of Indian homeopathic practitioners in treatment of diabetes mellitus: An online observational study. J Ayurveda Integr Med 2023; 14:100787. [PMID: 37751636 PMCID: PMC10692382 DOI: 10.1016/j.jaim.2023.100787] [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: 03/24/2023] [Revised: 05/31/2023] [Accepted: 07/04/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Studies have shown homoeopathy to effectively control blood sugar levels and improve quality of life (QOL), though a standard treatment protocol is required. OBJECTIVE This study intended to assess the homoeopathic practice, prescription habits, experience, and perception of Indian Homeopathic Practitioners (HPs) in treating DM. METHODOLOGY A web-based cross-sectional with a snowball sampling method was conducted between 30th July 2021 and 18th August 2021. A questionnaire to record clinical attributes of Indian HPs in the management of DM was formed after the consensus of the subject experts and pilot testing for feasibility. RESULTS Participants were 513 HPs with mean age [Standard Deviation (SD)] of 40.44 years (11.16) and a mean duration of the homoeopathic medical practice of 14.67 years [95% Confidence Interval (CI) = 13.71-15.63]. The majority of HPs made classical homoeopathic prescription (201, 39.2%) though the success in the management of DM was better among HPs who prescribed more than one potentized medicine [vs classical prescription, Odds Ratio (OR) = 2.34, p = 0.032]. As perceived by the HPs, homoeopathic treatment resulted in a major improvement in QOL of the diabetic patients (418, 81.5%) with very few adverse effect (100, 19.5%). The blood sugar level was controlled better when homoeopathy was given alongside conventional medicine (348, 67.8%). CONCLUSION The clinical experience of HPs in this study has shown that homoeopathic treatment can benefit DM patients in preventing complications and improving QOL. It further reported that homoeopathy can be an important adjuvant to conventional treatment in managing DM.
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Affiliation(s)
- Roja Varanasi
- Central Council for Research in Homoeopathy, New Delhi, Jawahar Lal Nehru Bhartiya Chikitsa Avum Homoeopathy Anusandhan Bhawan, 61-65, Institutional Area, Opposite D-Block, Janakpuri, New Delhi 110058, India
| | - Amit Srivastava
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur 795001, India.
| | - Shaji Kumar Rt
- Central Council for Research in Homoeopathy, New Delhi, Jawahar Lal Nehru Bhartiya Chikitsa Avum Homoeopathy Anusandhan Bhawan, 61-65, Institutional Area, Opposite D-Block, Janakpuri, New Delhi 110058, India
| | - Renu Bala
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur 795001, India
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Sanogo F, Xu K, Cortessis VK, Weigensberg MJ, Watanabe RM. Mind- and Body-Based Interventions Improve Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:69-79. [PMID: 36070591 DOI: 10.1089/jicm.2022.0586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims/Hypothesis: Only 51% of patients with type 2 diabetes achieve the hemoglobin A1c (HbA1c) <7% target. Mind and body practices have been increasingly used to improve glycemic control among patients with type 2 diabetes, but studies show inconsistent efficacy. The authors conducted a systematic review and meta-analysis to assess the association between mind and body practices, and mean change in HbA1c and fasting blood glucose (FBG) in patients with type 2 diabetes. Methods: The authors conducted a literature search of Ovid MEDLINE, Embase, and ClinicalTrials.gov seeking through June 10, 2022, published articles on mind and body practices and type 2 diabetes. Two reviewers independently appraised full text of articles. Only intervention studies were included. Reviewers extracted data for meta-analysis. Restricted maximum likelihood random-effects modeling was used to calculate the mean differences and summary effect sizes. The authors assessed heterogeneity using Cochran's Q and I2 statistics. Funnel plots were generated for each outcome to gauge publication bias. Weighted linear models were used to conduct study-level meta-regression analyses of practice frequency. Results: The authors identified 587 articles with 28 meeting the inclusion criteria. A statistically significant and clinically relevant mean reduction in HbA1c of -0.84% (95% confidence interval [CI]: -1.10% to -0.58%; p < 0.0001) was estimated. Reduction was observed in all intervention subgroups: mindfulness-based stress reduction: -0.48% (95% CI: -0.72% to -0.23%; p = 0.03), qigong: -0.66% (95% CI: -1.18% to -0.14%; p = 0.01), and yoga: -1.00% (95% CI: -1.38% to -0.63%; p < 0.0001). Meta-regression revealed that for every additional day of yoga practice per week, the raw mean HbA1c differed by -0.22% (95% CI: -0.44% to -0.003%; p = 0.046) over the study period. FBG significantly improved following mind and body practices, with overall mean difference of -22.81 mg/dL (95% CI: -33.07 to -12.55 mg/dL; p < 0.0001). However, no significant association was found between the frequency of weekly yoga practice and change in FBG over the study period. Conclusions/Interpretation: Mind and body practices are strongly associated with improvement in glycemic control in patients with type 2 diabetes. The overall mean reduction in HbA1c and FBG was clinically significant, suggesting that mind and body practices may be an effective, complementary nonpharmacological intervention for type 2 diabetes. Additional analyses revealed that the mean decrease in HbA1c was greater in studies requiring larger number of yoga practice sessions each week.
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Affiliation(s)
- Fatimata Sanogo
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Keren Xu
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Victoria K Cortessis
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Obstetrics and Gynecology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Marc J Weigensberg
- USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Richard M Watanabe
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,USC Diabetes and Obesity Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Physiology and Neuroscience, Keck School of Medicine of USC, Los Angeles, CA, USA
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Scott R, Nahin RL, Sussman BJ, Feinberg T. Physician Office Visits That Included Complementary Health Approaches in U.S. Adults: 2005-2015. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:641-650. [PMID: 35559729 PMCID: PMC9467635 DOI: 10.1089/jicm.2021.0331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Introduction: The Institute of Medicine has described the need for comparing models of care delivery involving complementary health approaches and conventional medical practitioners. As a step toward addressing this need, we used a nationally representative 11-year sample of office-based visits to physicians from the National Ambulatory Medical Care Survey (NAMCS), to examine a comprehensive list of factors believed to be associated with visits where complementary health approaches were recommended or provided. Methods: NAMCS is a national health care survey designed to collect data on the provision and use of ambulatory medical care services provided by office-based physicians in the United States. Patient medical records were abstracted from a random sample of office-based physician visits. We examined several visit characteristics, including patient demographics, physician specialty, documented health conditions, and reasons for health visit. We ran chi-square analyses to test bivariate associations between visit factors and whether complementary health approaches were recommended or provided to guide development of logistic regression models. Results: Of the 550,114 office visits abstracted, 4.43% contained a report that complementary health approaches were ordered, supplied, administered, or continued. Among complementary health visits, 87% of patient charts mentioned nonvitamin nonmineral dietary supplements. The prevalence of complementary health visits significantly increased from 2% in 2005 to almost 8% in 2015. Returning patient status, survey year, physician specialty and degree, menopause, cardiovascular, and musculoskeletal diagnoses were significantly associated with complementary health visits, as was seeking preventative care or care for a chronic problem. Conclusion: We present an overview of the first study of office-based physician visits where complementary health approaches were recommended or ordered to their patients. These data confirm the growing popularity of complementary health approaches in the United States, provide a baseline for further studies, and inform subsequent investigations of integrative health care.
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Affiliation(s)
- Remle Scott
- Kelly Government Solutions, Rockville, MD, USA
| | - Richard L. Nahin
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
| | - Barbara J. Sussman
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA
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Mulder LTC, Busch M, Kristoffersen AE, Hök Nordberg J, van der Werf ET. Prevalence and predictive factors of complementary medicine use during the first wave of the COVID-19 pandemic of 2020 in the Netherlands. BMC Complement Med Ther 2022; 22:43. [PMID: 35168630 PMCID: PMC8845358 DOI: 10.1186/s12906-022-03528-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/31/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Major life changing events such as the COVID-19 pandemic may have major impact on one’s health and general well-being. This study aimed to determine the prevalence and predictive factors, including gender specific differences, of Complementary Medicine (CM) use (including CM consultations, self-care management and self-help techniques) during the first wave of the COVID-19 pandemic in 2020 in the Netherlands. Methods CM use was studied among a random representative sample (n = 1004) of the adult Dutch population using an online survey conducted from 22–27 May 2020. The survey included a modified version of I-CAM-Q and additional questions on demographic characteristics, reasons for CM use, perceived effectiveness and side effects. Results 68.0% of the participants reported to have used CM (CM consultations (13.3%), self-management strategies (59.4%), self-help techniques (30.0%)). Most frequently reported reason of CM use was to improve general well-being (61.6%), prevention and/or treatment of COVID-19 was only reported by 10%. Perceived effectiveness of CM was high and number of experienced side effects low. Being a women, worried to get infected with COVID-19, higher education and living in northern/ middle region of the Netherlands were predictive factors to use CM. Conclusions In the Netherlands, specific groups (e.g. women/ highly educated) use CM, mainly to improve general wellbeing, and seem to benefit of it during the first months of the pandemic. The high perceived effectiveness and low reporting of side effects should encourage medical professionals and policy makers for more openness towards considering CM as being part of an integrative approach to public health in times life changing events occur. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03528-x.
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Affiliation(s)
- Louise T C Mulder
- Louis Bolk Institute, Kosterijland 3-5, 3981 AJ, Bunnik, The Netherlands
| | - Martine Busch
- Van Praag Institute, Springweg 7, 3511 VH, Utrecht, The Netherlands.,Dutch Consortium for Integrative Medicine and Health (CIZG), Utrecht, The Netherlands
| | - Agnete E Kristoffersen
- National Research Centre in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johanna Hök Nordberg
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden.,Department Neurobiology, Care Sciences & Society, Division of Nursing & Department Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Esther T van der Werf
- Louis Bolk Institute, Kosterijland 3-5, 3981 AJ, Bunnik, The Netherlands. .,Dutch Consortium for Integrative Medicine and Health (CIZG), Utrecht, The Netherlands.
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Alzahrani AS, Price MJ, Greenfield SM, Paudyal V. Global prevalence and types of complementary and alternative medicines use amongst adults with diabetes: systematic review and meta-analysis. Eur J Clin Pharmacol 2021; 77:1259-1274. [PMID: 33686454 PMCID: PMC8346452 DOI: 10.1007/s00228-021-03097-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022]
Abstract
AIM This study aimed to undertake a systematic review and meta-analysis of global prevalence and types of complementary and alternative medicine (CAM) use amongst adults with diabetes. METHODS Nine databases, including MEDLINE and EMBASE, were searched for studies published between 2009 and 2019 which included extractable data for CAM use in adult patients with diabetes. Study characteristics, types of CAM, and overall and subgroup prevalence data in relation to CAM use were extracted. Meta-analysis of aggregate level data on prevalence and prevalence ratios (PRs) was performed using a random effects model. RESULTS From the 38 studies included in the review, a total of 37 types of CAM and 223 types of herbs were identified. Pooled prevalence of CAM use was 51%. A wide variation in prevalence rates (predictive interval 8-93%) was observed. In the context of high heterogeneity, we found no evidence that CAM use was associated with gender, chronicity or type of diabetes. Approximately one third of patients did not disclose their use of CAM to healthcare professionals (95% PrI 25%, 97%). Herbal medicines, acupuncture, homoeopathy and spiritual healing were the common CAM types reported. CONCLUSIONS A wide variation in prevalence of CAM use by patients with diabetes was identified. Healthcare professionals should be aware of their patients' use of CAM to ensure treatment optimization, avoid herb-drug interactions and promote medication adherence in diabetes. Diabetic reviews and clinical guidelines should incorporate exploration of patient use of CAM as many patients do not proactively disclose the use of CAM to their healthcare professionals. REGISTRATION The protocol for this study was registered with the Centre for Review and Dissemination (CRD). Protocol registration number CRD42019125036.
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Affiliation(s)
- Abdulaziz S Alzahrani
- School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, UK
| | - Malcolm J Price
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sheila M Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, UK.
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Alonso Street EM, Grutzmacher S, Branscum A, Smit E. Self-Perceived Health and Chronic Conditions Among Users of Supplements With and Without Botanical Ingredients: Findings from the 2009-2014 National Health and Nutrition Examination Survey. J Diet Suppl 2021; 19:689-703. [PMID: 34033728 DOI: 10.1080/19390211.2021.1924336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this research was to investigate associations among self-reported health status, chronic conditions, and use of dietary supplements containing botanicals and describe reasons for use among U.S. adult supplement users. This was a cross-sectional analysis using data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES). Supplement information was collected with a 30-day recall interview. Self-reported general health status and doctor-informed diagnoses of chronic conditions were assessed using a health status questionnaire. We used weighted multivariate logistic regressions to assess associations between supplement use and perceived health and number of chronic conditions. Participants were 16,958 non-institutionalized U.S. adults aged 20 years and older. Adults with excellent or very good self-perceived health were more likely to use botanical supplements than adults with good perceived health (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.28-1.74). Adults with three or more chronic conditions were more likely to report using botanical supplements than adults with no chronic conditions (aOR, 1.49; 95% CI, 1.13-1.69). The most frequently reported reasons for both non-botanical and botanical supplements use were "personal choice or influenced by advertisements or word of mouth," "improve health," and "specific health conditions" (93.3%, 84.2%, and 64.7%, respectively). While perceptions of health are more positive among adults using botanical supplements, chronic conditions and reasons for botanical supplements use related to personal choice, improving health, or addressing specific conditions were more likely. Differentiating botanical supplements from other complementary and integrative therapies may be useful for facilitating a deeper understanding of the reasons.
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Affiliation(s)
- Ellen M Alonso Street
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Stephanie Grutzmacher
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Adam Branscum
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Ellen Smit
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Sari Y, Anam A, Sumeru A, Sutrisna E. The knowledge, attitude, practice and predictors of complementary and alternative medicine use among type 2 diabetes mellitus patients in Indonesia. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:347-353. [PMID: 33972194 DOI: 10.1016/j.joim.2021.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The prevalence of complementary and alternative medicine (CAM) usage among patients with type 2 diabetes mellitus (T2DM) in Indonesia is high. However, to date, little is known about why Indonesian T2DM patients choose CAM therapies, how their knowledge, attitude and practice (KAP) of CAM affects their choices, or how demographics correlate with patient choices. Therefore, this study aimed to investigate the KAP and predictors of CAM usage in T2DM patients in Indonesia. METHODS This was an observational, cross-sectional study. Patients were interviewed using a questionnaire. Chi-square tests or Fisher's exact tests were used to compare demographic and clinical data, as well as KAP assessments, between T2DM patients who use and do not use CAM. Multivariate logistic regression analyses were used to investigate predictors of CAM usage. RESULTS A total of 628 T2DM patients were enrolled in the study. CAM therapies were used by 341 patients (54.3%). The most common therapies were herbs and spiritual healing, used by 100.0% and 68.3% of CAM-using patients, respectively. CAM therapies were frequently recommended by family members (91.5%), and CAM users had significantly more knowledge and more positive attitudes toward CAM therapies than nonusers. Among users, 66% said they would not follow their healthcare providers' instructions to not use CAM therapies, and 69.5% said they would not disclose their plan to use CAM therapies with their healthcare provider. Neither demographic nor clinical characteristics were associated with CAM use. The factors that best predicted the use of CAM therapies were their availability and low cost (odds ratio [OR] = 4.59; 95% confidence interval [CI]: 3.01-7.01), the belief that CAM therapies were safe (OR = 2.04; 95% CI: 1.40-2.95), the belief that CAM therapies could help with diabetes control (OR = 1.75; 95% CI: 1.15-2.66), and the belief that CAM therapies could help maintain physical health (OR = 1.68; 95% CI: 1.13-2.49). CONCLUSION CAM therapy users were more knowledgeable and had more positive attitudes toward CAM, but most of them chose not to disclose their CAM use to their healthcare providers. CAM use in Indonesia was associated with its accessibility, affordability, safety and effectivity, but not with any demographic or clinical characteristics. This study provided new evidence and insights for nurses and physicians in Indonesia that will help to design educational programs about the safety and efficacy of CAM therapies.
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Affiliation(s)
- Yunita Sari
- Department of Nursing, Universitas Jenderal Soedirman, Purwokerto 53122, Central Java, Indonesia.
| | - Akhyarul Anam
- Department of Nursing, Universitas Jenderal Soedirman, Purwokerto 53122, Central Java, Indonesia
| | - Annas Sumeru
- Department of Nursing, Universitas Jenderal Soedirman, Purwokerto 53122, Central Java, Indonesia
| | - Eman Sutrisna
- Department of Pharmacology, Universitas Jenderal Soedirman, Purwokerto 53147, Central Java, Indonesia
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Anderson JG, Bartmess M, Jabson Tree JM, Flatt JD. Predictors of Mind-Body Therapy Use Among Sexual Minority Older Adults. J Altern Complement Med 2021; 27:352-359. [PMID: 33601924 PMCID: PMC8182477 DOI: 10.1089/acm.2020.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Introduction: Sexual minority (SM; lesbian, gay, bisexual) older adults age 50+ experience a higher prevalence of chronic disease and disability, as well as a poorer physical and mental health status, compared with their heterosexual peers. Many adults use complementary and integrative therapies, particularly mind-body therapies, as health-enhancing approaches and to support well-being. However, no study to date has examined the use of mind-body therapies among SM older adults. Materials and Methods: Data were from the 2017 National Health Interview Survey. Descriptive and summary statistics were calculated to describe use of mind-body therapies by SM older adults (aged 50+). The authors also tested associations between use of mind-body therapies and health and well-being among SM older adults and compared associations with their non-SM counterparts. Results: SM older adults reported higher usage (36%) of mind-body therapies compared with heterosexual adults (22%), with lesbian women reporting the highest use (39.4%). Having a SM identity was associated with mind-body therapy use; SM older adults were 57% more likely to use a mind-body therapy. Conclusion: Mind-body therapies may be a useful tool for SM older adults to enhance their health and well-being. Future qualitative research is needed to investigate more deeply the reasons SM older adults use mind-body therapies. To advance the health and well-being of SM older adults, the authors also need intervention studies that explore the effectiveness of mind-body interventions and the possible need for tailoring these to the unique needs of this population.
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Affiliation(s)
- Joel G. Anderson
- College of Nursing, and University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Marissa Bartmess
- College of Nursing, and University of Tennessee-Knoxville, Knoxville, TN, USA
| | | | - Jason D. Flatt
- School of Public Health, University of Nevada-Las Vegas, Las Vegas, NV, USA
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11
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Kumar S, Kumari P, Kumar V, Fatima M. Efficacy of Alternative Medicine in Reducing Hemoglobin A1c (HbA1c) in Type 2 Diabetes Mellitus. Cureus 2020; 12:e10246. [PMID: 33042685 PMCID: PMC7536103 DOI: 10.7759/cureus.10246] [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] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Diabetes mellitus is one of Pakistan's most common diseases, affecting nearly 27.4 million people. Complementary and alternative medicine (CAM) is becoming quite popular for the management of diabetes. We aim to study the subjects that use alternative medicine in order to assess the effect of alternative therapy on the glycemic control and overall health of the patients. METHODS This study was conducted from January 2019 to December 2019 in Karachi, Pakistan. A total of 101 diabetic patients who used alternative medicine as part of their diabetes treatment were enrolled in the study after oral informed consent. Patients who were using concomitant conventional therapy were excluded from the study. On day 0, the random blood glucose levels and hemoglobin A1c (HbA1c) levels were noted. Patients were followed up after 12 weeks, and their blood glucose levels and HbA1c levels were noted again. Out of 101 participants, around 92 of them completed the study and were included in the final analysis. RESULTS According to the results, 41 (44.5%) participants admitted that they used Herbal medicine, 32 (34.78%) participants used home remedies through dietary modifications, 11 (11.95%) participants used spiritual healing techniques, and 7 (7.60%) participants used cupping therapy. We found no significant reduction of HbA1c levels at the end of 12 weeks in any group. CONCLUSION This study failed to show any significant reduction in HbA1c levels after 12 weeks in patients taking various alternative medicine forms. There is a need for further large-scale trials to establish this mode of treatment's efficacy and safety.
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Affiliation(s)
- Sagar Kumar
- Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK
| | | | - Vikash Kumar
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Maham Fatima
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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12
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Demir-Dora D, Aksoyalp ZŞ, Nacitarhan C. Knowledge level and attitude towards complementary and alternative treatment methods among medical students: a cross-sectional survey study in Turkey. Curr Med Res Opin 2020; 36:1465-1471. [PMID: 32569486 DOI: 10.1080/03007995.2020.1786679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE People often use complementary and alternative medicine (CAM) methods in Turkey, but reliability of the application of these methods is controversial. Considering the role of medical students (i.e. physician candidates) in sustainable health, their perspectives on CAM methods are important. This report explores the level of knowledge, experience, and preferences for the use of CAM methods among medical school students. MATERIAL AND METHODS A survey about the use of CAM and interest in CAM methods was applied to 101 first-year and 87 fifth-year medical school students. The binary and multinomial logistic regression models were used for statistical analysis. RESULTS Sixteen percent of the first-year and 9% of the fifth-year students were familiar with "The Regulation on Traditional and Complementary Medical Practices" published by the Ministry of Health of Turkey in 2014. While participants reported the most familiarity with acupuncture treatment, they were the most unfamiliar with prolotherapy among all CAM methods. Seeking advice from a licensed physician before applying CAM methods was the general agreement among the participants. Interest in learning and practicing hypnosis was the highest-rated CAM method among the participants. CONCLUSIONS Increasing knowledge and awareness of CAM methods by including them into the medical curriculum would be essential for the correct use of CAM methods.
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Affiliation(s)
- Devrim Demir-Dora
- Faculty of Medicine, Department of Medical Pharmacology, Akdeniz University, Antalya, Turkey
| | - Zinnet Şevval Aksoyalp
- Faculty of Medicine, Department of Medical Pharmacology, Akdeniz University, Antalya, Turkey
| | - Cahit Nacitarhan
- Faculty of Medicine, Department of Medical Pharmacology, Akdeniz University, Antalya, Turkey
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13
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Felicilda-Reynaldo RFD, Choi SY, Driscoll SD, Albright CL. A National Survey of Complementary and Alternative Medicine Use for Treatment Among Asian-Americans. J Immigr Minor Health 2020; 22:762-770. [PMID: 31583560 PMCID: PMC7117985 DOI: 10.1007/s10903-019-00936-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Asian Americans (AAs) are more likely to use complementary and alternative medicine (CAM) compared to other race/ethnicities, yet previous studies have conflicting results. The 2012 National Health Interview Survey data was analyzed to investigate AA's (n = 2214) CAM use for treatment. AAs were divided into four subgroups: Chinese, Asian Indian, Filipino, and Other Asian. Only 9% of AAs reported using CAM for treatment, with 6% indicating CAM use specifically for chronic conditions. This could be a form of medical pluralism, a mixture of Eastern and Western health approaches. The "Other Asian" subgroup reported highest use of CAM for treatment. Significant predictors included age (≥ 65 years) and high educational attainment (≥ college degree). Sociodemographic factors were also significant predictors within Asian subgroups. Further investigation of this and other forms of medical pluralism among AAs are needed to explore potential cofounders and risks like underreporting, CAM schedules/dosages, cultural influences, and CAM's impact on one's health.
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Affiliation(s)
- Rhea Faye D Felicilda-Reynaldo
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster 402, Honolulu, HI, 96822, USA.
| | - So Yung Choi
- Biostatistics Core, Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Susan D Driscoll
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster 402, Honolulu, HI, 96822, USA
| | - Cheryl L Albright
- Office of Public Health Studies, Myron B. Thompson School of Social Work, School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
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14
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Arentz S, Hunter J, Deed G. Integrating Traditional and Complementary Medicine Recommendations into Clinical Practice Guidelines for People with Diabetes in Need of Palliative and End-of-Life Care: A Scoping Review. J Altern Complement Med 2020; 26:571-591. [PMID: 32673080 DOI: 10.1089/acm.2020.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: This study was conducted before an evidence review on Traditional and Complementary Medicine (TCM) to update the clinical practice guidelines (CPGs): "Deciding palliative and end-of-life (P/EoL) care for people with diabetes." The aim was to frame the PICO (population/problems, interventions/comparisons, and outcomes), ascertain their importance, and identify other modifying factors for grading recommendations. Design: A systematic scoping review mapped information about diabetes P/EoL problems and outcomes, TCM use, provision, benefits and risks, and stakeholder preferences and values. Thirteen electronic databases were searched in 2017/18 until no new information was identified. Relevant data were extracted, rated for quality, directness, and relevance, and synthesized using triangulation methods. Excluded was diabetes prevention or treatment, as this is not an important P/EoL problem. Results: Of the 228 included articles, except for diabetes P/EoL problems, insufficient direct evidence led to data being extrapolated from either adults with diabetes or any P/EoL diagnosis. The findings affirmed that caring for people with diabetes in need of P/EoL care is complex due to multiple fluctuating needs that are influenced by the P/EoL trajectories (stable, unstable, deteriorating, terminal, or bereaved), multimorbidity, and difficult-to-manage chronic and acute problems. The only problem specific to diabetes P/EoL care, was unstable glycemia. Over 50 TCM interventions commonly used by patients and/or provided by services were identified, of which, many might simultaneously address multiple problems and 18 had been appraised in systematic reviews. Physical and psychologic symptom reliefs were most often evaluated; however, these were only one aspect of a "good death." Other important outcomes were the quality and location of care, personal agency, relationships, preparations for the dying process, spirituality, and affirmation of the whole person. Other important modifying factors included opportunity costs, affordability, availability, preferences, cultural appropriateness, and alignment with beliefs about the meaning of illness and death. Conclusions: There is a role for TCM in the multidisciplinary holistic P/EoL care of people with diabetes. Due to the paucity of evidence specific to this population, the generalizability of some of these results is broader and the updated CPG will also need to consider indirect evidence from other patient groups. Along with recommendations about indications for TCM use, the CGP should provide guidance on ceasing unnecessary interventions, reducing polypharmacy and managing unstable glycemia is required. Before ceasing a TCM, a broader risk-benefit analysis is recommended, as unlike many conventional therapies, there may be multiple benefits warranting its continuation.
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Affiliation(s)
- Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Gary Deed
- Metabolism Ageing Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Raja R, Kumar V, Khan MA, Sayeed KA, Hussain SZM, Rizwan A. Knowledge, Attitude, and Practices of Complementary and Alternative Medication Usage in Patients of Type II Diabetes Mellitus. Cureus 2019; 11:e5357. [PMID: 31608192 PMCID: PMC6783209 DOI: 10.7759/cureus.5357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction Complementary and alternative medicine (CAM) is becoming popular among individuals affected by chronic diseases, such as diabetes mellitus. We aimed to determine the knowledge, attitude, and practices of complementary and alternative medicine use among type 2 diabetes patients in Karachi, Pakistan. Methods An observational, prospective, cross-sectional study was conducted in the institute of diabetology in a tertiary care hospital in Pakistan from 1st March 2018 till 31st August 2018. All patients of type 2 diabetes mellitus attending the clinic for routine follow-up visits during the study period were interviewed. Their demographic characteristics, clinical data, and knowledge, attitude, practices towards use of CAM products were assessed. Data was managed using SPSS for Windows version 16.0 (SPSS Inc, Chicago, IL). Results CAM therapies were being used by 151 (57.8%) individuals. Herbs (n = 121; 80.1%), specific diets (n = 98; 64.9%), and cupping (n = 68; 45.0%) were the most readily utilized CAM practices. CAM practices were associated with diabetes-related complications [p < 0.000; Odds Ratio (OR) 2.57; Confidence Interval (CI) 1.53, 4.34], poor glycemic control (p < 0.000; OR 0.29; CI 0.17, 0.5), lack of trust in pharmaceutical products (p < 0.000; OR 5.08; CI 2.28, 11.32), poor patient-doctor relationship (p = 0.06; OR 1.47; CI 0.26, 8.17), CAM products being readily available and cheaper (p < 0.000; OR 6.1; CI 3.02, 12.32), and belief that CAM products have fewer side effects (p < 0.000; OR 12.32; CI 6.83, 22.22) and can help in diabetes control (p < 0.000; OR 35.76; CI 16.79, 76.15). Conclusion Use of complementary medicine products among Pakistani diabetic population is high. Herbs and specific diets were common modes of CAM practices. Use of CAM showed significant association with female gender, older age, unemployment, longer duration of diabetes, diabetes-related complications, and poor glycemic control.
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Affiliation(s)
- Ravi Raja
- Internal Medicine, New Medical Center, Al Ain, ARE
| | - Vikash Kumar
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | | | - Khalid A Sayeed
- Medicine, Liaquat College of Medicine and Dentistry, Darul Sehat Hospital, Karachi, PAK
| | | | - Amber Rizwan
- Family Medicine, Dr. Ruth Pfau Hospital, Karachi, PAK
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Al-Eidi SM, Mohamed AG, Abutalib RA, AlBedah AM, Khalil MKM. Wet Cupping-Traditional Hijamah Technique versus Asian Cupping Technique in Chronic Low Back Pain Patients: A Pilot Randomized Clinical Trial. J Acupunct Meridian Stud 2019; 12:173-181. [PMID: 31028971 DOI: 10.1016/j.jams.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 02/12/2019] [Accepted: 04/03/2019] [Indexed: 11/25/2022] Open
Abstract
To evaluate the feasibility of comparing the effect of the traditional Hijamah and the Asian wet cupping techniques in the management of patients with chronic low back pain (CLBP), a randomized clinical trial comparing traditional and Asian wet cupping techniques for CLBP was conducted in two secondary care hospitals in Saudi Arabia. Seventy eligible participants with CLBP were randomized to receive one session of wet cupping using either Asian technique (34 patients) or traditional Hijamah technique (36 patients). Cupping was performed at four sites of the bilateral bladder meridian (BL23, BL24, and BL25). The numeric rating scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores were measured immediately after intervention, at seven days, and 14 days after intervention. In both groups, there was a significant decrease in the numeric rating scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores, immediately after intervention, at seven days, and 14 days after intervention. However, there was no significant difference between the two groups across all the outcome measures up to 14 days after intervention. The study did not show a superiority of one technique compared with the other. Longer follow-up periods and more than one cupping session may be needed to evaluate the difference, if any, between both the techniques. TRIAL REGISTRATION: NCT02012205.
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Affiliation(s)
- Sulaiman M Al-Eidi
- National Center for Complementary and Alternative Medicine, Ministry of Health, Riyadh, Saudi Arabia.
| | - Ashry Gad Mohamed
- Department of Community Medicine, King Saudi University, Riyadh, Saudi Arabia
| | - Raid A Abutalib
- Orthopedic Surgery Department, King Fahad Hospital, Ministry of Health, Madina, Saudi Arabia.
| | - Abdullah M AlBedah
- National Center for Complementary and Alternative Medicine, Ministry of Health, Riyadh, Saudi Arabia.
| | - Mohamed K M Khalil
- Consultant Public Health and Research Development, Research Unit, National Center for Complementary and Alternative Medicine, Ministry of Health, Riyadh, Saudi Arabia.
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Yan Y, Liang N, Liang S, Sun Y, Robinson N, Liu J. Evaluation of outcomes reported in randomized controlled trials for herbal remedies for adults with chronic hepatitis C. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2019. [DOI: 10.1016/j.jtcms.2019.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Catic T, Jusufovic R. Use of Food Supplements in Diabetes Mellitus Treatment in Bosnia and Herzegovina from the Pharmacists Perspective. Mater Sociomed 2019; 31:141-145. [PMID: 31452641 PMCID: PMC6690309 DOI: 10.5455/msm.2019.31.141-145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Food supplements utilization is showing increasing trend among healthy as well as chronic disease population. Diabetes as a pandemic disease is treated by different interventions and traditional pharmacological treatment, but also utilization of natural products and food supplements (FS) are becoming important. Role of the pharmacist in diabetes management includes different interventions like counseling and recommendation of FS. Aim To explore current trends in dietary supplements utilization among diabetic patients from the pharmacists' perspective, pharmacists' attitudes and knowledge about this group of products and suggest future directions related to this issue. Methods We have analyzed pharmacists' perception of FS utilization for diabetes and its complication treatment by conducting online survey. The survey was developed by authors based on research aim and published literature. Results It has been found that 72% of patients with diabetes are purchasing different FS and that they are willing to pay between 5,0-15,0 EUR per visit for this products. Even in majority of cases pharmacists proactively advice patients about FS selection they identify need for specific education in this field in order to strengthen their competencies and competitiveness. Pharmacists also identified need for FS specially formulated and intended for blood glucose controls and most often diabetes complications and related conditions. Conclusion This is the first study in this field conducted in Bosnia and Herzegovina suggesting further activities and research of this topic.
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Affiliation(s)
- Tarik Catic
- Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Rasim Jusufovic
- Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
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Rudra RT, Farkas GJ, Haidar S, Slavoski KE, Lokey NE, Hudson TR. Complementary alternative medicine practices and beliefs in spinal cord injury and non-spinal cord injured individuals. J Spinal Cord Med 2018; 41:659-666. [PMID: 28782431 PMCID: PMC6217471 DOI: 10.1080/10790268.2017.1360831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT/OBJECTIVE To compare the beliefs and practices of individuals with spinal cord injury (SCI), their friends and family members (F&F SCI), and healthcare professionals (HCP) regarding complementary alternative medicine (CAM). DESIGN A questionnaire regarding CAM practices and beliefs was administered to participants on paper or online. SETTING An academic rehabilitation hospital. PARTICIPANTS Ninety-six individuals voluntarily participated in the study. Participants included 28 patients with SCI, 36 F&F SCI, and 32 HCP. INTERVENTIONS Not applicable Outcome Measures: The questionnaire assessed participants' prior or current use of 14 CAM modalities, their willingness to use CAM in the future or recommend its use, and their beliefs and opinions of CAM. RESULTS Participants with SCI and their family and friends, were more likely than HCP to have used CAM (P ≤ 0.01 and P ≤ 0.03, respectively) and recommend its use (P ≤ 0.04 and P ≤ 0.03, respectively). All three groups showed statistical significance in their willingness to ever use certain CAM modalities (P ≤ 0.03 for SCI, P ≤ 0.04 for F&F SCI, and P ≤ 0.02 for HCP). SCI, F&F SCI, and HCP groups had similar beliefs and opinions regarding CAM. CONCLUSION Patients with SCI as well as their friends and family, have significantly more experience with CAM and are more likely to recommend its use than HCP, suggesting that they are interested and find benefit in alternative healthcare. This warrants further investigation of the integration of CAM into general health practices for those with SCI.
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Affiliation(s)
| | - Gary J. Farkas
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA,Correspondence to: Gary J. Farkas, Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, 500 University Drive, P.O. Box 850, Mail Code R120, Hershey, Pennsylvania 17033-0850, USA; Ph: 717-531-0003, x284930, 717-531-0354.
| | - Shahd Haidar
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kristin E. Slavoski
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Nancy E. Lokey
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Timothy R. Hudson
- Department of Physical Medicine and Rehabilitation, McGuire Veterans Medical Center, Richmond, Virginia, USA
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Zghebi SS, Rutter MK, Ashcroft DM, Salisbury C, Mallen C, Chew-Graham CA, Reeves D, van Marwijk H, Qureshi N, Weng S, Peek N, Planner C, Nowakowska M, Mamas M, Kontopantelis E. Using electronic health records to quantify and stratify the severity of type 2 diabetes in primary care in England: rationale and cohort study design. BMJ Open 2018; 8:e020926. [PMID: 29961021 PMCID: PMC6042592 DOI: 10.1136/bmjopen-2017-020926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus (T2DM) presents a significant burden on affected individuals and healthcare systems internationally. There is, however, no agreed validated measure to infer diabetes severity from electronic health records (EHRs). We aim to quantify T2DM severity and validate it using clinical adverse outcomes. METHODS AND ANALYSIS Primary care data from the Clinical Practice Research Datalink, linked hospitalisation and mortality records between April 2007 and March 2017 for patients with T2DM in England will be used to develop a clinical algorithm to grade T2DM severity. The EHR-based algorithm will incorporate main risk factors (severity domains) for adverse outcomes to stratify T2DM cohorts by baseline and longitudinal severity scores. Provisionally, T2DM severity domains, identified through a systematic review and expert opinion, are: diabetes duration, glycated haemoglobin, microvascular complications, comorbidities and coprescribed treatments. Severity scores will be developed by two approaches: (1) calculating a count score of severity domains; (2) through hierarchical stratification of complications. Regression models estimates will be used to calculate domains weights. Survival analyses for the association between weighted severity scores and future outcomes-cardiovascular events, hospitalisation (diabetes-related, cardiovascular) and mortality (diabetes-related, cardiovascular, all-cause mortality)-will be performed as statistical validation. The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions. We anticipate that the developed algorithm will be a practical tool for practitioners, aid clinical management decision-making, inform stratified medicine, support future clinical trials and contribute to more effective service planning and policy-making. ETHICS AND DISSEMINATION The study protocol was approved by the Independent Scientific Advisory Committee. Some data were presented at the National Institute for Health Research School for Primary Care Research Showcase, September 2017, Oxford, UK and the Diabetes UK Professional Conference March 2018, London, UK. The study findings will be disseminated in relevant academic conferences and peer-reviewed journals.
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Affiliation(s)
- Salwa S Zghebi
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
- NIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - Martin K Rutter
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
- Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Darren M Ashcroft
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - Chris Salisbury
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Christian Mallen
- Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Carolyn A Chew-Graham
- Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - David Reeves
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - Harm van Marwijk
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton, UK
| | - Nadeem Qureshi
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Stephen Weng
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Niels Peek
- Division of Informatics, Imaging & Data Sciences (L5), School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - Claire Planner
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - Magdalena Nowakowska
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
- NIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - Mamas Mamas
- Keele Cardiovascular Research group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK
| | - Evangelos Kontopantelis
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
- NIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
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Rahmanian M, Hojat M, Fatemi NS, Mehran A, Parvizy S. The predictive role of spiritual intelligence in self-management in adolescents with type 1 diabetes. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:69. [PMID: 29922698 PMCID: PMC5963205 DOI: 10.4103/jehp.jehp_182_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/23/2018] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Self-management leads to blood glucose control and reduced morbidity and mortality in adolescents with type 1 diabetes. Different factors affect the self-management whose role and effect are still unknown. Among the influential factors whose effect is vague are spiritual intelligence, and this study aims to investigate the predictive role of spiritual intelligence in diabetes management. MATERIALS AND METHODS In this descriptive-correlation study, 200 adolescents with type 1 diabetes were enrolled. To measure spiritual intelligence, the 24-question SISRI questionnaire and to measure self-management of diabetes, the SMOD-A questionnaire (48 questions) were used. Data were analyzed using SPSS software version 18 using linear regression analysis tests. Data collection was conducted by simple sampling. RESULTS Mean score of self-management of diabetes and spirituality was 86.1 ± 15.1 and 60.42 ± 12.9, respectively. Linear regression test (ANOVA: 0.002, F = 9.839) showed effect on diabetes self-management (β: 0.218). CONCLUSION This study showed that spiritual intelligence can predict diabetes self-management, though poorly predicted, and by strengthening it, has a decisive role in improving the health of adolescents with diabetes. Considering the findings of this study, a new window of nurses' performance in managing diabetes based on the promotion of spiritual intelligence in the educational, care, counseling, and support roles of nursing science can be opened.
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Affiliation(s)
- Mojdeh Rahmanian
- Department of Nursing, Research Center for Non Communicable Diseases Pediatric Nursing Master of Science, Nursing Faculty, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohsen Hojat
- Department of Nursing, Research Center for Non Communicable Diseases, PhD of Nursing Nursing Faculty, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Naima Seyed Fatemi
- Department of Nursing, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Mehran
- Department of Biostatistics, Instructor of Nursing School, Tehran Medical University of Medical Sciences, Tehran, Iran
| | - Soroor Parvizy
- Department of Pediatric Nursing and Midwifery Factually, Iran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Prof. Soroor Parvizy, Iran University of Medical Sciences, Tehran, Iran. E-mail:
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Thind H, Lantini R, Balletto BL, Donahue ML, Salmoirago-Blotcher E, Bock BC, Scott-Sheldon LAJ. The effects of yoga among adults with type 2 diabetes: A systematic review and meta-analysis. Prev Med 2017; 105:116-126. [PMID: 28882745 PMCID: PMC5653446 DOI: 10.1016/j.ypmed.2017.08.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 12/31/2022]
Abstract
The purpose of this meta-analysis was to examine the effects of yoga for glycemic control among adults with type 2 diabetes (T2DM). Comprehensive electronic databases searches located 2559 unique studies with relevant key terms. Studies were included if they (1) evaluated a yoga intervention to promote T2DM management, (2) used a comparison group, (3) reported an objective measure of glycemic control at post-intervention, and (4) had follow-up length or post-test of at least 8weeks from baseline. Independent raters coded participant, design and methodological characteristics and intervention content. Summary effect sizes and 95% confidence intervals (CI) were calculated. Twenty-three studies with 2473 participants (mean age=53years; 43% women) met eligibility criteria. Compared with controls, yoga participants were successful in improving their HbA1c (d+=0.36, 95% CI=0.16, 0.56; k=16), FBG (d+=0.58, 95% CI=0.40, 0.76; k=20), and PPBG (d+=0.40, 95% CI=0.23, 0.56; k=14). Yoga was also associated with significant improvements in lipid profile, blood pressure, body mass index, waist/hip ratio and cortisol levels. Overall, studies satisfied an average of 41% of the methodological quality (MQ) criteria; MQ score was not associated with any outcome (Ps >0.05). Yoga improved glycemic outcomes and other risk factors for complications in adults with T2DM relative to a control condition. Additional studies with longer follow-ups are needed to determine the long-term efficacy of yoga for adults with T2DM.
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Affiliation(s)
- Herpreet Thind
- Department of Public Health, University of Massachusetts Lowell, One University Avenue, Southwick 326 A, Lowell, MA 01854, United States.
| | - Ryan Lantini
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States
| | - Brittany L Balletto
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States
| | - Marissa L Donahue
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States
| | - Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Medicine, Alpert School of Medicine, Brown University, 593 Eddy Street, Providence, RI 02903, United States
| | - Beth C Bock
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, 700 Butler Dr., Providence, RI 02906, United States; Department of Behavioral and Social Science, Alpert School of Medicine, Brown University, 121 South Main Street, Providence, RI 02903, United States
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, 700 Butler Dr., Providence, RI 02906, United States; Department of Behavioral and Social Science, Alpert School of Medicine, Brown University, 121 South Main Street, Providence, RI 02903, United States
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Christie GJ, Hamilton T, Manor BD, Farb NAS, Farzan F, Sixsmith A, Temprado JJ, Moreno S. Do Lifestyle Activities Protect Against Cognitive Decline in Aging? A Review. Front Aging Neurosci 2017; 9:381. [PMID: 29209201 PMCID: PMC5701915 DOI: 10.3389/fnagi.2017.00381] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/06/2017] [Indexed: 12/26/2022] Open
Abstract
The number of patients suffering from dementia is expected to more than triple by the year 2040, and this represents a major challenge to publicly-funded healthcare systems throughout the world. One of the most effective prevention mechanisms against dementia lies in increasing brain- and cognitive-reserve capacity, which has been found to reduce the behavioral severity of dementia symptoms as neurological degeneration progresses. To date though, most of the factors known to enhance this reserve stem from largely immutable history factors, such as level of education and occupational attainment. Here, we review the potential for basic lifestyle activities, including physical exercise, meditation and musical experience, to contribute to reserve capacity and thus reduce the incidence of dementia in older adults. Relative to other therapies, these activities are low cost, are easily scalable and can be brought to market quickly and easily. Overall, although preliminary evidence is promising at the level of randomized control trials, the state of research on this topic remains underdeveloped. As a result, several important questions remain unanswered, including the amount of training required to receive any cognitive benefit from these activities and the extent to which this benefit continues following cessation. Future research directions are discussed for each lifestyle activity, as well as the potential for these and other lifestyle activities to serve as both a prophylactic and a therapeutic treatment for dementia.
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Affiliation(s)
- Gregory J Christie
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada.,Science and Technology for Aging Research Institute, Simon Fraser University, Surrey, BC, Canada
| | - Tara Hamilton
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada
| | - Bradley D Manor
- Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Norman A S Farb
- Department of Psychology, University of Toronto, Mississauga, ON, Canada
| | - Faranak Farzan
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada.,School of Mechatronics and Systems Engineering, Simon Fraser University, Surrey, BC, Canada
| | - Andrew Sixsmith
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada.,Science and Technology for Aging Research Institute, Simon Fraser University, Surrey, BC, Canada.,Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Jean-Jacques Temprado
- Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Aix-Marseille Université, Marseille, France
| | - Sylvain Moreno
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada.,Science and Technology for Aging Research Institute, Simon Fraser University, Surrey, BC, Canada.,School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada
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24
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Ghezeljeh TN, Nasari M, Haghani H, Rezaei Loieh H. The effect of nature sounds on physiological indicators among patients in the cardiac care unit. Complement Ther Clin Pract 2017; 29:147-152. [PMID: 29122253 DOI: 10.1016/j.ctcp.2017.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/12/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Environmental noises may create physiological and psychological disorders in patients hospitalized in the CCU. Therefore, this study was conducted to investigate the effects of nature sounds on physiological indicators among patients in the CCU. MATERIALS & METHODS This randomized clinical trial was conducted on 93 patients hospitalized in the cardiac care units of three teaching hospitals in 2016. The patients were selected using the convenient method with three randomized blocks. The patients were assigned into three groups as nature sounds, silence that received a set of headphones without playing sounds, and control groups. In addition to routine care, the patients in the intervention group listened to nature sounds for 30 min using a set of headphones for two days. The patients in the control group only received routine care. In addition to routine care, the patients in the silence group used a set of headphones for 30 min to block noises and no sound was played for them. Physiological indicators such as heartbeat rate, systolic and diastolic blood pressures, respiration rate, and arterial O2 saturation were assessed using monitoring devices. Descriptive and inferential statistics were used for data analysis via the SPSS software. FINDINGS Nature sounds and silence had no statistically significant effects on physiological indicators. However, a statistically significant difference was reported in the heart rate in the nature sound group before and after the intervention in the first day of the intervention (P = 0.046). In the second day of the intervention, there were statistically significant differences in the diastolic blood pressure in the nature sounds group (P = 0.028), heart rate (P = 0.001) and diastolic blood pressure (P = 0.013) in the silence group, and heart rate (P = 0.014) in the control group before and after the intervention. CONCLUSION Listening to nature sounds or the use of headphones blocked environmental noises and could influence mean arterial pressure. Future studies can examine the effects of this intervention implemented for a longer term using nature sounds by patients.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Maryam Nasari
- Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Hamid Haghani
- Statistic and Mathematics Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
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25
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Liu Y, Wang K, Maisonet M, Wang L, Zheng S. Associations of lifestyle factors (smoking, alcohol consumption, diet and physical activity) with type 2 diabetes among American adults from National Health and Nutrition Examination Survey (NHANES) 2005-2014. J Diabetes 2017; 9:846-854. [PMID: 27753238 DOI: 10.1111/1753-0407.12492] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/11/2016] [Accepted: 10/12/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Over the long term, unhealthy lifestyles can lead to many health problems, especially type 2 diabetes (T2D). The aim of the present study was to determine associations between lifestyle factors (smoking, alcohol consumption, physical activity, and diet) and T2D in American adults (aged ≥20 years) in a nationally representative sample. METHODS Data for 12 987 American adults participating in the National Health and Nutrition Examination Survey 2005-2014 were evaluated. Weighted multiple logistic regression models were used to examine associations between the four lifestyle factors and T2D after adjusting for demographics and socioeconomic status (SES). Prevalence trends for T2D were examined using Cochran-Armitage tests. RESULTS There was a significant increasing prevalence trend for T2D among American adults. Smokers and individuals consuming >12 alcoholic drinks in the past year were less likely to report having T2D than non-smokers (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.35-0.48) and those consuming <12 alcoholic drinks (OR 0.46; 95% CI 0.39-0.55). Participants with light physical activity have a greater likelihood of having T2D than those engaging in vigorous physical activity (OR 5.72; 95% CI 4.30-7.60). Individuals consuming a poor diet were more likely to report having T2D than those eating an excellent diet (OR 1.18; 95% CI 1.02-1.41). All these relationships remained significant after adjustment for demographics and SES. CONCLUSION All four lifestyle factors were significantly associated with T2D among American adults. The findings of the present study provide useful information for healthcare providers that may help them promote specific lifestyle modifications.
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Affiliation(s)
- Ying Liu
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Kesheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Mildred Maisonet
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Shimin Zheng
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
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26
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Putthapiban P, Sukhumthammarat W, Sriphrapradang C. Concealed use of herbal and dietary supplements among Thai patients with type 2 diabetes mellitus. J Diabetes Metab Disord 2017; 16:36. [PMID: 28852643 PMCID: PMC5569552 DOI: 10.1186/s40200-017-0317-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/16/2017] [Indexed: 12/29/2022]
Abstract
Background Diabetes mellitus (DM) has been one of the most common chronic diseases that create great impacts on both morbidities and mortalities. Many patients who suffering from this disease seek for complementary and alternative medicine. The aim of this study was to determine the prevalence and related factors of herbal and dietary supplement (HDS) use in patients with DM type 2 at a single university hospital in Thailand. Methods A cross-sectional study was performed in 200 type 2 DM patients via face-to-face structured interviews using developed questionnaires comprised of demographic data, diabetes-specific information, details on HDS use, and medical adherence. Results From the endocrinology clinic, 61% of total patients reported HDS exposure and 28% were currently consuming. More than two-thirds of HDS users did not notify their physicians, mainly because of a lack of doctor concern; 73% of cases had no awareness of potential drug-herb interaction. The use of drumstick tree, turmeric and bitter gourd and holy mushroom were most frequently reported. The main reasons for HDS use were friend and relative suggestions and social media. Comparisons of demographic characteristics, medical adherence, and hemoglobin A1c among these non-HDS users, as well as current and former users, were not statistically significantly different. Conclusions This study revealed a great number of DM patients interested in HDS use. The use of HDS for glycemic control is an emerging public health concern given the potential adverse effects, drug interactions and benefits associated with its use. Health care professionals should aware of HDS use and hence incorporate this aspect into the clinical practice. Electronic supplementary material The online version of this article (doi:10.1186/s40200-017-0317-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Prapaipan Putthapiban
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road Bangkok, Bangkok, 10400 Thailand.,Faculty of Science, Mahidol University, Bangkok, 10400 Thailand
| | - Weera Sukhumthammarat
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road Bangkok, Bangkok, 10400 Thailand.,Faculty of Dentistry, Mahidol University, Bangkok, 10400 Thailand
| | - Chutintorn Sriphrapradang
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road Bangkok, Bangkok, 10400 Thailand
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27
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Henson JB, Brown CL, Chow SC, Muir AJ. Complementary and Alternative Medicine Use in United States Adults With Liver Disease. J Clin Gastroenterol 2017; 51:564-570. [PMID: 27479144 PMCID: PMC7245507 DOI: 10.1097/mcg.0000000000000617] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
GOALS To describe the complementary and alternative medicine (CAM) use in US adults with liver disease. BACKGROUND The prevalence and patterns of CAM use among US adults with liver disease have not been well characterized. The 2012 National Health Interview Survey is considered the most current and comprehensive source of information on CAM use in US adults. STUDY Using the results of the 2012 National Health Interview Survey, the prevalence of CAM use, most common modalities used, reasons for CAM use, perceived benefits, perceived helpfulness and importance, and disclosure of CAM to health care providers were compared between adults with and without liver disease. RESULTS Of the 647 adults with liver disease, 41% reported using CAM in the prior year, compared with 33% of adults without liver disease. The most common modality was herbs and supplements (23%), and 3% of respondents reported consumption of a potentially hepatotoxic substance in the previous 30 days. Only a small proportion of CAM therapies were used specifically for liver disease, with milk thistle being the most common. Among respondents with liver disease, CAM was used more commonly for anxiety or depression, fatigue, and substance use. The majority believed that these therapies improved health. Nearly one-third of therapies were not reported to health care providers, mostly due to failure of the provider to ask. CONCLUSIONS CAM use, particularly herbs and supplements, is prevalent among US adults with liver disease. Many do not disclose their CAM use to their providers, despite some using potentially hepatotoxic substances.
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Affiliation(s)
- Jacqueline B. Henson
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine
| | | | - Shein-Chung Chow
- Department of Biostatistics and Department of Bioinformatics, Duke University School of Medicine
| | - Andrew J. Muir
- Department of Medicine, Division of Gastroenterology
- Duke Clinical Research Institute, Durham, NC
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28
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Christensen CM, Morris RS, Kapsandoy SC, Archer M, Kuang J, Shane-McWhorter L, Bray BE, Zeng-Treitler Q. Patient needs and preferences for herb-drug-disease interaction alerts: a structured interview study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:272. [PMID: 28526079 PMCID: PMC5438528 DOI: 10.1186/s12906-017-1630-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 02/08/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND While complementary and alternative medicine (CAM) is commonly used in the United States and elsewhere, and hazardous interactions with prescription drugs can occur, patients do not regularly communicate with physicians about their CAM use. The objective of this study was to discover patient information needs and preferences for herb-drug-disease interaction alerts. METHODS We recruited 50 people from several locations within the University of Utah Hospital to participate in this structured interview study. They were asked to provide their preferences for the herb-drug-disease interaction alerts. Qualitative methods were used to reveal the themes that emerged from the interviews. RESULTS Most participants reported they had previously used, or they were currently using, CAM therapies. The majority had made the effort to inform their healthcare provider(s) about their CAM usage, although some had not. We found that most respondents were interested in receiving alerts and information about potential interactions. Many preferred to receive the alerts in a variety of ways, both in person and electronically. CONCLUSIONS In addition to conventional medicine, many patients regularly use complementary and alternative therapies. And yet, communication between patients and providers about CAM use is not consistent. There is a demand for interventions in health care that provide timely, integrative communication support. Delivering the herb-drug-disease alerts through multiple channels could help meet critical patient information needs.
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29
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Downer B, Crowe M, Markides KS. Influence of Type II Diabetes and High Depressive Symptoms on the Likelihood for Developing Activities of Daily Living (ADL) Disability and Mortality in Older Puerto Ricans. J Aging Health 2017; 29:1079-1095. [PMID: 28553827 DOI: 10.1177/0898264317708882] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To examine the development of activities of daily living (ADL) disability and mortality according to diabetes and high depressive symptoms among Puerto Rican adults aged 60 and older. METHOD Data came from Wave I and Wave II of the Puerto Rican Elderly: Health Conditions Study ( n = 3,419). Logistic regression was used. Using insulin and receiving psychiatric treatment were proxy measures of disease severity for diabetes and depressive symptoms, respectively. RESULTS High depressive symptoms at baseline were associated with developing ADL disability (OR = 2.21; 95% CI = [1.68, 2.91]). Diabetes at baseline was associated with mortality at follow-up (OR = 1.72; 95% CI = [1.34, 2.19]). Baseline diabetes was associated with developing ADL disability but only for those who reported using insulin (OR = 1.69; 95% CI = [1.08, 2.61]). Participants with comorbid diabetes and high depressive symptoms had the highest odds for developing ADL disability and mortality. DISCUSSION Diabetes and high depressive symptoms are risk factors of developing ADL disability and mortality for older Puerto Ricans.
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Affiliation(s)
- Brian Downer
- 1 University of Texas Medical Branch, Galveston, USA
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30
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Jang A, Kang DH, Kim DU. Complementary and Alternative Medicine Use and Its Association with Emotional Status and Quality of Life in Patients with a Solid Tumor: A Cross-Sectional Study. J Altern Complement Med 2017; 23:362-369. [PMID: 28453297 PMCID: PMC5446597 DOI: 10.1089/acm.2016.0289] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: Complementary and alternative medicine (CAM) has been used widely in various populations for various purposes, including emotional support and improvement of quality of life (QOL). However, CAM use and purposes for using CAM are less clear among Korean patients with a solid tumor. The purpose of this study was to determine the prevalence and type of CAM use, and the association between CAM use and anxiety, depression, and QOL in patients with a solid tumor. Design: A cross-sectional survey. Setting: A cancer center in Korea. Subjects: Two hundred and sixteen patients diagnosed with a solid tumor. Outcome measures: Standard questionnaires on CAM use, Hospital Anxiety and Depression Scale, and European Organization for Research and Treatment of Cancer QLQ-C30. Results: One hundred thirty one patients (60.6%) reported using CAM. CAM users, compared with non-CAM users, were significantly younger (57.8 vs. 60.9 years, p = 0.05), had higher level of education (p = 0.008), had higher income (p = 0.008), were less likely to seek physician consultation on CAM use (p = 0.002), and had a more advanced stage of tumor (p = 0.003) with more distant metastasis (p = 0.001). The most commonly used CAM was herbal medicine (n = 89, 67.9%). CAM users had significantly lower anxiety (t = 5.21, p < 0.001) and depression (t = 4.90, p < 0.001) than non-CAM users. When the effects of CAM use were tested on anxiety, depression, and QOL, controlling for covariates, CAM use was significantly associated with 8.7% and 8.8% of variance in decreasing anxiety and depression, but there was no unique association of CAM use with variance in QOL. Conclusions: CAM use is prevalent and younger age, higher education levels, higher income, less physician consultation, and higher cancer stage are significant correlates to CAM use. Controlling for covariates (e.g., gender, BMI), CAM use is significantly associated with lower anxiety and depression compared with those of non-CAM users.
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Affiliation(s)
- Aelee Jang
- 1 School of Nursing, The University of Texas Health Science Center at Houston , Houston, TX
| | - Duck-Hee Kang
- 1 School of Nursing, The University of Texas Health Science Center at Houston , Houston, TX
| | - Dong Uk Kim
- 2 School of Medicine, Pusan National University, and Biomedical Research Institute, Pusan National University Hospital , Busan, South Korea
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Li L, Gong S, Xu C, Zhou JY, Wang KS. Sleep duration and smoking are associated with coronary heart disease among US adults with type 2 diabetes: Gender differences. Diabetes Res Clin Pract 2017; 124:93-101. [PMID: 28119195 DOI: 10.1016/j.diabres.2016.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
AIMS The associations of moderate alcohol consumption, sleep duration, and tobacco smoking with coronary heart disease (CHD) among patients with type 2 diabetes mellitus (T2D) are not clearly clarified. The aims of the study were to evaluate the associations of lifestyle factors, hypertension, obesity, depression and sleep duration with CHD development among patients with T2D, and particularly, to examine the gender differences in risk factors for CHD. METHODS A total of 2335 T2D adults were selected from the 2012 National Health Interview Survey. Weighted univariate and multiple logistic regression analyses were used to estimate the odds ratios with 95% confidence intervals. RESULTS The CHD prevalence among patients with T2D was 14.2% (18.1% and 10.4% for males and females, respectively), which increased with age (10.3% and 19.6% for age groups 18-64 and 65+, respectively). After adjusting for other factors, weighted logistic regression analyses showed that CHD among patients with T2D was significantly associated with being male, older age, past smoking, long sleep duration, hypertension, and high cholesterol level. Furthermore, the significant association of older age, past smoking, hypertension and high cholesterol level were observed particularly in males, while the association of long sleep duration with CHD was only observed in females. Hypertension was associated with CHD for both genders. CONCLUSIONS Gender, age, past smoking, long sleep duration, hypertension and high cholesterol level were significantly associated with CHD among T2D patients; however, such associations differed by gender. Such gender disparities should be considered in the prevention and treatment of T2D.
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Affiliation(s)
- Lixin Li
- Department of Physician Assistant, Central Michigan University, Mount Pleasant, MI 37614, USA.
| | - Shaoqing Gong
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Chun Xu
- Department of Health & Biomedical Science, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA
| | - Joseph Yi Zhou
- Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - Ke-Sheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
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32
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Trivedi R, Salvo MC. Utilization and Safety of Common Over-the-Counter Dietary/Nutritional Supplements, Herbal Agents, and Homeopathic Compounds for Disease Prevention. Med Clin North Am 2016; 100:1089-99. [PMID: 27542428 DOI: 10.1016/j.mcna.2016.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Dietary supplements are commonly used by patients as part of their medical care plan. Often clinicians may not be aware of their use, because patients do not always consider these to be medications. All clinicians need to continually ask patients about their use of dietary supplements when collecting a medication history. Dietary supplements and prescription medications often share similar enzymatic pathways for their metabolism. These interactions may lead to severe adverse reactions. This article reviews available evidence for a variety of dietary supplements in select disease categories.
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Affiliation(s)
- Ruchir Trivedi
- Division of Nephrology, Department of Medicine, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06032, USA.
| | - Marissa C Salvo
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, 69 North Eagleville Road, Unit 3092, Storrs, CT 06269, USA
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33
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Al-Eidi S, Tayel S, Al-Slail F, Qureshi NA, Sohaibani I, Khalil M, Al-Bedah AM. Knowledge, attitude and practice of patients with type 2 diabetes mellitus towards complementary and alternative medicine. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2016; 14:187-96. [PMID: 27181125 DOI: 10.1016/s2095-4964(16)60244-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The use of complementary and alternative medicine (CAM) is relatively common among patients with type 2 diabetes mellitus (T2DM) around the world. Like many other countries, Saudi Arabia has a high incidence of T2DM, and incorporates the use of CAM in its treatment. This study explores the knowledge, attitude and practice (KAP) of CAM therapies among patients with T2DM and explores the relationships between sociodemographics and the KAP of CAM modalities. METHODS This is a hospital-based, observational, cross-sectional study that selected 302 outpatients with T2DM, from Diabetic Center of King Salman bin Abdul-Aziz Hospital, in Riyadh city, in May 2014. Patients were interviewed using a predesigned questionnaire. RESULTS The mean age of patients was (51.6 ± 10.6) years and 43.4% of them were males. The prevalence of CAM practices was 30.5%; 30.39% of them used herbs, 20.58% used wet cupping and 17.64% used nutritional supplements and other therapies. The factors found to predict the use of CAM therapies among patients with T2DM were: age above 51 years, unemployment and the participants± knowledge about the effectiveness of CAM products. CONCLUSION This preliminary study estimated the prevalence of CAM use, revealed positive attitude towards CAM and found three significant predictors of CAM use among patients with T2DM, which is consistent with regional data. A community-based research with a larger sample that targets T2DM population is needed in Saudi Arabia.
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Affiliation(s)
- Sulaiman Al-Eidi
- Family & Community Medicine, Faculty of Medicine, King Saud University, Riyadh-11321, Saudi Arabia.,Ministry of Health, National Center for Complementary and Alternative Medicine, Riyadh-11662, Saudi Arabia
| | - Salwa Tayel
- Family & Community Medicine, Faculty of Medicine, King Saud University, Riyadh-11321, Saudi Arabia
| | - Fatima Al-Slail
- Ministry of Health, National Diabetes Prevention & Control Program, Riyadh-11341, Saudi Arabia
| | - Naseem Akhtar Qureshi
- Ministry of Health, National Center for Complementary and Alternative Medicine, Riyadh-11662, Saudi Arabia
| | - Imen Sohaibani
- Ministry of Health, National Center for Complementary and Alternative Medicine, Riyadh-11662, Saudi Arabia
| | - Mohamed Khalil
- Ministry of Health, National Center for Complementary and Alternative Medicine, Riyadh-11662, Saudi Arabia
| | - Abdullah Mohammad Al-Bedah
- Ministry of Health, National Center for Complementary and Alternative Medicine, Riyadh-11662, Saudi Arabia
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Ezuruike U, Prieto JM. Assessment of Potential Herb-Drug Interactions among Nigerian Adults with Type-2 Diabetes. Front Pharmacol 2016; 7:248. [PMID: 27559312 PMCID: PMC4978708 DOI: 10.3389/fphar.2016.00248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/27/2016] [Indexed: 11/29/2022] Open
Abstract
It is becoming increasingly evident that patients with diabetes do not rely only on prescription drugs for their disease management. The use of herbal medicines is one of the self-management practices adopted by these patients, often without the knowledge of their healthcare practitioners. This study assessed the potential for pharmacokinetic herb-drug interactions (HDIs) amongst Nigerian adult diabetic patients. This was done through a literature analysis of the pharmacokinetic profile of their herbal medicines and prescription drugs, based on information obtained from 112 patients with type-2 diabetes attending two secondary health care facilities in Nigeria. Fifty percent of the informants used herbal medicines alongside their prescription drugs. Worryingly, 60% of the patients taking herbal medicines did not know their identity, thus increasing the risk of unidentified HDIs. By comparing the pharmacokinetic profile of eight identified herbs taken by the patients for the management of diabetes against those of the prescription drugs, several scenarios of potential HDIs were identified and their clinical relevance is discussed. The lack of clinical predictors points toward cultural factors as the influence for herb use, making it more difficult to identify these patients and in turn monitor potential HDIs. In identifying these possible interactions, we have highlighted the need for healthcare professionals to promote a proactive monitoring of patients' use of herbal medicines.
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Affiliation(s)
- Udoamaka Ezuruike
- Department of Pharmaceutical and Biological Chemistry, Centre for Pharmacognosy and Phytotherapy, University College London School of Pharmacy London, UK
| | - Jose M Prieto
- Department of Pharmaceutical and Biological Chemistry, Centre for Pharmacognosy and Phytotherapy, University College London School of Pharmacy London, UK
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Falci L, Shi Z, Greenlee H. Multiple Chronic Conditions and Use of Complementary and Alternative Medicine Among US Adults: Results From the 2012 National Health Interview Survey. Prev Chronic Dis 2016; 13:E61. [PMID: 27149072 PMCID: PMC4858448 DOI: 10.5888/pcd13.150501] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction More than 25% of American adults report having 2 or more chronic conditions. People with chronic conditions often use complementary and alternative medicine (CAM) for self-care and disease management, despite a limited evidence base. Methods Data from the 2012 National Health Interview Survey (NHIS) (n = 33,557) were analyzed to assess associations between presence of multiple chronic conditions (n = 13) and CAM use, using multivariable relative risk and linear regressions weighted for complex NHIS sampling. CAM use was defined as self-reported use of one or more of 16 therapies in the previous 12 months. Results Chronic conditions were common. US adults reported one (22.3%) or 2 or more (33.8%) conditions. Many used at least one form of CAM. Multivitamins, multiminerals, or both (52.7%); vitamins (34.8%); and minerals (28.4%) were the most common. Compared with adults with no conditions, adults with 2 or more conditions were more likely to use multivitamins or multiminerals or both, vitamins, minerals, nonvitamins or herbs, mind–body therapies, chiropractic or osteopathic manipulation, massage, movement therapies, special diets, acupuncture, naturopathy, or some combination of these therapies (P <.003). Conclusion People with multiple chronic conditions have a high prevalence of CAM use. Longitudinal studies are needed to understand the association between CAM use and chronic disease prevention and treatment.
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Affiliation(s)
- Laura Falci
- 722 W. 168th St, 7th Floor, New York, NY 10032.
| | - Zaixing Shi
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Heather Greenlee
- Department of Epidemiology, Mailman School of Public Health, Columbia University, and Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York
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Downer B, Rote S, Markides KS, Al Snih S. The Comorbid Influence of High Depressive Symptoms and Diabetes on Mortality and Disability in Mexican Americans Aged 75 and Above. Gerontol Geriatr Med 2016; 2:2333721416628674. [PMID: 27617272 PMCID: PMC5017791 DOI: 10.1177/2333721416628674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/27/2015] [Accepted: 11/02/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the individual and combined effects of depression and diabetes on mortality and disability over 6 years among Mexican Americans aged ≥75. METHOD The final sample included 1,785 participants from the Hispanic Established Population for the Epidemiological Study of the Elderly. Cox proportional hazards regression models were used to estimate the hazard ratios for incidence for mortality and disability according to diabetes and depressive symptoms. RESULTS Diabetics were more likely to become activities of daily living (ADL) disabled Hazard Ratio (HR) = 1.44, 95% confidence interval [CI] = [1.18, 1.77]) and deceased (HR = 1.47, 95% CI = [1.24, 1.74]) compared with non-diabetics. Diabetics reporting high depressive symptomatology were more than two times as likely to become ADL disabled and deceased compared with diabetics not reporting high depressive symptoms. Participants with high depressive symptoms and taking insulin alone or both oral medications and insulin were at the greatest risk of disability (HR = 3.83, 95% CI = [1.66, 8.81]). CONCLUSION Diabetes increases the risk of disability and mortality, especially among Mexican Americans with high depressive symptoms or who are taking insulin alone or both oral medications and insulin. Interventions that are able to reduce the prevalence of depression and diabetes are needed to limit the future burden of disability and mortality in this population.
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Affiliation(s)
- Brian Downer
- University of Texas Medical Branch, Galveston,TX, USA
| | | | | | - Soham Al Snih
- University of Texas Medical Branch, Galveston,TX, USA
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Amaranath B, Nagendra HR, Deshpande S. Effect of integrated Yoga module on positive and negative emotions in Home Guards in Bengaluru: A wait list randomized control trial. Int J Yoga 2016; 9:35-43. [PMID: 26865769 PMCID: PMC4728956 DOI: 10.4103/0973-6131.171719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The beneficial aspect of positive emotions on the process of learning and the harmful affect of negative emotions on coping with stress and health are well-documented through studies. The Home Guards (HGs) are working in a very stressful situation during election, managing traffic and other crowded places. It is quite essential in present day circumstances that they have to manage their emotions and cope up with different stressful situations. OBJECTIVE To study the efficacy of integrated Yoga module (IYM) on emotions (positive and negative affect [PA and NA]) of HGs. METHODS A total of 148 HGs both males and females who qualified the inclusion and exclusion criteria were randomly divided into Yoga group (YG) and control groups (CG). The YG had supervised practice sessions (by trained experts) for 1 h daily, 6 days a week for 8 weeks along with their regular routine work whereas CG performing their routine work. Positive affect negative affect scale (PANAS) was assessed before and after 8 weeks using a modified version of PANAS. RESULTS PA in YG had significantly increased (P < 0.05) whereas it had decreased significantly (P < 0.05) in CG. Other positive effect in YG had significantly increased (P < 0.001), whereas it had decreased significantly (P < 0.001) in CG. NA in YG had significantly decreased (P < 0.001), whereas it had significantly increased (P < 0.001) in CG. Other NA in YG had significantly decreased (P < 0.001), whereas it had significantly increased (P < 0.01) in CG. CONCLUSIONS The results suggested that IYM can be useful for HGs to improve the PA and to decrease NA score. Moreover, IYM is cost-effective and helps HGs for coping up with emotions in stressful situations.
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Affiliation(s)
- B Amaranath
- Department of Yoga and Life Science, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - Hongasandra R Nagendra
- Department of Yoga and Life Science, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - Sudheer Deshpande
- Department of Yoga and Life Science, S-VYASA Yoga University, Bengaluru, Karnataka, India
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Chao MT, Handley MA, Quan J, Sarkar U, Ratanawongsa N, Schillinger D. Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes. PATIENT EDUCATION AND COUNSELING 2015; 98:1360-6. [PMID: 26146238 PMCID: PMC4609248 DOI: 10.1016/j.pec.2015.06.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Patient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. METHODS We used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n=278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication. RESULTS Among racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n=133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR=2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR=1.50, 95% CI: 1.03, 2.19), shared decision making (AOR=1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR=1.46, 95% CI: 1.03, 2.09). CONCLUSION Safety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication. PRACTICE IMPLICATIONS Patient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches.
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Affiliation(s)
- M T Chao
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - M A Handley
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, CA, USA
| | - J Quan
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, CA, USA
| | - U Sarkar
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, CA, USA
| | - N Ratanawongsa
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, CA, USA
| | - D Schillinger
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, CA, USA
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Nahin RL, Stussman BJ, Herman PM. Out-Of-Pocket Expenditures on Complementary Health Approaches Associated With Painful Health Conditions in a Nationally Representative Adult Sample. THE JOURNAL OF PAIN 2015; 16:1147-62. [PMID: 26320946 DOI: 10.1016/j.jpain.2015.07.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/10/2015] [Accepted: 07/14/2015] [Indexed: 11/25/2022]
Abstract
UNLABELLED National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain, and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, the use of complementary health approaches, the reasons for this use, and the associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for comorbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (standard error [SE] = $.9 billion) on these approaches to manage these painful conditions. Total OOP expenditures by those using complementary approaches for their back pain ($8.7 billion, SE = $.8 billion) far outstripped OOP expenditures for any other condition; the majority of these costs ($4.7 billion, SE = $.4 billion) were for visits to complementary providers. Annual condition-specific per person OOP costs varied from a low of $568 (SE = $144) for regular headaches to a high of $895 (SE = $163) for fibromyalgia. PERSPECTIVE Adults in the United States spent $14.9 billion on complementary health approaches (eg, acupuncture, chiropractic manipulation, and herbal medicines) to manage painful conditions including back pain ($8.7 billion). This back pain estimate is almost one-third of the total conventional health care expenditure for back pain ($30.4 billion) and two-thirds higher than conventional OOP expenditures ($5.1 billion).
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Affiliation(s)
- Richard L Nahin
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland.
| | - Barbara J Stussman
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
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Koren R, Lerner A, Tirosh A, Zaidenstein R, Ziv-Baran T, Golik A, Koren S. The Use of Complementary and Alternative Medicine in Hospitalized Patients with Type 2 Diabetes Mellitus in Israel. J Altern Complement Med 2015; 21:395-400. [PMID: 26052873 DOI: 10.1089/acm.2015.0019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION The use of complementary and alternative medicine (CAM) has been on the rise in recent years in the general population, as well as among patients with chronic diseases such as diabetes mellitus. The aim of this study was to add information regarding the use of CAM in patients with type 2 diabetes mellitus (DM2) in Israel and explore possible interactions between CAM and prescription medication (PM). METHODS This is a cross-sectional study based on questionnaires. The study included type 2 diabetic patients who were hospitalized in an internal medicine department at Assaf Harofeh Medical Center, Zerifin, Israel, between December 2013 and December 2014. Possible interactions between CAM and PM were evaluated by a clinical pharmacist and a clinical pharmacologist. RESULTS Out of 111 diabetic patients, 23.4% used CAM. There was no significant difference between the consumers and nonconsumers in terms of age, education, income, smoking, or alcohol habits. Only 11 of the 26 CAM consumers informed their physician regarding the use. We found possible drug-herb interactions in 19 of the 26 CAM consumers. A major interaction was found between omega-3 and antiaggregants and was encountered in 7 (26.9%) of the CAM consumers. Other minor and major interactions were found with vitamin E, ginkgo-biloba, co-enzyme Q10, green tea, fenugreek seeds, pyridoxine, and dandelion. CONCLUSIONS Since CAM consumption is on the rise, it is desirable to improve our knowledge concerning their potential effects and adverse effects, especially in conjunction with PM. Given the complexity of pharmaceutics in patients with chronic diseases, among them patients with DM, the use of supplementary medicine cannot be ignored.
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Affiliation(s)
- Ronit Koren
- 1 Department of Internal Medicine A, Assaf Harofeh Medical Center , Zerifin, Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Ayelet Lerner
- 3 Endocrinology and Metabolism Unit, Rabin Medical Center , Petah Tikva, Israel
| | - Amit Tirosh
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,3 Endocrinology and Metabolism Unit, Rabin Medical Center , Petah Tikva, Israel
| | - Ronit Zaidenstein
- 1 Department of Internal Medicine A, Assaf Harofeh Medical Center , Zerifin, Israel
| | - Tomer Ziv-Baran
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,4 Department of Epidemiology and Preventive Medicine, School of Public Health , Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ahuva Golik
- 1 Department of Internal Medicine A, Assaf Harofeh Medical Center , Zerifin, Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Shlomit Koren
- 1 Department of Internal Medicine A, Assaf Harofeh Medical Center , Zerifin, Israel .,5 Diabetes Unit, Assaf Harofeh Medical Center , Zerifin, Israel
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Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002-2012. NATIONAL HEALTH STATISTICS REPORTS 2015:1-16. [PMID: 25671660 PMCID: PMC4573565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This report presents national estimates of the use of complementary health approaches among adults in the United States across three time points. Trends in the use of selected complementary health approaches are compared for 2002, 2007, and 2012, and differences by selected demographic characteristics are also examined. METHODS Combined data from 88,962 adults aged 18 and over collected as part of the 2002, 2007, and 2012 National Health Interview Survey were analyzed for this report. Sample data were weighted to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. RESULTS Although the use of individual approaches varied across the three time points, nonvitamin, nonmineral dietary supplements remained the most popular complementary health approach used. The use of yoga, tai chi, and qi gong increased linearly across the three time points; among these three approaches, yoga accounted for approximately 80% of the prevalence. The use of any complementary health approach also differed by selected sociodemographic characteristics. The most notable observed differences in use were by age and Hispanic or Latino origin and race.
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Lee MS, Jun JH, Lim HJ, Lim HS. A systematic review and meta-analysis of tai chi for treating type 2 diabetes. Maturitas 2015; 80:14-23. [DOI: 10.1016/j.maturitas.2014.09.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 09/20/2014] [Indexed: 02/08/2023]
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Du Y, Wolf IK, Zhuang W, Bodemann S, Knöss W, Knopf H. Use of herbal medicinal products among children and adolescents in Germany. Altern Ther Health Med 2014; 14:218. [PMID: 24988878 PMCID: PMC4091953 DOI: 10.1186/1472-6882-14-218] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 06/20/2014] [Indexed: 11/23/2022]
Abstract
Background Germany is a country with a high use of herbal medicinal products. Population-based data on the use of herbal medicinal products among children are lacking. The aim of this study is to investigate the prevalence, patterns and determinants of herbal medicine use among children and adolescents in Germany. Methods As data base served the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a representative population based survey conducted 2003–2006 by the Robert Koch Institute. 17,450 boys and girls aged 0–17 years provided information on drug use in the preceding seven days. Herbal medicinal products were defined according to the European and German drug laws. SPSS Complex Sample method was used to estimate prevalence rates and factors associated with herbal medicine use. Results The prevalence rate of herbal medicinal product use amounts to 5.8% (95% confidence interval 5.3-6.3%). Use of herbal medicine declines along with increasing age and shows no difference between boys and girls in younger age groups. Teenage girls are more likely to use herbal medicines than teenage boys. Two thirds of herbal medicines are used for the treatment of coughs and colds; nearly half of herbal medicines are prescribed by medical doctors. Determinants of herbal medicinal product use are younger age, residing in South Germany, having a poor health status, having no immigration background and coming from a higher social class family. Children’s and parents-related health behavior is not found to be associated with herbal medicine use after adjusting for social class. Conclusions Use of herbal medicinal products among children and adolescents between the ages of 0 and 17 years in Germany is widely spread and shows relatively higher rates compared to international data. This study provides a reference on the use of herbal medicinal products for policy-makers, health professionals and parents. Further studies are needed to investigate the effectiveness and safety of specific herbal medicinal products, potential effects of long term use as well as possible interactions of herbal medicinal products with concomitantly used conventional medicines.
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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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Pomegranate polyphenols lower lipid peroxidation in adults with type 2 diabetes but have no effects in healthy volunteers: a pilot study. J Nutr Metab 2013; 2013:708381. [PMID: 23936637 PMCID: PMC3723081 DOI: 10.1155/2013/708381] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 06/22/2013] [Indexed: 12/30/2022] Open
Abstract
Aims. To examine the antioxidant and anti-inflammatory effects of pomegranate polyphenols in obese patients with type 2 diabetes (T2DM) (n = 8) and in healthy nondiabetic controls (n = 9). Methods. Participants received 2 capsules of pomegranate polyphenols (POMx, 1 capsule = 753 mg polyphenols) daily for 4 weeks. Blood draws and anthropometrics were performed at baseline and at 4 weeks of the study. Results. Pomegranate polyphenols in healthy controls and in T2DM patients did not significantly affect body weight and blood pressure, glucose and lipids. Among clinical safety profiles, serum electrolytes, renal function tests, and hematological profiles were not significantly affected by POMx supplementation. However, aspartate aminotransferase (AST) showed a significant increase in healthy controls, while alanine aminotransferase (ALT) was significantly decreased in T2DM patients at 4 weeks (P < 0.05), though values remained within the normal ranges. Among the biomarkers of lipid oxidation and inflammation, oxidized LDL and serum C-reactive protein (CRP) did not differ at 4 weeks in either group, while pomegranate polyphenols significantly decreased malondialdehyde (MDA) and hydroxynonenal (HNE) only in the diabetic group versus baseline (P < 0.05). Conclusions. POMx reduces lipid peroxidation in patients with T2DM, but with no effects in healthy controls, and specifically modulates liver enzymes in diabetic and nondiabetic subjects. Larger clinical trials are merited.
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