Features of complementary and alternative medicine use by patients with coronary artery disease in Beijing: a cross-sectional study

The Prevalence of Complementary and Integrative Health Approach Use and Quality of Life Among Patients With Heart Failure: A Cross-sectional, Descriptive, and Comparative Study

This study aimed to determine the prevalence of complementary and integrative health approach (CIHA) use in patients with heart failure (HF) and compare quality of life (QoL) between CIHA users and nonusers. This was a cross-sectional, descriptive, and comparative study including 130 patients with HF in Turkey. The data were collected using the sociodemographic and CIHA information form and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The mean age was 64.51 ± 10.40 years. Furthermore, 26.1% of the participants had used at least one form of CIHA in the previous year. The most used CIHA was herbal therapies (94.2%). The total scores of the KCCQ were 47.70 ± 9.50 in the study, and a statistically significant difference was found in the total scores of the KCCQ between CIHA users and nonusers. The findings of this study revealed that more than a quartile of patients with HF used at least one form of CIHA. Further prospective studies are warranted to follow up with patients having HF who use any form of CIHA for a longer period and determine other parameters that directly influence QoL.

Traditional and complementary medicine for promoting healthy ageing in WHO Western Pacific Region: Policy implications from utilization patterns and current evidence

BACKGROUND

With increasing burden of chronic non-communicable diseases (NCD), ageing becomes a global public health concern, and the World Health Organization Western Pacific Region has no exception. To address the NCD challenge, priority should be given to promote healthy ageing across the life-course. As traditional and complementary medicine (T&CM) is popular within the Region, it is of policy interest to explore possibilities of applying T&CM for promoting healthy ageing.

METHODS

We first summarized sources of clinical evidence supporting the use of T&CM. We then searched publications through MEDLINE from its inception to April 2020 to identify studies focusing on the perception of T&CM among older people. Finally, taking current evidence base and patient choice into account, we generated policy recommendations for of integrating T&CM into health systems.

RESULT

Experiences from countries with different income levels suggested that promoting evidence-based T&CM as self-care modalities would be the most efficient way of maximizing impact among the older population, especially via a train the trainer approach. Meanwhile, popularity of natural products in the Region mandates policy makers to implement appropriate regulation and quality assurance, and to establish pharmacovigilance to detect potential harm. The role of pharmacists in advising patients on self-medication using natural products needs to be strengthened.

CONCLUSION

Policy-makers will benefit from continued global dialogue and sharing of experience in T&CM policy development and implementation. Harmonizing regulatory frameworks for natural products at regional and global levels, including mutual recognition of regulatory approval, to improve standards and protect patients could be a priority.

'What the herbal medicine can do for me in a week, the orthodox does in a year': Perceived efficacy of local alternative therapies influences medication adherence in patients with atherosclerotic cardiovascular disease

Background

There is strong evidence that anti‐platelet therapy, ACE inhibitors, beta‐blockers and statins are cost‐effective in reducing subsequent cardiovascular disease (CVD) events in patients with atherosclerotic cardiovascular disease (ACVD). In some settings, only a low proportion of people have access to these medications, and even lower adhere to them. The current study explored and presents data on the causes of poor adherence to orthodox medication and motivations for alternative therapies in patients with established atherosclerotic cardiovascular disease (ACVD).

Methods

The study was conducted among city‐dwelling adults with ACVD in Accra – Ghana's capital city. Eighteen interviews were conducted with patients with established ACVD. A follow‐up focus group discussion was conducted with some of them. The protocol was approved by two ethics review committees based in Ghana and in the United Kingdom. All participants were interviewed after informed consent. Analysis was done with the Nvivo qualitative data analysis software.

Results

We identified motivations for use of alternatives to orthodox therapies. These cover the five dimensions of adherence: social and economic, health‐care system, condition‐related, therapy‐related, and patient‐related dimensions. Perceived inability of an orthodox medication to provide immediate benefit is an important motivator for use of alternative forms of medication.

Conclusions

A multiplicity of factors precipitate non‐adherence to orthodox therapies. Perceived efficacy and easy access to local alternative therapies such as herbal and faith‐based therapies are important motivators.

Complementary Therapies Used by Indonesians With Myocardial Infarction

This descriptive, cross-sectional study was conducted to identify types, frequency, methods, duration, and purpose of complementary therapies used by Indonesians with myocardial infarction. The majority of the respondents used biologically based therapies, with the most common subtype being herbs. The purpose of using biologically based therapies was for health promotion.

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

OBJECTIVES

To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe.

METHODS

A literature search was performed on Pubmed, ScienceDirect and EMBASE.

KEYWORDS

'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage.

RESULTS

231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05).

CONCLUSIONS

Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.

Complementary and alternative medicine use in coronary heart disease patients: a cross-sectional study from Palestine

BACKGROUND

There is a lack of data on the use of complementary and alternative medicine (CAM) in patients with coronary heart disease (CHD). This study examined the use of CAM among patients with CHD, the reasons and factors influencing their use, the types of CAM used, and the relationship between patient's demographics and the use of CAM.

METHODS

In order to determine the prevalence and usage of CAM among Palestinian patients with CHD, a cross-sectional descriptive study was performed from three different hospitals. Using a convenient sampling method, a questionnaire was completed in a face-to-face interview with the patients. Descriptive statistics were used for socio-demographic, and clinical variables. Siahpush scale was used to examine the attitude of CHD patients toward CAM use.

RESULTS

Of the 150 patients that were interviewed, 128 (85.3%) of the patients completed the questionnaire. The majority of CAM users reported CAM use for health problems other than CHD, while a total of 59 (45.9%) patients have used CAM for their heart problems. On the other hand, it was found that the place of residency and pattern of CHD were significantly associated with CAM use (p = 0.039 and 0.044, respectively). In addition, religious practices were found to be the most common form of CAM used by patients, while body and traditional alternative methods were the least being used. A significant association between the attitudes of patients with CHD and their use of CAM was found (patients' attitudes towards alternative medicine and natural remedies were p = 0.011 and 0.044, respectively).

CONCLUSIONS

CAM use among our respondents is common. Despite a lack of evidence-based research supporting its potential benefits and side effects. Understanding the factors that affect CAM use by CHD patients offers healthcare workers and policymakers an opportunity to better understand CAM use and ultimately improve patient-physician interactions.

The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q)

BACKGROUND

In Taiwan, numerous studies have been conducted to investigate the use of complementary and alternative medicine (CAM). However, most of them focused on specific diseases or the use of particular methods. Therefore, the results of those studies were quite different and difficult to compare with those of studies from other countries. The International CAM Questionnaire (I-CAM-Q), meanwhile, is a unified tool that can provide comparable results for studies conducted worldwide. Thus, the aim of this study was to discover the proportions of people in Taiwan receiving CAM treatments from different types of health care providers by using an adapted version of I-CAM-Q (I-CAM-QT).

METHODS

I-CAM-QT was developed by translating the Korean version of I-CAM-Q (I-CAM-QK) into traditional Chinese language because of the similarity of CAM usage and doctor licensing system. This study had two stages: the first was a pretest survey used to adjust the questionnaire, while the second was an internet-based survey used to collect data from the community.

RESULTS

Of the 1200 survey respondents, 37% and 37.7% were prescribed or advised to use Chinese herbal medicine (CHM) by Western medicine (WM) physicians and traditional Chinese medicine (TCM) doctors, respectively. Other than CHM, dietary supplements and massage were the forms of CAM most commonly prescribed or recommended by WM physicians or TCM doctors. Overall, walking and relaxation techniques were the most commonly used self-help practices (used by 61.9% and 40.4% of the respondents, respectively). Additionally, 70.3% of the respondents had used at least one kind of dietary supplement in the past 12 months.

CONCLUSION

Regarding the utilization of CAM in Taiwan, this internet-based survey revealed that CHM, dietary supplements, and massage were the types of CAM most commonly prescribed or recommended by WM physicians or TCM doctors.

Use of Complementary and Alternative Medicine in Japan: A Cross-sectional Internet Survey Using the Japanese Version of the International Complementary and Alternative Medicine Questionnaire

Introduction:

Although there have been several national survey studies on complementary and alternative medicine (CAM) use in Japan, previous studies have not been compared with investigations conducted in other countries. An international CAM questionnaire known as I-CAM-Q was developed through a two-day international workshop in 2006. The purpose of this study was to investigate the use of CAM by the general Japanese population using a modified version of the I-CAM-Q for the Japanese (I-CAM-QJ).

Methods:

We developed the I-CAM-QJ to conduct an internet survey of 3,208 participants from the general population of Japan in February 2016. The respondents included 1,592 males (49.6%), 1,348 university graduates (38.8%), 1,105 individuals in good health (34.4%), and 1,028 individuals with long-term illness or disability (32.0%).

Results:

Of the 3,208 respondents, 411 participants reported CAM use during the past 12 months (12.8%). The following therapies and products were used: Kampo medicines (over-the-counter Kampo medicines: 15.7%; prescribed Kampo medicines: 15.4%), dietary supplements 11.8%, massage services 3.9%, and physical therapy 3.5%. Regarding the use of self-care methods during the last 12 months, the following methods and products were used: bath salts 25.8% and walking 25.3%.

Conclusions:

An internet survey on CAM use by the general Japanese population with a modified I-CAM-Q (I-CAM-QJ) revealed that Kampo medicines and dietary supplements were the most commonly used CAMs in Japan.

The utilization of nonprescription medications in Saudi patients with cardiovascular diseases

BACKGROUND

Cardiovascular diseases (CVDs) are the most common cause of disease-related death in Saudi Arabia. The incidence of CVDs continues to increase, presenting a major health care problem. Nonprescription medications are widely used by patients with CVD and may cause adverse drug events, either by worsening the disease or by harmfully interacting with prescribed medications. We investigated the patterns of nonprescription medication utilization and the factors associated with their use in patients with CVD.

METHODS

This was a cross-sectional study conducted at the Cardiology Clinics of an academic tertiary health care center. Participants were asked about their sociodemographic characteristics, medical history and frequency of using nonprescription medications including over-the-counter (OTC) products, dietary supplements, and herbal products. Moreover, we investigated the participants' sources of information about nonprescription medications. Multivariate logistic regression analysis was conducted to examine the predictors of nonprescription medication use.

RESULTS

A total of 209 participants were interviewed. The mean age of the participants was 56 ± 15 years, and 110 (52.6%) were female. Of the 209 participants, 116 (55%) reported routine use of nonprescription medications. Black seeds and garlic were the most frequently used herbal products. Acetaminophen, cold/cough remedies, and ibuprofen were the most commonly reported OTC drugs. Of the surveyed patients, 54 (46.5%) used nonprescription medications to manage cardiovascular conditions specifically. Compared with other comorbidities, diabetes mellitus was associated with a higher use of nonprescription medications.

CONCLUSION

In patients with CVD, the routine use of nonprescription medications was common for a number of reasons. Health care providers should proactively discuss nonprescription use with their CVD patients to avoid potential harmful outcomes.

Complementary and alternative medicine use amongst patients with cardiovascular disease in Singapore

BACKGROUND

Data on complementary and alternative medicine (CAM) use in patients with cardiovascular disease (CVD) are lacking. We aim to investigate the prevalence of CAM use among patients with CVD attending a tertiary centre for cardiovascular care, their attitudes and beliefs towards CAM, and factors associated with CAM usage.

METHODS

A cross-sectional, self-administered written survey was conducted on consecutive patients attending outpatient cardiovascular clinics at our tertiary institution over 2 months from June to July 2014. Information gathered included demographic data and various aspects of CAM use.

RESULTS

A total of 768 responses (562 males, mean age 57 ± 13 years, 74 % Chinese, 6 % Malay, 14 % Indian) were included. The prevalence of CAM use in the cohort was 43.4 % (333/768). Biologically-based systems (29.4 %) was the most common type of CAM used. Some patients (19.0 %) used multiple types of CAM simultaneously. External influences (78.1 %) were cited more than internal influences (47.8 %) to affect CAM use. Malay ethnicity (compared to Chinese) was the only significant negative multivariate predictor of CAM use (OR = 0.531 (95 % CI 0.147 to 0.838), p = 0.018). A significantly higher proportion of CAM users compared to non-CAM users were non-compliant to medications (35.6 %, n = 114 vs. 20.5 %, n = 84, p < 0.001) and consults (41.4 %, n = 130 vs. 28.1 %, n = 112, p < 0.001) respectively.

CONCLUSION

The usage of CAM is prevalent amongst our patients with CVD. CAM use was associated with poorer reported compliance to medications and consults. Understanding the factors influencing CAM use amongst CVD patients provides medical professionals with an opportunity to better discuss CAM use and potentially enhance the patient-physician interaction.

Complementary and alternative medicine usage among cardiac patients: a descriptive study

BACKGROUND

The use of complementary and alternative medicine (CAM) persists, despite the availability of conventional medicine (CM), modernisation, globalisation, technological advancement, and limited scientific evidence supporting CAM. People with cardiovascular diseases often use CAM, despite possible major adverse effects and lack of evidence supporting CAM claims. This study explored CAM use among cardiac patients, the types of CAM used, reasons and factors that influence its use, and the association between patient demographics and CAM use.

METHODS

This cross-sectional quantitative study was conducted using quota sampling to survey 329 public clinic adult cardiac patients within the South-West Regional Health Authority (SWRHA) of Trinidad and Tobago. From 1 July 2012 to 31August 2012, each participant completed questionnaires, after consenting to participate. Data analysis included χ(2) tests and binary logistic regression.

RESULTS

One hundred eighty-five (56.2%; standard error [SE] = 2.74%) patients used CAM. Herbal medicine was the most common CAM (85.9%; SE = 2.56%), followed by spiritual therapy/mind-body systems (61.6%; SE = 3.58%), physical therapy/body manipulation (13.5%; SE = 2.51%), alternative systems (8.1%; SE = 2.01%), and other methods (3.8%; SE = 1. 41%). The patients believed that CAM promotes health and wellness (79.5%; SE = 2.97%), assists in fighting illness (78.9%; SE = 3.00%), addresses the limitations of CM (69.2%; SE = 3.56%), alleviates symptoms (21.6%; SE = 6.51%), costs less than CM (21.6 %, SE = 3.03), and has fewer adverse/damaging effects than CM (29.7, SE =3.36), or they were disappointed with CM (12.4%, SE = 2.42). Ethnicity and religion were associated with CAM usage, but only ethnicity was a useful predictor of CAM use.

CONCLUSIONS

Complementary and alternative medicine use was high among cardiac patients (56.2%, SE = 2.74%), and associated with ethnicity and religion. Friends, family, and perceived mode of action influenced a patient's use of CAM.

Reasons why Thai patients with chronic kidney disease use or do not use herbal and dietary supplements

BACKGROUND

Despite a high prevalence of herbal and dietary supplement use (HDS) in pre-dialysis patients, the reasons are unknown as to why they decide to use HDS. Objectives of the cross-sectional and qualitative studies were to determine reasons for the use and non-use of HDS in Thai patients with chronic kidney disease (CKD).

METHODS

This prospective study recruited 421 patients with stage 3-5 CKD from two kidney clinics in Thailand, and 357 were followed up regarding their HDS use over 12 months. Patients receiving renal replacement therapy at baseline were excluded. Participants were interviewed at baseline and in the twelfth month regarding their HDS use, and reasons for their use or non-use of HDS. Among HDS users, 16 patients were enrolled in a qualitative study and were interviewed using eight-open ended questions about reasons for HDS use. Descriptive and thematic analyses were performed.

RESULTS

Thirty-four percent of patients with CKD consistently used HDS over the 12 months and 17% of all patients intermittently took them during the follow-up period. At baseline, family or friends' recommendation was the most common reason for HDS use (35%), followed by having a perception of benefits from using HDS (24%). During the follow-up period, perceived benefits of HDS was a frequently reported reason for either continuing with HDS use (85%) or starting to use HDS (65%). Negative experience from using HDS influenced patients to stop using them (19%). Although the main reason for non-use of HDS was trust in a doctor or effectiveness of conventional medicine (32%), doubt about the benefits from HDS or concerns about negative effects were frequently reported reasons for non-use (23%). Doctor's recommendations to avoid using HDS were the main influence for non-users (19%) and for those who had stopped using HDS (23%). The media and patients' social network had an impact on HDS use.

CONCLUSIONS

Patients who perceived benefits from HDS use were more likely to use HDS, whilst non-users had negative attitudes towards HDS. Health professionals therefore should educate patients and their relatives about the risks and benefits from using HDS.

Acupoint application in patients with chronic stable angina pectoris: study protocol of a randomized, double-blind, controlled trial

Background. Chronic stable angina pectoris (CSAP) is a major syndrome of ischemic heart disease (IHD). CSAP manifests as chest pain or discomfort and affects patients' quality of life. Acupoint application (AP) has been reported to be effective for managing the symptoms of CSAP, but the evidence is not convincing. Therefore, we designed a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of AP in the treatment of CSAP. Methods and Analysis. Two hundred participants with CSAP will be randomly assigned in a 1 : 1 : 1 : 1 ratio into 4 groups. All participants will receive 12 sessions of treatment in 4 weeks and the same basic treatment procedure. The participants will be visited and assessed for 12 weeks, including a 4-week screening, a 4-week treatment phase, and a 4-week follow-up phase. The primary outcome is the change in the total frequency of self-reported angina attack at 4th week compared with the baseline. The secondary outcomes include the intensity of angina pain, consumption of nitroglycerin or Suxiao Jiuxin pills, CCS angina classification, SAQ, SAS and SDS score. Ethics. The study protocol has been reviewed and approved by the Sichuan Regional Ethics Review Committee on TCM (number 2013kl-001). This trial is registered with clinicaltrials.gov NCT02029118.