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Iyengar P, Godoy-Brewer G, Maniyar I, White J, Maas L, Parian AM, Limketkai B. Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:934. [PMID: 38612967 PMCID: PMC11013716 DOI: 10.3390/nu16070934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Herbal medicines are used by patients with IBD despite limited evidence. We present a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating treatment with herbal medicines in active ulcerative colitis (UC). A search query designed by a library informationist was used to identify potential articles for inclusion. Articles were screened and data were extracted by at least two investigators. Outcomes of interest included clinical response, clinical remission, endoscopic response, endoscopic remission, and safety. We identified 28 RCTs for 18 herbs. In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97-6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99-2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71-1.26). There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18-5.63), but not for AP (RR 1.31, 95% CI 0.86-2.01). Higher rates of endoscopic response (RR 1.56, 95% CI 1.08-2.26) and remission (RR 19.37, 95% CI 2.71-138.42) were significant for CL. CL has evidence supporting its use as an adjuvant therapy in active UC. Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.
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Affiliation(s)
- Preetha Iyengar
- Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA;
| | | | - Isha Maniyar
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA;
| | - Jacob White
- Welch Library, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Laura Maas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Alyssa M. Parian
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Berkeley Limketkai
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA;
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Bauer N, Kairey L, Schlee C, Uecker C, Öznur Ö, Langhorst J. Use of complementary and alternative medicine (CAM) in patients with inflammatory bowel disease (IBD): results from a German nationwide survey of 2019 compared to a previous survey of 2002. Scand J Gastroenterol 2022; 57:1209-1215. [PMID: 35722930 DOI: 10.1080/00365521.2022.2078667] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION In 2002, 50% of patients with Inflammatory Bowel Disease (IBD) had used complementary and alternative medicine (CAM) in Germany. This survey aimed to examine changes from 2002 to 2019 and predictors of CAM use in 2019. MATERIALS AND METHODS In 2019, a questionnaire was sent randomly to 1000 members of the German Crohn's Colitis Association, the same sampling strategy was chosen 2002. Items assessed included, demographic characteristics, IBD diagnosis and disease history, medication use, patients' symptoms/quality of life, anxiety/depression and use of complementary therapies. RESULTS The 2019 sample only differed slightly in case of gender (55% women) and disease (43% Ulcerative Colitis) from the 2002 sample. In 2019, 54% (227/417) reported having ever used CAM and 75% (396/417) planned to use CAM for their IBD in the future, whereby there was an evidence of a decrease in exclusive CAM use from 2002 (28%; 96/344) to 2019 (16%, 37/277; BF<.01). In logistic regression analyses, ulcerative colitis compared to Crohn's Disease (OR 0.59, p=.005), side effects of standard therapy (OR 1.94, p=.012), the use of corticosteroids (OR 0.54, p=.038) or biologics (OR 1.90, p = .020) and lower quality of life (OR 0.96, p=.002) were associated with CAM use in 2019. CONCLUSIONS Every other patient with IBD used CAM and has thus indicated a need for a safe and evidence-based combination of conventional and complementary approaches. This would further support the desired decrease in exclusive -alternative- CAM use.
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Affiliation(s)
- Nina Bauer
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
| | - Lana Kairey
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
| | - Christoph Schlee
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany.,Department of Sociology, University of Bamberg, Bamberg, Germany
| | - Christine Uecker
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
| | - Özlem Öznur
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
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D’Silva A, Marshall DA, Vallance JK, Nasser Y, Taylor LM, Lazarescu A, Raman M. Gastroenterologist and Patient Attitudes Toward Yoga as a Therapy for Irritable Bowel Syndrome: An Application of the Theory of Planned Behaviour. J Can Assoc Gastroenterol 2022; 6:17-25. [PMID: 36789144 PMCID: PMC9915057 DOI: 10.1093/jcag/gwac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives To identify irritable bowel syndrome (IBS) patients' attitudes, subjective norms, perceived control and intention to practice yoga and gastroenterologists' attitudes and current yoga recommendations for their patients with IBS. Methods Gastroenterologists and IBS patients completed online surveys including Theory of Planned Behaviour (TPB) constructs. Among IBS patients, multiple linear regression determined the multivariate associations between TPB variables and intention to practice yoga while controlling for significant socio-demographic variables. Gastroenterologists were asked about their attitudes and current yoga recommendations for patients with IBS. Chi-square analyses examined associations between gastroenterologists' demographics and recommending yoga. Binomial logistic regression described associations between attitude variables and current yoga recommendations. Results For patients (n = 109), controllability (β = 0.5, P < 0.001), affective attitude (β = 0.4, P < 0.05) and self-efficacy (β = 0.3, P < 0.05) were significantly associated with intention to do yoga in the regression model. TPB variables explained 34% of the variance in patients' intentions to practice yoga. The binomial regression analysis revealed that gastroenterologists (n = 79) who have confidence in recommending yoga (39%) were seven times more likely to recommend it (odds ratio = 7.3, P = 0.002) and those who agreed yoga improves IBS symptom severity (54%) were 10 times more likely to recommend yoga (odds ratio = 10.1, P < 0.001). Most (86%) wanted more evidence to support efficacy of yoga for IBS and 44% asked for more knowledge on how to refer a patient. Conclusion Controllability, affective attitude and self-efficacy predicted IBS patients' intentions to practice yoga. Although gastroenterologists believed yoga is safe and beneficial for IBS patients, most do not recommend yoga due to lack of confidence and scientific evidence.
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Affiliation(s)
- Adrijana D’Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada,Arthur J.E. Child Chair, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lorian M Taylor
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Adriana Lazarescu
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maitreyi Raman
- Correspondence: Maitreyi Raman, MD, Faculty of Medicine, University of Calgary, 6D33 TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada, e-mail:
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Nutraceuticals and Diet Supplements in Crohn's Disease: A General Overview of the Most Promising Approaches in the Clinic. Foods 2022; 11:foods11071044. [PMID: 35407131 PMCID: PMC8998137 DOI: 10.3390/foods11071044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
Crohn's disease (CD) is a chronic inflammatory gastrointestinal disorder requiring lifelong medications. The currently approved drugs for CD are associated with relevant side effects and several studies suggest an increased use of nutraceuticals among CD patients, seeking for what is perceived as a more "natural" approach in controlling this highly morbid condition. Nutraceuticals are foods or foods' components with beneficial health properties that could aid in CD treatment for their anti-inflammatory, analgesic and immunoregulatory activities that come along with safety, high tolerability, easy availability and affordability. Depending on their biological effect, nutraceuticals' support could be employed in different subsets of CD patients, both those with active disease, as adjunctive immunomodulatory therapies, and/or in quiescent disease to provide symptomatic relief in patients with residual functional symptoms. Despite the increasing interest of the general public, both limited research and lack of education from healthcare professionals regarding their real clinical effectiveness account for the increasing number of patients turning to unconventional sources. Professionals should recognize their widespread use and the evidence base for or against their efficacy to properly counsel IBD patients. Overall, nutraceuticals appear to be safe complements to conventional therapies; nonetheless, little quality evidence supports a positive impact on underlying inflammatory activity.
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Mousavi T, Nikfar S, Abdollahi M. Comprehensive study on the administrative, economic, regional, and regulatory prospects of complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD). Expert Rev Clin Pharmacol 2021; 14:865-888. [PMID: 33993811 DOI: 10.1080/17512433.2021.1925108] [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: 12/07/2022]
Abstract
Introduction: Due to the high cost, low effectiveness, and adverse effects plus the life-long nature of inflammatory bowel disease (IBD), and misconception on safety, efficacy, and cost-effectiveness of complementary and alternative medicine (CAM), the market demand for CAM has risen over the past decades. A critical review of patients' and physicians' attitudes, market drivers, economic aspects, regulatory roles, and regional distribution is lacking.Areas covered: Through relevant databases, the existing English language literature concerning the association of CAM use with IBD was collected over the past two decades. Data was then analyzed, comprehensively summarized in tables/figures, and justified concerning administrative, organizational, regional, economic, and regulatory perspectives.Expert opinion: Although CAM utilization is more prevalent among younger, female, and high-educated IBD patients, issues concerning weak study designs, limited-time period/regional distribution of recent surveys, and lack of economic evaluations on CAM make it entirely unfeasible to draw a firm conclusion. Regulators are lagging in meeting the dire need of IBD patients, especially the elderly. Lack of legislation regarding registration, sales monitoring, licensing, insurance coverage, efficacy/safety assessments, post-marketing surveillance, quality assurance, and reference pricing alongside the limited support for CAM research are the main matters that should be urgently addressed.
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Affiliation(s)
- Taraneh Mousavi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Personalized Medicine Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Evidence-Based Evaluation of Cost-Effectiveness and Clinical Outcomes Group, Pharmaceutical Sciences Research Center (PSRC), and the Pharmaceutical Management and Economics Research Center (PMERC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Personalized Medicine Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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6
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Wemrell M, Olsson A, Landgren K. The Use of Complementary and Alternative Medicine (CAM) in Psychiatric Units in Sweden. Issues Ment Health Nurs 2020; 41:946-957. [PMID: 32497455 DOI: 10.1080/01612840.2020.1744203] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mental ill-health has been termed the pandemic of the 21st century, and a large share of those exposed do not receive treatment. Many people with depression, anxiety and other mental health problems consult complementary or alternative medicine (CAM), and CAM is used in conventional psychiatric care, in Sweden and in other countries. However, the extent to which CAM is used in psychiatric care, and for what purposes, are largely unknown. This study is based on a survey distributed to all heads of regional, municipal, private and governmental health care units treating persons with psychiatric symptoms across Sweden in 2019. CAM was reportedly used by 62% of the 489 responding health care units, for symptoms including anxiety, sleep disturbances and depression. Main motivations for CAM use were symptom relief, meeting patients' requests and reduced demand for pharmaceutical medication. Very few respondents reported side effects. The most common reason for interrupting CAM use at a unit was a lack of trained professionals. This study confirms the need for further research about CAM, and for CAM education and training among healthcare professionals.
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Affiliation(s)
- Maria Wemrell
- Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden.,Department of Gender Studies, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Anna Olsson
- Health Sciences Center, Faculty of Medicine, Lund University, Sweden
| | - Kajsa Landgren
- Health Sciences Center, Faculty of Medicine, Lund University, Sweden.,Office of Psychiatry and Habilitation, Psychiatric Clinic in Lund, Sweden Region Skåne
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Picardo S, Altuwaijri M, Devlin SM, Seow CH. Complementary and alternative medications in the management of inflammatory bowel disease. Therap Adv Gastroenterol 2020; 13:1756284820927550. [PMID: 32523629 PMCID: PMC7257842 DOI: 10.1177/1756284820927550] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 04/23/2020] [Indexed: 02/04/2023] Open
Abstract
The use of complementary and alternative medications (CAM), products, and therapies not considered to be part of conventional medicine is common among patients with inflammatory bowel disease (IBD). Patients often turn to these therapies as they are considered natural and safe, with significant benefit reported beyond disease control. There is emerging evidence that some of these therapies may have anti-inflammatory activity; however, robust evidence for their efficacy in modulating disease activity is currently lacking. Patients often avoid discussing the use of CAM with their physicians, which may lead to drug interactions and/or reduced adherence with conventional therapy. It is important for physicians to be aware of the commonly used CAM and current evidence behind these therapies in order to better counsel their patients about their use in the management of IBD. This narrative review provides an overview of the evidence of the more commonly used CAM in patients with IBD.
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Affiliation(s)
| | | | - Shane M. Devlin
- Inflammatory Bowel Disease Unit, Department of
Gastroenterology, Cumming School of Medicine, University of Calgary, AB,
Canada
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8
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Experiences With Traditional Chinese Medicine Among Patients With Inflammatory Bowel Disease: A Qualitative Study. Gastroenterol Nurs 2020; 43:135-145. [PMID: 32251215 DOI: 10.1097/sga.0000000000000418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Despite the increasing number of inflammatory bowel disease (IBD) patients using traditional Chinese medicine (TCM), relatively few studies have examined their experiences with TCM in the Chinese healthcare context. The aim of this study was to explore these experiences from the perspective of IBD patients. Adopting a qualitative descriptive method, IBD patients from several comprehensive hospitals in Hangzhou, Zhejiang were recruited through purposive sampling. Data were collected using semistructured interviews and analyzed by a conventional content analysis method. The results are presented thematically. Fourteen IBD patients participated in the study. They often used TCM, such as Chinese herbal medicine, retention enemas of Chinese medicine, and acupuncture, as a complementary therapy instead of as an alternative to conventional therapies. Three themes emerged from the analysis: triggers for initiating TCM, the experienced efficacies of TCM, and disturbances caused by TCM use. The IBD patients initiate TCM treatment due to the unsatisfactory effects of conventional therapies and TCM culture. However, the efficacies of TCM are subjective and slow acting and vary across individuals. There are communication gaps between physicians and patients concerning TCM. Thus, healthcare professionals are encouraged to gain more knowledge on these therapies and employ a participatory decision-making style based on this understanding.
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9
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The Use of Complementary and Alternative Medicine in Patients With Inflammatory Bowel Disease. Gastroenterol Hepatol (N Y) 2018. [PMID: 30166957 DOI: 10.1007/978-94-011-4002-7_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Complementary and alternative medicine (CAM) includes products or medical practices that encompass herbal and dietary supplements, probiotics, traditional Chinese medicines, and a variety of mind-body techniques. The use of CAM in patients with inflammatory bowel disease (IBD) is increasing as patients seek ways beyond conventional therapy to treat their chronic illnesses. The literature behind CAM therapies and their application, efficacy, and safety is limited when compared to studies of conventional, allopathic therapies. Thus, gastroenterologists are often ill equipped to engage with their patients in informed and meaningful discussions about the role of CAM in IBD. The aims of this article are to provide a comprehensive summary and discussion of various CAM modalities and to appraise the evidence for their use.
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Portela F, Dias CC, Caldeira P, Cravo M, Deus J, Gonçalves R, Lago P, Morna H, Peixe P, Ramos J, Sousa H, Tavares L, Vasconcelos H, Magro F, Ministro P. The who-when-why triangle of CAM use among Portuguese IBD patients. Dig Liver Dis 2017; 49:388-396. [PMID: 28117198 DOI: 10.1016/j.dld.2016.12.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/29/2016] [Accepted: 12/30/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND The use of complementary and alternative medicines is increasing among chronic patients, particularly those afflicted with inflammatory bowel diseases. AIM This study aimed to address the prevalence of complementary and alternative medicines use among Portuguese inflammatory bowel diseases' patients. METHODS Patients were invited to fill an anonymous questionnaire concerning the use of complementary and alternative medicines. RESULTS Thirty-one per cent of the patients reported having used complementary and alternative medicines in the past, whereas 12% were using them by the time the questionnaire was administered. Fifty-nine per cent of the users did not share this information with their physician, whereas 14% and 8% discontinued their medication and periodical examination, respectively. Steroids prescription (OR=2.880) and a higher instruction level (OR=3.669) were predictors of complementary and alternative medicines use in this cohort. CONCLUSIONS Roughly a third of Portuguese IBD patients had used CAM. Steroid treatment and an academic degree are associated with CAM use. Given the potential side effects and interactions, patient information about the benefits and limitations of conventional and complementary treatments should be reinforced.
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Affiliation(s)
- Francisco Portela
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
| | - Camila C Dias
- CIDES - Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Paulo Caldeira
- Gastroenterology Department, Centro Hospitalar do Algarve, Portugal
| | - Marilia Cravo
- Serviço de Gastrenterologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - João Deus
- Serviço de Gastrenterologia, Hospital Fernandes da Fonseca, Amadora, Portugal
| | | | - Paula Lago
- Gastroenterology Department, Centro Hospitalar Porto-Hospital Santo António, Portugal
| | - Henrique Morna
- Serviço de Gastrenterologia, Hospital do Funchal, Funchal, Portugal
| | - Paula Peixe
- Serviço de Gastrenterologia, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Jaime Ramos
- Serviço de Gastrenterologia, Hospital dos Capuchos, Lisboa, Portugal
| | - Helena Sousa
- Gastroenterology Department, Centro Hospitalar do Algarve, Portugal; Biomedical Sciences and Medicine Department, University of Algarve, Portugal
| | - Lurdes Tavares
- Serviço de Gastrenterologia, Hospital de Santa Maria, Lisboa, Portugal
| | | | - Fernando Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal; Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal; MedInUP - Centre for Drug Discovery and Innovative Medicines, University of Porto, Portugal
| | - Paula Ministro
- Serviço Gastrenterologia, Centro Hospitalar de Tondela - Viseu, Viseu, Portugal
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Jong M, Lundqvist V, Jong MC. A cross-sectional study on Swedish licensed nurses' use, practice, perception and knowledge about complementary and alternative medicine. Scand J Caring Sci 2015; 29:642-50. [DOI: 10.1111/scs.12192] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/08/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Mats Jong
- Department of Nursing; Mid Sweden University; Sundsvall Sweden
| | | | - Miek C. Jong
- Department of Nursing; Mid Sweden University; Sundsvall Sweden
- Louis Bolk Institute; Driebergen The Netherlands
- National Information and Knowledge Centre for Integrative Medicine; Amsterdam The Netherlands
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12
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Lindberg A, Fossum B, Karlen P, Oxelmark L. Experiences of complementary and alternative medicine in patients with inflammatory bowel disease - a qualitative study. Altern Ther Health Med 2014; 14:407. [PMID: 25338541 PMCID: PMC4210588 DOI: 10.1186/1472-6882-14-407] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/16/2014] [Indexed: 12/16/2022]
Abstract
Background The use of Complementary and Alternative Medicine (CAM) in Inflammatory Bowel Disease (IBD) is increasing. Although CAM often improves patients’ well-being, it can also lead to side-effects and interactions with conventional medications. Research on patients with IBD in Sweden who have experiences of CAM is sparse. More studies are needed to enhance awareness of and improve communication about CAM. The aim of this study was to describe experiences of CAM in the healthcare context reported by patients with IBD. Methods Fifteen patients with IBD, eight with Crohn’s disease (CD) and seven with ulcerative colitis (UC), were recruited. Semi-structured qualitative interviews were conducted and qualitative content analysis was performed. Results The analysis revealed the theme Knowledge and communication lead to participation in the area of CAM based on three categories; CAM use, Communication and Self-care. Patients with IBD wanted to be asked about CAM to be able to start a dialogue, as some perceived being treated in a disparaging manner and not taken seriously when raising the subject. Healthcare professionals (HCPs) need to be aware of this in order to meet and understand patient needs. Patients with IBD found it easier to communicate about CAM with the IBD nurses than physicians and dietary changes was one important CAM treatment. Conclusions The finding that it was easier to discuss CAM with nurses than physicians emphasizes the important role of the IBD nurse in communication and monitoring patients’ CAM use. Patients wanted to be asked about CAM to be able to start a dialogue, as some perceived not taken seriously when raising the subject. Furthermore, HCPs need to understand that many patients with IBD regard dietary changes as an important part of CAM treatment. Further research in these areas is needed.
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13
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Schjøtt J, Erdal H. Questions about complementary and alternative medicine to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS): a descriptive pilot study. Altern Ther Health Med 2014; 14:56. [PMID: 24529279 PMCID: PMC3932037 DOI: 10.1186/1472-6882-14-56] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 02/11/2014] [Indexed: 12/30/2022]
Abstract
Background Provision of clinically relevant information about complementary and alternative medicine (CAM) to health care professionals is not well described. The aim of the study was to assess questions about CAM to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS). Methods All question-answers pairs (QAPs) in the RELIS database indexed with alternative medicine from 2005-2010 constituted the study material. A randomly selected sample of 100 QAPs was characterized with regard to type of question (category, patient-specific or general), occupation and workplace of enquirer, the type of information search performed (simple or advanced), and if the answers contained information to provide factual or consultative replies (facts about or advice on clinical use of CAM, respectively). Proportions were compared with Fisher’s exact test with significance at the 0.05 level. Results One thousand and thirty-eight (7.7%) out of 13 482 questions involved CAM. Eighty-two out of 100 questions concerned products containing one or more herbs, vitamins and minerals as well as other substances. Thirty-eight out of 100 questions concerned the category documentation (substance identification and/or literature reports about clinical effects), 36 interactions, 16 adverse effects, 9 pregnancy and lactation, and 1 question concerned contraindications. Sixty-three questions were patient-specific and 37 general. Fifty-four questions came from physicians, 33 from pharmacists and 13 from others (including nurses, midwives, students, CAM practitioners, and the public). Pharmacists asked more frequently about interactions while physicians asked more frequently about adverse effects (p < 0.05). Seventy-six of the questions came from outside hospital, mainly general practice and community pharmacies. Fifty-nine answers were based on a simple and 41 on an advanced information search. Thirty-three factual and 38 consultative answers were provided. In 29 answers, search provided no information. Lack of information to provide an answer was not significantly different between patient-specific (31.7%) and general questions (24.3%). Conclusions General practice and community pharmacies are the main sources for questions about CAM to RELIS. Physicians are concerned about adverse effects while pharmacists are concerned about interactions. Lack of information to provide answers to patient-specific and general questions about CAM represents a problem.
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