Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: a descriptive cross-sectional survey

Attitude, knowledge, and barriers of Chinese clinical and nursing students in implementing complementary and alternative medicine for COVID-19：a cross-sectional study

Background

Complementary and alternative medicine (CAM) has emerged to combat the global COVID-19 pandemic. However, no studies have been conducted to evaluate the attitudes, knowledge, and barriers of Chinese clinical and nursing students in implementing CAM during this period.

Objective

The aim of this study was to investigate the attitude, knowledge, and barriers of Chinese clinical and nursing students in using CAM in the context of COVID-19.

Methods

An online-based cross-sectional survey was carried out among Chinese medical students, majoring in clinical medicine or nursing, in Nanjing, Jiangsu Province, and Zhengzhou, Henan Province from May to July 2022. A total of 402 clinical and 644 nursing students responded to a self-administered questionnaire through the Questionnaire Star and WeChat APPs. SPSS 25 (version 25) was used for data analysis. Proportions were compared by Chi-square test. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test.

Results

The average score of attitude was 46.63 (SD: 7.38) in clinical students and 49.84 (SD: 6.76) in nursing students. The top four most commonly used CAM treatments in China were proprietary Chinese medicine, diet therapy, decoction, and acupuncture and moxibustion (59.66 %, 22.28 %, 11.66 %, 9.85 %). The students had a good mastery of knowledge about CAM-based prevention and control of COVID-19 (mean score 7.36). The score of CAM knowledge in nursing students was significantly higher than that in clinical students (7.56 VS 7.04, P = 0.000). Gender, grade, previous use, age, and knowledge score could affect students' attitude towards CAM. The main barriers in spreading CAM use included time-consumption, bad taste, and fear of treatment-related pain (24.5 %). Compared with clinical students, nursing students were more likely to recommend CAM to patients in the future (P = 0.002).

Conclusions

During the COVID-19 pandemic, nursing students were more positive towards CAM use, had a better mastery of CAM knowledge than clinical students. CAM is expected to provide better outcomes in COVID-19 patients. Future studies should focus on the changes in students' attitudes over time and exploration of influencing factors on CAM use.

Pharmacy Students' Knowledge and Attitudes about Homeopathy: A Descriptive Survey Conducted in Turkey

BACKGROUND

 Homeopathy belongs to "Traditional and Complementary Medicine" (TCM) and is defined in the TCM regulation in Turkey as a holistic practice method that aims to improve health status with personalized medicines. The international and national literature includes a limited number of studies that examine individuals' knowledge, attitudes and behaviors toward homeopathy. Although in Turkey the Regulation on Pharmacists and Pharmacies states that the sale of homeopathic medicines is allowed only in pharmacies, no study was found that evaluated awareness about homeopathy among pharmacy students.

OBJECTIVE

 The present study aims to assess pharmacy students' knowledge and attitudes toward homeopathy and to identify the factors that influence them.

METHODS

 This descriptive study was conducted between December 1, 2021 and February 1, 2022 among the students of the Faculty of Pharmacy, Karadeniz Technical University (KTU), through a face-to-face survey. In total, 418 questionnaires suitable for data quality were included in the study. The SPSS 23.0 statistical program was used to analyze the data and the statistical significance level was taken as p < 0.05.

RESULTS

 It was determined that 73% of the participants had heard about TCM practices and 55% had heard of homeopathy. Students in the fifth grade (p = 0.0001) and those working in an income-generating job (p = 0.026) were found to be those most aware of homeopathy. The students of the Faculty of Pharmacy correctly knew the basic working principles of homeopathy (p = 0.002). The source from which students obtained the most information about homeopathy was undergraduate courses. 80.4% of the participants thought that homeopathy should be applied by pharmacists. 47.0% of the students wanted to learn more about homeopathy or to carry out studies in the field of homeopathy in their careers.

CONCLUSION

 The results of this research revealed a high awareness amongst KTU pharmacy students about the practice of homeopathy.

Incorporation of yoga in pharmacy education

BACKGROUND

The well-being of pharmacists is critical to support personal and professional health. Identifying and integrating a variety of practices that promote wellness is prudent for schools/colleges of pharmacy so students may form habits before entering the profession as practitioners. Yoga, a practice that combines muscular activity with mindfulness, can be incorporated with minimal resources via numerous mechanisms within and outside of the curriculum.

METHODS

The objective was to provide a summary of various strategies incorporating yoga in pharmacy professional curricula as well as detail various approaches to integrating yoga into pharmacy curricula. Literature was evaluated across professional pharmacy programs pertaining to yoga knowledge, beliefs, approaches, and benefits.

RESULTS

Ten articles about yoga awareness, knowledge, beliefs, and benefits in professional pharmacy curricula were identified. Improvement in mental health and decreased stress were recognized as benefits. Within schools/colleges of pharmacy, yoga programming has been included in required as well as elective courses, co-curriculum programming, extracurricular activities, and post-graduate training.

IMPLICATIONS

Schools of pharmacy can consider incorporation of yoga practice into curricula as a tool to promote well-being and resiliency.

The effectiveness of teaching complementary and alternative medicine based on the components of theory of planned behavior on nutrition students: multicenter research study

OBJECTIVE

Safe and beneficial use of complementary and alternative medicine (CAM) modalities results from integrating CAM education into curricula and increasing CAM knowledge. We sought how much teaching CAM procedures in a virtual environment can influence the components of the theory of planned behavior (TPB), including knowledge, attitude, behavioral intention, and behavior of nutrition students.

METHODS

This cross-sectional descriptive-analytic study was conducted on 162 undergraduate nutrition students were selected through convenience sampling based on inclusion criteria in 2021-2022. Data were collected through a validated researcher-made CAM questionnaire that was designed based on TPB questionnaire that consisted of four constructs (knowledge, attitude, behavioral intention, and behavior). The content validity index and content validity ratio of the questionnaire were evaluated.

RESULTS

Our results revealed that students who significantly scored the highest scores in attitude, behavioral intention, and behavior constructs were the students who claimed that "teaching two credits of CAM for nutrition students is not enough" (p. value =  < 0.001, < 0.001, and 0.005, respectively). In addition, these students used treatment methods of CAM for themselves, suggested treatment methods of CAM to others, and followed the recommendations of the CAM specialists (for three pairwise comparisons: p. value =  < 0.001, < 0.001, and < 0.001, respectively). The attitude could predict 70% of behavioral intention. However, attitude and behavioral intention could predict 90% of behavior.

CONCLUSION

Attitude was the most critical determinant influencing behavioral intention and behavior. CAM teaching using evidence-based CAM-ITM principles with a succinct, concerted, and collaborative curriculum, integration of CAM into continuing education, and integration of educational CAM programs continuously for several years into the academic curriculum in the actual setting influence the success of the educational CAM program.

Knowledge, attitude, perceived effectiveness and self-practice of complementary and alternative medicine: a cross-sectional comparison between medical and non-medical students of Bangladesh

BACKGROUND

Bangladesh's population commonly utilizes Complementary and alternative medicine (CAM) to treat their health issues. Despite the increasing interest in CAM, it has been excluded from conventional medical training in Bangladesh for many years. Therefore, this study assessed and compared the knowledge level, attitude, perceived effectiveness, and self-practice of CAM among undergraduate students of Bangladesh.

METHODS

This cross-sectional group comparison study was conducted among undergraduate (both medical and non-medical) students of Bangladesh between November and December 2021. Data was collected using a self-reported pretested semi-structured online questionnaire. The questionnaire contained questions regarding background information, knowledge regarding CAM, source of CAM knowledge, attitude towards CAM, interest in attaining CAM knowledge, perceived effectiveness of CAM, perceived adverse effects of CAM, self-practice of CAM, and whether would they refer CAM to others. A total of 576 students responded and the data gathered allowed for the following: (1) an overview of the study groups, (2) respondents' general perception and knowledge regarding CAM, and (3) a comparison of respondents' CAM knowledge, general perception, and usage by area of study. Data were analyzed using STATA (v.16) and descriptive statistics, Pearson's chi-square test, and Mann-Whitney U test were performed.

RESULTS

A total of 329 medical students and 247 non-medical students participated in the study. The mean age of the participants was 21.57 ± 1.8 years and 56.2% of them were male. The most known CAM among medical (M) students was homeopathy (44.6%) and among non-medical (NM) students were herbal medicine (45.7%). Non-medical students had significantly better knowledge about nine out of twelve CAM modalities included in the study, and no significant differences were present for the rest of the modalities. Medical (81.1%) and non-medical students (86.2%) perceived traditional Chinese medicine and homeopathy to be the most effective respectively. "Incorporating CAM with conventional medicine would result in increased patient satisfaction" showed the most statistically significant (p = 0.0002) difference among both groups. Yoga was the most often practiced modality among medical students and homeopathy among non-medical students.

CONCLUSION

Medical students have a lacking of knowledge and a positive attitude towards CAM, despite its very common practice among the people of Bangladesh. Therefore, emphasis should be put on the inclusion of CAM modules in medical training.

Assessing knowledge of herbal medicine course for dental students

BACKGROUND

The aims of this article are to assess dental students' knowledge about herbal medicine usage and the potential benefits and side effects, and to conduct a short course about herbal medicine.

METHODS

All fourth-year pre-doctoral students were invited to participate in a herbal medicine course as a test while the sixth-year students were the control group. A survey was tested for validity and reliability. It comprised of 16 multiple choice questions was given before the course and one month after the course. The sum score of knowledge for each participant was calcuated based on the ability to identify the use of herbs in dentistry with high-quality evidence (correct answer) or total answer for periodontal disease and caries.

RESULTS

The response rate for completing the study was 112 fourth-year students (73.7%) and 64 sixth-year students (39.0%). More than half of the participants (52.5%) were unsure about the importance of herbal medicine in dentistry. However, the majority also stated that the most common herbs used in dentistry were clove (62.9%), followed by curcuma turmeric (54.7%) and meswak (43.0%). The fourth-year students displayed evidence of a higher overall knowledge score after the course in herbal medicine related to periodontal disease in total and correct answers (mean 4.48 ± 4.13, 3.73 ± 3.31, respectively) compared to before the course (mean 0.84 ± 1.23, 0.74 ± 1.16, respectively) (p-value < 0.001). The post-course periodontal disease total and correct answers were statistically significant between fourth- and sixth-year students.

CONCLUSION

Herbal medicine has a potential positive impact on dentistry. However, these effects are not fully investigated and received full attention in academic institute. This short educational program related to medicinal herbs can improve the knowledge of dental students. This will help increase the awareness about the use and potential side effects of herbal medicine in the dental field.

Knowledge, Attitude, and Use of Complementary and Alternative Medicine among Final-Year Pharmacy and Medical Students in Benghazi, Libya

Introduction Complementary and alternative medicine (CAM) is a growing branch of medicine that can improve the quality of life of many people. This study aimed to assess comparatively the knowledge, attitude, and use of CAM among graduation year pharmacy and medicine students at the University of Benghazi, Libya.

Method A cross-sectional survey was conducted among graduation year pharmacy and medicine students at the University of Benghazi for 4 months. The study tool was a self-administered online questionnaire and consisted of four main sections: demographic data, use, knowledge, and attitude toward CAM.

Results Most of the study respondents were females, and most were from Benghazi city. CAM use among pharmacy students was significantly higher (p-value= 0.001), with ruguia being the most commonly used modality (52.5%), followed by cupping-Al hijama and herbal medicine. Minor ailments and acute illnesses were the main medical conditions treated with CAM, and the unnecessary physician intervention was the top reason for practicing CAM among students. CAM knowledge and attitude were significantly higher among pharmacy students (p-value= 0.000 and 0.001, respectively).

Conclusion CAM was commonly practiced among the study participants. Their overall knowledge of CAM was limited, whereas their attitude toward it was positive, with pharmacy students having a better degree of both.

Iranian healthcare professionals' knowledge, attitudes, and use of complementary and alternative medicine: a cross sectional study

Background

The present study aims to investigate the knowledge, attitude, and performance of Iranian Healthcare Professionals (HP) about Complementary and Alternative Medicine (CAM) modalities.

Methods

This cross-sectional study was carried out on 210 HP in 2019. Samples were selected from healthcare centers, clinics, and hospitals using census sampling. Data collection tools included demographic information, attitude, knowledge, and the amount of use of CAM modalities. Data analysis was performed using SPSS ver. 24.

Results

In this study, the response rate was 85.3% (n=209). A majority of respondents had a positive attitude toward CAM (n=166, 79%), but their level of knowledge was limited (n=154, 73.6%). The most commonly used CAM modalities were herbal medicine (93.2%), exercise therapy (75.4%), and hydrotherapy (75.2%), respectively, and the least commonly used ones were magnetic therapy (2.9%) and hypnosis (4.8%). The most important reasons for the use of CAM modalities by HP included fewer side effects than medical treatments (57.4%), its lowest cost than medical treatments (34.9%), non-serious disease with no need for referral to a clinic (32.1%), and its more convenient access than medical treatments (30.6%). The results showed that there was a significant relationship between the education level and the use of CAM modalities (p<0.05). There was also a significant relationship between the suggestion of CAM modalities and the amount of use of these modalities, and those who used these modalities would also have recommended them to their clients more frequently (p<0.05).

Conclusion

The results showed that most of HP used at least one of the CAM modalities and had a positive attitude towards CAM. As the level of knowledge was limited, training courses should be implemented to increase health practitioner’s level of knowledge on CAM.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-021-03421-z.

How do Polish pharmacy staff evaluate own qualifications, competences, relevance, motivation, effectiveness in health promotion?

Health promotion programmes are complex and need to engage all health care specialists, including pharmacists. Pharmacies are considered as a potentially ideal place for health promotion and education. To evaluate own qualifications, competences, relevance, motivation and effectiveness of Polish pharmacy staff with regard to health-related information provided to patients, which contributes to health promotion. 308 pharmacy staff from Lublin (Poland) were surveyed with a questionnaire prepared by the researchers and piloted previously. It consisted of 5 domains: qualifications, competences, relevance, motivation, and effectiveness of health promotion. Items in each domain were scored by respondents in 1 − 10 scale where 1 is ‘very low’ and 10 is ‘very high’. Pharmacy staff rated the relevance of health promotion the highest, while the lowest—own competences and effectiveness in health promotion. Female pharmacy staff assessed the relevance of health promotion significantly higher than males (7.1 vs. 6.1, p = 0.005). Higher self-assessments of qualifications, competences, relevance, motivation and effectiveness in health promotion were provided by: the youngest pharmacy staff, those with a short period of employment, and pharmacy staff working in pharmacies employing up to 3 persons. Qualification and competences in health promotion were assessed higher by pharmacy technicians and masters of pharmacy with post-graduate studies or professional specialization, or Ph.D. than by masters of pharmacy. Relevance and effectiveness in health promotion were evaluated higher by pharmacy staff in pharmacies serving more than 100 customers daily. There is a need to improve qualifications, competences, relevance, motivation and effectiveness in health promotion conducted by Polish pharmacy staff.

Revisiting the Food- and Nutrition-Related Curriculum in Healthcare Education: An Example for Pharmacy Education

Objective: This study aimed to obtain an objective overview of nutritional topics discussed in community pharmacies to adapt the nutrition-related course content in pharmacy education. Methods: We performed an observational study between July 2014 and April 2015 in 136 community pharmacies in Belgium. During four months, each pharmacy intern recorded the first two food- and nutrition-related cases with which they were confronted. Each case was classified into one of 18 categories. Results: 1004 cases were included by 135 pharmacy interns. The most often discussed subjects include “food supplements” (38%), “baby food” (19%), and “healthy food and nutritional recommendations” (11%). In 45% (447/1004) of all cases, pharmacy interns were able to immediately discuss the cases without searching for additional information. Eventually, after looking up extra information, 95% (958/1004) of cases could be answered. Conclusions: Food- and nutrition-related cases are discussed in primary healthcare. We recommend food- and nutrition-related courses in the curriculum of every healthcare profession.

Improving Holistic Care Skills for Advanced Practice Registered Nurses: Integration of a Complementary and Alternative Medicine Course into a Doctor of Nursing Practice Curriculum

BACKGROUND

Complementary alternative medicine (CAM) is an expanding domain of healing practices harmonized with Western medicine to provide comprehensive treatment of individuals as holistic beings. Patients and healthcare providers worldwide are increasingly inviting and employing CAM practices into healthcare delivery routines. Implementation of courses to introduce CAM into Advanced Practice Registered Nurse (APRN) programs exposes future practitioners to current best practices for integrative treatment strategies and encourages consideration when developing a holistic patient-centered care plan.

OBJECTIVE/METHODS

A case presentation of an interprofessional CAM course delivered to military graduate nursing students with a pretest posttest course survey to evaluate student's confidence and knowledge of CAM theory and practices. The format included online modules, evidence-based literature critique, knowledge checks, and an immersive hands-on immersion experience.

RESULTS

A total of 240 pre-/postcourse surveys were completed by military graduate nursing students (N = 140) participating in a CAM course. Statistically significant increases in CAM knowledge, communication, and skills confidence levels were found. Following participation in the course, nearly all students (97%) agreed CAM is important and benefits future advanced practice.

CONCLUSION/NURSING IMPLICATIONS

CAM is a compendium of holistic healing modalities increasingly being utilized by patients worldwide with similar requests for alternative care techniques from healthcare providers. Military APRN students participating in a CAM course increased knowledge and confidence, and garnered appreciation for an expanded skill set to augment future practice. Case presentation is compelling for standard inclusion of CAM and similar graduate interprofessional courses into all APRN programs.

Traits of cancer patients and CAM usage

Background

The use of Complementary Alternative Medicine (CAM) Methods is increasing and therefore gaining importance also in conventional western medicine. Identifying personal traits to make out by whom and why CAM is used can help physicians in successful physician–patient interaction, and thus improve patient’s compliance and trust towards their physician.

Patients and methods

A questionnaire was passed on to cancer patients in an ambulant clinical and a rehabilitation setting. Multiple regression analyses were run to examine possible predictors for CAM use, such as gender, age, level of education, spirituality, attentiveness, self-efficacy and resilience. To differentiate within CAM users, two dependent variables were created: “holistic and mind–body methods”, such as Yoga, meditation or Homeopathy and “material based methods”, such as food supplements or vitamins.

Results

Higher level of education, younger age and religion-independent attentiveness were significant predictors for the use of “material based methods”. Female gender, higher education and religious spirituality were detected as significant predictors for “holistic and mind–body methods”.

Conclusion

This study is among the first to take a more detailed look at how numerous personal traits are associated with the use of CAM methods and differentiate between the applied methods. Our finding should be considered by conventional health care providers and could be integrated into a holistic assessment, to offer information about complementary medicine and meeting patients’ needs.

Awareness and Use of Complementary and Alternative Medicine in Korean Lung Cancer Patients

Background

Complementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients.

Methods

This prospective survey–based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users.

Results

Of the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users.

Conclusion

Specific clinical parameters were associated with patients’ awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

Traditional and complementary medicine use among Ebola survivors in Sierra Leone: a qualitative exploratory study of the perspectives of healthcare workers providing care to Ebola survivors

BACKGROUND

Considerable number of patients, including Ebola survivors, in Sierra Leone, are using traditional and complementary medicine (T&CM). Healthcare providers' (HCPs) views about T&CM is crucial in addressing the increased need for T&CM among patients. However, healthcare providers' views about T&CM in Sierra Leone is unknown. Our study explores healthcare providers' knowledge of and perception towards T&CM and how that influence their personal and professional T&CM use, communication with Ebola survivors about T&CM as well as its integration into the healthcare system in Sierra Leone.

METHODS

We employed a qualitative exploratory study design using semi-structured interviews to collect data from 15 conveniently sampled HCPs in all four geographical regions of Sierra Leone. We analysed our data using thematic network analysis framework.

RESULTS

Healthcare providers perceived their knowledge about T&CM to be low and considered T&CM to be less effective and less safe than conventional medicine as well as not evidence-based. HCPs perception of T&CM as non-scientific and their lack of knowledge of T&CM were the key barriers to HCPs' self-use and recommendation as well as their lack of detailed discussion about T&CM with Ebola survivors. HCPs are open to T&CM integration into mainstream healthcare in Sierra Leone although at their terms. However, they believe that T&CM integration could be enhanced by effective professional regulation of T&CM practice, and by improving T&CM evidenced-based knowledge through education, training and research.

CONCLUSION

Changing HCPs' negative perception of and increasing their knowledge about T&CM is critical to promoting effective communication with Ebola survivors regarding T&CM and its integration into the healthcare system in Sierra Leone. Strategies such as educational interventions for HCPs, conducting rigorous T&CM research, proper education and training of T&CM practitioners and effective professional regulation of T&CM practice could help in that direction.

Complementary and alternative medicine practice and perceptions of attendees of primary care centers in Eastern Saudi Arabia

BACKGROUND

Complementary and alternative medicine (CAM) refers to the use of nonconventional medical practices together with standard medical care. Specific forms of CAM included in this study are the use of honey, dry and wet Hijama, Quran, Zamzam water, Nigella sativa (black seed), and others. The objective was to determine the prevalence of the use of different CAM modalities by the attendees of primary health-care centers (PHCCs) and assess the reasons behind their use.

MATERIALS AND METHODS

A cross-sectional study was conducted at PHCCs in the cities of Dammam and Al Khobar, over a period of 12 months. The study population was patients and their accompanying relatives attending the PHCCs, aged 18 years and above. Data were collected using a self-administered questionnaire in Arabic designed by the investigators after a review of the literature on the use of CAM. Questionnaire was modified after pilot testing among 200 medical students, and was validated by two expert consultants of the family and community medicine department at the university. The questionnaire was administered and supervised by the 3^rd and 4^th year medical students. Data were entered and analyzed using the SPSS version 16 (SPSS Inc., Chicago, IL, USA) statistical software. Descriptive statistics were computed, and odds ratios were calculated for associations between CAM use and various independent factors. Logistic regression analysis was used to determine the factors which predict the use of CAM by attendees. All the analyses were performed at α =0.05.

RESULTS

The total number of attendees interviewed was 2114; 52.5% of whom reported using CAM. The types of CAM varied in their popularity of use, the majority of users favoring honey and Quran, 24.6% and 20.5%, respectively. Recommendations by relatives and friends were reported as the most common reason in this sample for using CAM (56.1%). Age, awareness of CAM, perceptions that use of CAM is better, use of CAM helps, herbs had no side effects, CAM was easy to obtain, and the attendee currently suffers from a disease were significantly associated with higher CAM use.

CONCLUSION

More than 50% of the participants reported using CAM; honey and Quran were the most widely used modalities. For people to make informed decisions on the use of complementary medicine, physicians should impress on their patients to inform their doctors of their use of complementary medicine modalities so that encouragement could be given where appropriate.

Awareness, Self-Use, Perceptions, Beliefs, and Attitudes toward Complementary and Alternative Medicines (CAM) among Health Professional Students in King Saud bin Abdulaziz University for Health Sciences Jeddah, Saudi Arabia

Background

Around 75% of the world's population relies on the use of complementary and alternative medicines (CAM) for their healthcare. Thus, we aimed at assessing the attitude and perception of health professional students about CAM and correlate the results with their demographical data.

Methods

An observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia, by enrolling 350 students. A self-administered questionnaire was used for data collection. Descriptive and inferential statistical analysis was performed using SPSS.

Results

Results of our data suggested that majority of students were aware of the CAM modalities and considered prayers/spirituality (83.6%), massage (72.5%), nutritional supplements (74.1%), cupping (68.5%), herbal medicine (66.2), and yoga (61.6%) as most effective and least harmful CAM modalities. The students acquired more information about CAM from media (55%), books (56%), friends/relatives (59.7%), and other health professionals (58.4%), however, very little information from formal CAM courses or training (36.7%), which shows the lack of courses and trained health professional in the field of CAM. Despite utilizing nonreliable sources of CAM information, the majority of students had positive attitudes and perceptions about CAM usage. Majority of the students (75.8%) believe in the use of CAM for the mental and spiritual aspect of health and think that CAM providers give good information on maintaining a healthy lifestyle. The data also showed a significant (P < 0.05) association between awareness about CAM and gender. A significantly higher percentage of female students were using yoga and aromatherapy, while cupping was mostly used by male students. Similarly, a significant association was found among the different colleges and level of students in most of the CAM modalities. However, no association was found between the awareness and use of CAM with the educational level of parents or relatives in health sector except for acupuncture and cupping, where student's awareness about acupuncture and cupping was found to have a significant positive association with mother educational level. On the other hand, a significant inverse association was found between acupuncture, yoga, cupping, and aromatherapy with family income.

Conclusion

In conclusion, despite the lack of proper courses and professionally trained healthcare providers in the field of CAM, students demonstrated positive attitudes and beliefs toward the safety and effectiveness of CAM.

A Survey on Perceptions of Complementary and Alternative Medicine among Undergraduates in China

In recent years, complementary and alternative medicine (CAM) is more widely known and used globally. This study was the first to investigate undergraduates' attitude toward CAM, and influencing factors and barriers for students to use CAM. Students of five different grades in six universities of China were selected for this study from February to May 2019. First, the participants were divided into two groups based on their majors and fulfilled a previously validated 10-item CAM Health Belief Questionnaire (CHBQ) to evaluate their attitudes toward CAM. Second, the chi-square test was used to analyze the differences between the groups, and correlation analysis was conducted to investigate the relationship of the data between the two groups. Third, we used frequency analysis to identify the types that students wanted to study and the barriers to use CAM. The overall mean score of the CHBQ was 48.87 ± 8.594, which was higher than that in other countries. The students in lower grades had a stronger desire to learn CAM than those in higher grades (89% vs 83%, p < 0.05). “Too time-consuming and bad tastes,” “Western medicine was enough,” and “lack of relevant knowledge” were found to be the main interruptions for students to use CAM. 82.3% of students wanted CAM to be incorporated into the curriculum and desired to learn more about CAM. 72.3% of the students who had never learned CAM wanted to know more about CAM. 55.5% of the students were willing to recommend CAM. Most undergraduates desired to learn more about CAM. It is necessary to introduce or integrate CAM courses into the present curriculum, and it should be started in the lower grades. We hope this study can provide evidence for the authority in China to make appropriate changes and integrate CAM into the college curriculum.

An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross-sectional study

BACKGROUND

We examined the magnitude and correlates of Ebola virus disease (EVD)-related stigma among EVD survivors in Sierra Leone since their return to their communities. In addition, we determined whether EVD-related stigma is a predictor of informal health care use among EVD survivors.

METHODS

We conducted a cross-sectional study among 358 EVD survivors in five districts across all four geographic regions (Western Area, Northern Province, Eastern Province and Southern Province) of Sierra Leone. Ebola-related stigma was measured by adapting the validated HIV related stigma for people living with HIV/AIDS instrument. We also measured traditional and complementary medicine (T&CM) use (as a measure of informal healthcare use). Data were analysed using descriptive statistics and regression analysis.

RESULTS

EVD survivors report higher levels of internalised stigma (0.92 ± 0.77) compared to total enacted stigma (0.71 ± 0.61). Social isolation (0.96 ± 0.88) was the highest reported enacted stigma subscale. Ebola survivors who identified as Christians [AOR = 2.51, 95%CI: 1.15-5.49, p = 0.021], who perceived their health to be fair/poor [AOR = 2.58, 95%CI: 1.39-4.77. p = 0.003] and who reside in the northern region of Sierra Leone [AOR = 2.80, 95%CI: 1.29-6.07, p = 0.009] were more likely to experience internalised stigma. Verbal abuse [AOR = 1.95, 95%CI: 1.09-3.49, p = 0.025] and healthcare neglect [AOR = 2.35, 95%CI: 1.37-4.02, p = 0.002] were independent predictors of T&CM use among EVD survivors.

CONCLUSION

Our findings suggest EVD-related stigma (internalised and enacted) is prevalent among EVD survivors since their return to their communities. Religiosity, perceived health status and region were identified as independent predictors of internalised stigma. Verbal abuse and healthcare neglect predict informal healthcare use. EVD survivor-centred and community-driven anti-stigma programs are needed to promote EVD survivors' recovery and community re-integration.

Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone

Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors' attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57-9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92-13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10-30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74-9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors' attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner-survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services.

A cross-sectional assessment of knowledge, attitudes and self-perceived effectiveness of complementary and alternative medicine among pharmacy and non-pharmacy university students

Background

Traditional medicine has always been Pakistan’s cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy.

Methods

A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22).

Results

Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones.

Conclusion

In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2503-y) contains supplementary material, which is available to authorized users.

Herbal medicine use during breastfeeding: a cross-sectional study among mothers visiting public health facilities in the Western area of Sierra Leone

BACKGROUND

The use of medications, including herbal medicines during breastfeeding is always a concern among women. Currently, there is no published evidence on whether Sierra Leonean women use herbal medicine during breastfeeding. This study investigates the prevalence, correlates and pattern of herbal medicine use during breastfeeding.

METHODOLOGY

We conducted a cross-sectional study among 378 current breastfeeding mothers visiting public healthcare facilities within the Western area of Sierra Leone. Descriptive statistics and logistic regression analysis were used for data analysis.

RESULTS

Over a third of mothers (n = 140, 37.0%) used herbal medicine during breastfeeding. However, very few herbal medicine users (2.1%, n = 3) used herbal medicine to augment breastfeeding. Dietary changes were the most common method used to increase breast milk supply (93.9%, n = 355) with cassava leaves sauce and tubers being the most common dietary addition. Mothers with children more than six months old were more likely to use herbal medicine than mothers with younger children (OR:1.8; CI:1.13-2.85,p = 0.013). Among herbal medicine users, only 11.4% (n = 16) disclosed their herbal medicine use to their conventional healthcare providers.

CONCLUSION

The use of herbal medicine among breastfeeding mothers attending public health facilities in the Western area of Sierra Leone is common. Whilst this use is not usually specific to increasing breast milk supply, our study indicates that herbal medicines may be used to 'cleanse' initial breast milk.

Aloysia citriodora Palau (lemon verbena) for insomnia patients: A randomized, double-blind, placebo-controlled clinical trial of efficacy and safety

Aloysia citriodora (A. citriodora) has a long history of traditional use for sedation and treatment of insomnia in different societies. This study was carried out to assess the efficacy of A. citriodora in patients with insomnia. One hundred patients were randomly divided into two groups of A. citriodora (total essential oil 1.66 mg/10 ml and total amount of flavonoid in terms of quercetin 3.22 mg/10 ml of the syrup) and placebo. They were advised to use 10 cc of the syrups; an hour before the bedtime for a period of 4 weeks. Participants were assessed using Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires at the baseline and then 2 and 4 weeks after the enrollment. Mean scores of global PSQI and its four components including sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality and also ISI score in the A. citriodora group improved significantly after 4 weeks of treatment when compared with the placebo group (p < 0.001, for all of them). Also, improvement of global score of PSQI and ISI was observed in the intervention group as compared with the placebo group, 2 weeks after the enrollment (p < 0.001). The results of this study showed that oral intake of A. citriodora can be suggested as a complementary treatment for patients with insomnia.

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

Background

The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region.

Methods

We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken.

Results

Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers.

Conclusion

TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.

Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone

In resource-poor countries where access to infertility care is limited, women may turn to traditional medicine to achieve motherhood. It is unknown whether Sierra Leonean women with such condition use herbal medicine. This study investigates the prevalence and factors associated with herbal medicine use among women seeking care for infertility. This was a questionnaire-based cross-sectional study conducted among women seeking care for infertility at various clinics within Freetown, Sierra Leone. Data analysis included Chi-square tests and logistic regression. Out of the 167 women that participated, 36.5% used herbal medicine for infertility treatment. Women with no formal (AOR 4.03, CL: 1.38-11.76, p = 0.011), primary education (AOR: 6.23, CL: 2.02-19.23, p = 0.001) and those that visited a traditional medicine practitioner (AOR: 20.05, CL: 2.10-192.28, p = 0.009) as well as women suffering from other reproductive health problems (AOR: 2.57, CL: 1.13-5.83, p = 0.024) were more likely to use herbal medicines. Friends and family (n = 57, 96.7%) were the main influencers of herbal medicine use. Only (n = 12) 19.7% of users disclosed their status to their healthcare provider. Over half (n = 32, 52.5%) could not remember the name of the herb they used. Luffa acutangula (n = 29, 100%) was the herbal medicinal plant users could recall. Herbal medicine use among women seeking care for infertility in Freetown is common. Healthcare providers should be aware of the potential dyadic use of herbal and allopathic medicines by their patients and be knowledgeable about commonly used herbal remedies as well as being proactive in communicating the potential risks and benefits associated with their use.

Herbal medicine use among hypertensive patients attending public and private health facilities in Freetown Sierra Leone

OBJECTIVE

This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown.

METHODS AND MATERIALS

We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant.

RESULTS

Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider.

CONCLUSION

There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes.

Practice of community pharmacists related to multivitamin supplements: a simulated patient study in Iran

Background Multivitamin supplements are a subset of dietary supplements sold in pharmacies as over-the-counter medicines. Community pharmacists are regarded as responsible professionals and relied on for their safe practice and efficacy. Objective The aim of this study was to evaluate the counselling practices of community pharmacists relating to typical use, interactions, contraindications, and side effects of multivitamin supplements using simulated patients. Setting Ninety-seven community pharmacies in Kerman, Iran. Method Two male students acted as simulated patients who role-played a scenario in the community pharmacies in two steps. In step 1, they spontaneously mentioned they were a student and did not eat properly through lack of time and requested a multivitamin supplement. In Step 2, if the pharmacists did not request a drug history, they would explain that they had severe acne and had been taking oral isotretinoin for a month. The counselling practice of the pharmacists was audio recorded. Main outcome measure The number of pharmacists who provided information about multivitamin use and identified isotretinoin-vitamin A interaction. Results Thirteen pharmacists in charge were absent at the time of the purchases. None of the pharmacists provided information about contraindications and side effects of multivitamin products. Twenty pharmacists provided instruction for multivitamin use, and two pharmacists took a drug history. In Step 1, only two pharmacists identified isotretinoin-vitamin A interaction, but in Step 2, this number increased to 15. Conclusion The counselling practice of pharmacists should be improved to promote effective and safe use of multivitamin supplements.

Herbal medicines use during pregnancy in Sierra Leone: An exploratory cross-sectional study

BACKGROUND

The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care.

AIM

This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone.

METHODS

A cross-sectional study was conducted among pregnant women (n=134) who were at least 18 years of age and who have had at least one previous pregnancy, using face to face interview. Descriptive statistics, univariate and multivariate logistic regression analysis were used for data analysis.

RESULTS

The response rate was 82.7%. Nearly two-thirds of pregnant women reported using herbal medicine (62.7%). Herbal medicine users were more likely to be Muslim than Christian. Luffa acutangula (L.) Roxb was the most cited herbal medicine used and was mostly indicated for urinary tract infection and pedal oedema. Perceived effectiveness and safety over conventional medicine (70.2%) was key driver for use, and majority did not disclose their use of herbs to their maternal health professional (95.2%).

CONCLUSION

Herbal medicine use among pregnant women in this study was widespread. Maternal health providers should be aware of this relatively common practice and routinely discuss and educate pregnant women on the potential risks and benefits associated with the use of herbs.

General perception and self-practice of complementary and alternative medicine (CAM) among undergraduate pharmacy students of Bangladesh

Background

Complementary and Alternative Medicine (CAM) is a combination of herbal medicine, traditional therapies, and mind-body intervention. This descriptive study was designed to assess the knowledge, attitudes, perception and self-use of CAM among Bangladeshi undergraduate pharmacy students. The study also evaluated their opinions about its integration into the pharmacy course curriculum.

Methods

It was a cross-sectional, questionnaire-based study conducted on 250 pharmacy students of five reputed public universities of Bangladesh.

Results

This study revealed that majority of the pharmacy students were using or had previously used at least one type of CAM. Among the students, 59% had used homeopathy followed by Ayurveda (30%), meditation (29%), massage (13%), Unani (9%), yoga (6%) and acupuncture (2%). Students’ attitudes towards CAM were influenced by family and friends, books and journals, the internet and to a lesser degree by health practitioners. A significant (p < 0.05) number of students had knowledge about CAM. A majority of the students (90%) had positive, while 10% had negative attitudes towards CAM. Lack of knowledge and trained professionals were found to be the major interruptions to CAM use. 84.45% acknowledged the importance of knowledge about CAM for them as future healthcare practitioners. Furthermore, the majority of the students also believed that ideas and methods of CAM would be beneficial for conventional medicine.

Conclusions

From the findings of the study, it can be recommended that an approach should be taken to educate the students about the fundamentals of CAM use so that it may fulfill the professional needs of our future pharmacists.

Knowledge, attitudes, and practices among health care providers regarding complementary and alternative medicine in Trinidad and Tobago

Background

Health care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use. We explored the knowledge, attitudes, and practices of health care providers regarding CAM.

Methods

This cross-sectional study was conducted between March 1 and July 31, 2015 among health care providers working mainly in the public sector in Trinidad and Tobago. A 34-item questionnaire was distributed and used for data collection. Questionnaire data were analysed using inferential and binary logistic regression models.

Results

Response rate was 60.3% (362/600). Responders were 172 nurses, 77 doctors, 30 pharmacists, and 83 other health care providers of unnamed categories (mainly nursing assistants). Responders were predominantly female (69.1%), Indo-Trinidadian (55.8%), Christian (47.5%), self-claimed “very religious” (48.3%), and had <5 years of working experience (40.6%). The prevalence of CAM use was 92.4% for nurses, 64.9% for doctors, 83.3% for pharmacists, and 77.1% for other health care providers. The majority (50–75%) reported fair knowledge of herbal, spiritual, alternative, and physical types of CAM, but had no knowledge of energy therapy and therapeutic methods. Sex, ethnicity, and type of health care provider were associated with both personal use and recommendation for the use of CAM. Predictors of CAM use were sex, religion, and type of health care provider; predictors of recommendation for the use of CAM were sex and type of health care provider. About half of health care providers (51.4%) and doctors (52%) were likely to ask their patients about CAM and <15% were likely to refer patients to a CAM practitioner. However, health care providers expressed interest in being educated on the subject. Doctors (51.9%) and pharmacists (63.3%) said that combination therapy is superior to conventional medicine alone. Less than 10% said conventional medicine should be used alone.

Conclusion

Knowledge about CAM is low among health care providers. The majority engages in using CAM but is reluctant to recommend it. Predictors of CAM use were sex, religion, and profession; predictors of recommendation for the use of CAM were sex and profession. Health care providers feel the future lies in integrative medicine.

Trends and challenges toward integration of traditional medicine in formal health-care system: Historical perspectives and appraisal of education curricula in Sub-Sahara Africa

The population residing Sub-Sahara Africa (SSA) continues to suffer from communicable health problems such as HIV/AIDS, malaria, tuberculosis, and various neglected tropical as well as non-communicable diseases. The disease burden is aggravated by shortage of medical personnel and medical supplies such as medical devices and minimal access to essential medicine. For long time, human beings through observation and practical experiences learned to use different plant species that led to the emergence of traditional medicine (TM) systems. The ancient Pharaonic Egyptian TM system is one of the oldest documented forms of TM practice in Africa and the pioneer of world's medical science. However, the medical practices diffused very fast to other continents being accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health-care system. Challenging issues that drag back integration is the development of education curricula for training TM experts as the way of disseminating the traditional medical knowledge and practices imbedded in African culture. The few African countries such as Ghana managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone, and Tanzania have TM products being sold over the counters due to the availability of education training programs facilitated by research. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should take in the integration process to safeguard the SSA population from disease burdens.

Exploring self-use, attitude and interest to study complementary and alternative medicine (CAM) among final year undergraduate medical, pharmacy and nursing students in Sierra Leone: a comparative study

Background

CAM inclusion into the curricula of health training institutions, a strategy for its integration into the main stream healthcare delivery system is growing globally. Future healthcare professionals knowledge and perception of CAM are key determinants to its successful integration. Thus, the main objective of this study was to compare the use, attitude and interest to study CAM among final year undergraduate medical, pharmacy and nursing students at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL).

Methods

A questionnaire based cross-sectional survey was carried out among final year medical, pharmacy and nursing students enrolled at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Chi square, fisher exact two tailed test and Kruskal-wallis test were used to analyze data collected.

Results

Close to two-thirds (61 %) of all the three groups of final year students used one form of CAM or the other with pharmacy (72.7 %) and nursing (55.6 %) students being the highest and least users respectively. No significant difference was observed among the three groups. In general, final year students in all three cadres demonstrated a positive attitude toward CAM (33.80 ± 3. 2) with medical students showing more positive attitude than pharmacy (p = 0.022) and nursing student (p = 0.008). No significant difference in attitude was observed between students in pharmacy and nursing programs (p = 0.354). More than three quarter (76.6 %) of the students in all the three groups indicated their interest in studying CAM, with preference for the subject to be taught as an elective module (81.6 %).

Conclusion

An appreciable number of final year medical, pharmacy and nursing students at COMAHS-USL have used at least one CAM modality and demonstrated an overall positive attitude towards CAM. Interest to study CAM was also observed among most of them even though they preferred it to be taught as an elective module.

Electronic supplementary material

The online version of this article (doi:10.1186/s12906-016-1102-4) contains supplementary material, which is available to authorized users.

Knowledge, Attitudes, and Usage of Apitherapy for Disease Prevention and Treatment among Undergraduate Pharmacy Students in Lithuania

Traditional medicine therapies are historically used worldwide for disease prevention and treatment purposes. Apitherapy is part of the traditional medicine based on bee product use. Complementary medicine practices which incorporate use of some traditional herbal, mineral, or animal kind substances very often are discussed with pharmacy professionals because these products are often sold in pharmacies as dietary supplements. This study is aimed at determining the attitude, knowledge, and practices of apitherapy among undergraduated pharmacy students (Master of Pharmacy) who already have a pharmacy technician diploma and from 1 to 20 years of practice working in a community pharmacy as pharmacy assistants. A method of questionnaire was chosen. The questions about attitudes, experience, knowledge, and practices for disease prevention and treatment of different bee products, their safety, and informational sources were included. Respondents shared opinion that use of bee product is part of the traditional medicine. Most of them had experience on honey product use for treatment and disease prevention for themselves and their family members (62%) although the need of more evidence based information was expressed. The most known bee products were honey, propolis, and royal jelly. They are widely used for enhancing the immune system and prevention of respiratory tract infection.

A Retrospective Analysis of Patients' Conditions Using Acupuncture in a Traditional Korean Medicine Hospital

Objective. The aim of this study was to identify the patient demographics, health issues, and type of acupuncture treatments who visited a traditional Korean medical hospital for acupuncture treatment. Methods. We retrospectively analysed the data using the electronic medical records (EMRs) of patients treated with at least one treatment of acupuncture from 1 January 2010 to December 2012 in the Chung-Ju Korean hospital at Semyung University. Results. The total number of identified patients was 1189 inpatients and 10138 outpatients. The 50–59 age group received acupuncture treatment in the hospital the most, followed by the 40–49 age group. Among the patients undergoing acupuncture treatment because of a diagnosis of pain, 82.74% were outpatients and 72.85% were inpatients. Additionally, all patients with a spine condition received acupuncture treatment. The most common musculoskeletal conditions of patients at the traditional Korean medicine (TKM) hospital were associated with spine conditions, such as low back pain and neck pain. Various treatments have been performed at the hospital in conjunction with acupuncture. The study results show a high prevalence of acupuncture treatment for diagnosed diseases. Conclusion. Our study suggests the need to investigate additional TKM hospitals to analyse characteristics of patients who received specific treatments. Analysis of the characteristics of patients treated with Korean acupuncture at the TKM hospital in this study will help future researchers who want to implement strong clinical evidence. However, we cannot completely discount all symptoms because of the retrospective nature of this study, and only one hospital was used, which limits the generalisation of our findings.

Characterizing Herbal Medicine Use for Noncommunicable Diseases in Urban South Africa

Economic challenges associated with noncommunicable diseases (NCDs) and the sociocultural outlook of many patients especially in Africa have increased dependence on traditional herbal medicines (THMs) for these diseases. A cross-sectional descriptive study designed to determine the prevalence of and reasons for THM use in the management of NCDs among South African adults was conducted in an urban, economically disadvantaged area of Cape Town, South Africa. In a cohort of 1030 participants recruited as part of the existing Prospective Urban and Rural Epidemiological (PURE) study, 456 individuals were identified. The overall prevalence of THM use was 27%, of which 61% was for NCDs. Participants used THM because of a family history (49%) and sociocultural beliefs (33%). Hypertensive medication was most commonly used concurrently with THM. Healthcare professionals need to be aware of the potential dualistic use of THM and conventional drugs by patients, as this could significantly influence health outcomes. Efforts should be made to educate patients on the potential for drug/herb interactions.

Safety assessment of Guibi-tang: Subchronic toxicity study in Crl:CD SD rats

Guibi-tang (Kihi-To in Japanese and Qui-Pi-Tang in Chinese) is a multiherbal traditional Korean medicinal formula used for treatment of amnesia, fatigue, poor memory or forgetfulness, anemia, insomnia, and necrosis. The aim of the present study was to investigate potential safety, if any, of subchronic administration of Guibi-tang aqueous extract (GBT) in laboratory animals. For this study, 0, 1000, 2000, and 5000 mg/kg/day of GBT was administered to Crl:CD Sprague Dawley rats (10/sex/group) for 13 weeks via oral gavage. Administration of the GBT did not result in any mortality, body weight, food consumption, hematology, serum biochemistry, clinical or ophthalmological signs or changes in urinalysis, gross findings, or organ weight. However, histopathology revealed forestomach hyperplasia and duodenum mucosal hyperplasia in rats of both sexes at the highest dose of GBT, 5000 mg/kg/day. Therefore, the no-observed-adverse-effect level in rats was established for GBT at 2000 mg/kg/day under the conditions of this study.

Beliefs, attitudes and self-use of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy medicines among senior pharmacy students: An exploratory insight from Andhra Pradesh, India

OBJECTIVES

To assess the beliefs, attitudes and self-use of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) medicines among senior pharmacy students.

METHODOLOGY

This was a descriptive cross-sectional study conducted among pharmacy students in four pharmacy schools located in Andhra Pradesh in South India. This study was conducted from the August to September 2014. The study population included all pharmacy students enrolled in Doctor of Pharmacy, Bachelor of Pharmacy and Diploma in Pharmacy programs in studied pharmacy schools. The pretested AYUSH survey had 8 questions on AYUSH related beliefs and 8 question on AYUSH related attitudes. The survey also asked participants about AYUSH related knowledge, frequency of use of AYUSH and the reason for using AYUSH. The data analysis was performed using SPSS Version 20. Chi-square test and Mann-Whitney U-test were employed to study the association between the independent and dependent variables.

RESULTS

A total of 428 pharmacy students participated in the survey. 32.2% of the study population was females and 32.5% of the population resided in rural areas. Males were more likely to have positive beliefs about AYUSH when compared to females (odd ratio [OR] = 4.62, confidence interval [CI] = 2.37-8.99, P < 0.001). Similarly, students living in hostels were more positive in their beliefs about AYUSH compared with students living at home (OR = 2.14, CI = 1.12-4.07, P < 0.05). Students living in hostel also had a positive attitude about AYUSH use (OR = 1.74, CI = 1.03-2.93, P < 0.05).

CONCLUSION

Pharmacy students held favorable attitude and beliefs about AYUSH use. This baseline survey provides important information about the pharmacy student's perception about AYUSH. Further research is needed to explore the reasons that shape the pharmacy student's beliefs and attitudes about AYUSH.