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

A review of the WHO strategy on traditional, complementary, and integrative medicine from the perspective of academic consortia for integrative medicine and health

Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.

Knowledge, perception, attitude, and practice of complementary and alternative medicine by health care workers in Garki hospital Abuja, Nigeria

BACKGROUND

Healthcare workers are currently making efforts to offer services that cater to the holistic care needs of their patients. Previous studies have shown that some healthcare workers encounter challenges when advising patients about Complementary and Alternative Medicine (CAM), even though its use is widespread. Many health care workers may not have received formal education or training in CAM and consequently are unable to address their patients' questions about it. This study explored the knowledge, perception, attitude and practice of CAM by healthcare workers in Garki Hospital, Abuja, Nigeria.

METHODS

This was an institution-based cross-sectional study, design and a convergent parallel, mixed methods design was used for data collection. Five (5) healthcare workers were purposively selected as participants for the key informant interviews, while two hundred and fifty (250) selected using a simple random sampling method completed the questionnaire. The data collection instruments used were a key informant interview guide and a 35-item self-administered questionnaire. Knowledge was assessed with a 4-item scale with a maximum score of 8. Perceptions and attitudes were assessed using Likert scales with a maximum score of 45 and 20, respectively. Practice was assessed with a 6-item scale with a maximum score of 18. Qualitative data was analysed using framework analysis. Quantitative data was analysed using descriptive and inferential statistics. Data acquired from both methods were integrated to form the findings.

RESULTS

The average age of respondents for the quantitative study was 34.0 ± 7.8 years, and they were predominantly females (61.2%) with one to ten years of work experience (68.8%). The mean knowledge, perception and attitude scores were 1.94 ± 1.39, 13.08 ± 2.34 and 32.68 ± 6.28, respectively. Multiple linear regression result showed that knowledge (t = 2.025, p = 0.044) and attitude (t = 5.961, p = 0.000) had statistically significant effects on the practice of CAM. Qualitative data revealed that the majority of the participants perceive CAM favourably, provided it is properly introduced into mainstream medicine with evidence of safety and research to prove its efficacy.

CONCLUSION

The study has shown the gaps in knowledge and the practices of CAM by conventional medical practitioners. This has implications for their ability to counsel and refer patients who may require CAM therapies. Policy, research and programmatic initiatives that seek to enhance their knowledge of CAM, and improve collaboration with CAM practitioners are recommended.

Expert consensus-based clinical recommendation for an integrative anthroposophic treatment approach to acute tonsillitis in childhood

BACKGROUND

Medical guidelines are an important basis for qualitative and cost-effective patient care. However, there is a lack of clinical recommendations in anthroposophic medicine (AM), an integrative medicine approach frequently practised in Europe. Acute tonsillitis, which includes tonsillopharyngitis, is a common childhood disease. that is mostly caused by a viral infection. Symptomatic treatment is therefore of high importance, and AM can offer several therapy options.

METHODS

53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprises five survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel.

RESULTS

Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%).

CONCLUSION

The clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.

Knowledge and attitudes of midwives towards collaboration with traditional birth attendants for maternal and neonatal healthcare services in rural communities in South Africa

OBJECTIVES

We assessed the knowledge and attitude of registered midwives towards collaborating with traditional birth attendants for maternal and neonatal healthcare services in rural communities.

DESIGN

A descriptive cross-sectional survey was followed in this study.

PARTICIPANTS

Registered midwives in selected clinics in the City of Tshwane Municipality. Participants were recruited by stratified random sampling. Data was collected at the Thirty-four primary healthcare facilities in Gauteng province, South Africa.

MEASUREMENT AND RESULTS

A self-assessment questionnaire was administered to 304 registered midwives. Two-hundred and sixty respondents returned the questionnaire representing a response rate of 86.6 % which was statistically significant. The majority of Midwives in South Africa displayed a low level of knowledge (mean = 41.8, SD=1.7) on the role and practices of traditional birth attendants). Only 30.8 % (n = 80) of midwives knew of the roles of traditional birth attendants for maternal and neonatal healthcare (MNH) services. With respect to knowledge, there was significant associated with the Professional category (p < 0.015). In terms of attitude, registered midwives displayed negative attitudes towards collaborating with traditional birth attendants (mean = 46.8, SD=2.1). Approximately half (54.2 %, n = 140) of midwives were amenable towards collaborating in the provision of antenatal care, and 70.4 % (n = 183) of midwives agreed to collaborate with traditional birth attendants for extended roles such as accompanying women to health facilities. Association of demographic data and level of attitude showed there was significant relationship (p < 0.05) between registered midwives' level of education and their attitude towards collaboration.

KEY CONCLUSIONS

Midwives demonstrated positive attitude towards collaborating with traditional birth attendants at the antenatal care level only. Midwives were not amenable to collaboration at the level of intrapartum and postpartum care.

IMPLICATIONS FOR PRACTICE

Based on our results, collaboration should be at antenatal care level to allow for early detection, treatment, and prevention of antenatal complications thus reducing maternal mortality and morbidity.

Knowledge, attitude, and perceptions of healthcare professionals towards complementary and alternative medicine: a cross-sectional survey from twin cities of Pakistan

BACKGROUND

The growing popularity and use of complementary and alternative medicine (CAM) products among the general public worldwide has been well documented. This study aimed to investigate the knowledge, attitude, and perceptions (KAP) of Pakistani healthcare professionals (HCP) toward CAM and to document their views on integrating CAM education with the curriculum of undergraduate health science programs.

METHOD

A cross-sectional study using simple random sampling was conducted for a duration of ten months among HCPs from Pakistan's twin cities: Islamabad and RawalpindiThe data were collected using a self-administered and validated (Cronbach's alpha: 0.71) questionnaire. This questionnaire consisted of five sections, namely; demographic, attitude, perception, integration and knowledge.

RESULT

The response rate was 91.20% (500/456). The participants included 160 physicians, 155 nurses,and 141 pharmacists. The majority of the respondents were females, 67.50%, and unmarried (60.50%).The majority of HCPs participating in this study agreed that CAM modalities may benefit conventional medicine system. Likewise, most HCPs perceived different CAM therapies aseffective treatment options. More than 50% HCPs suggested CAM elective courses in the curriculum of the health sciences program.Overall, 79.17% of the HCPs have poor knowledge of CAM. Physicians have the highest knowledge score 25.63%, followed by pharmacists 21.99%, and nurses 12.26%. Knowledge status was significantly associated with age, profession, and experience of practice (p = 0.001,0.001 & 0.019).

CONCLUSION

This study revealed that despite the overall positive attitude of HCPs toward CAM, the score of knowledge is low. Therefore, the survey recommends evidence-based guidelines for the rationale use of CAM and updated syllabi of undergraduate health programs which will assist the future HCPs in increasing professionals' knowledge toachieve better health outcomes for the general public.

Pharmacy education in traditional and complementary medicines - A systematic review

BACKGROUND

Traditional and complementary medicines (T&CMs) are not typically covered in medical curricula despite 80% of the world's population using some form of herbal product as part of their healthcare. Concurrent use of T&CMs with conventional therapies is common, and both are primarily accessed in pharmacies. There is an expectation that pharmacists should be knowledgeable about T&CMs. Therefore, this review aimed to investigate what is currently known about pharmacists' T&CMs education and training to inform developments in pharmacy education.

METHODS

Eligible studies published between 01/01/2016 and 28/02/2023 were identified across six databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). Data were extracted from included studies and categorized into key themes and sub-themes and reported descriptively.

FINDINGS

Fifty-eight studies were identified, conducted across 30 countries, that included information about pharmacists' T&CMs education and training. Within the four main themes extracted, six subthemes were identified including: T&CMs education and training received; inadequate education and training opportunities; knowledge, and confidence towards T&CMs in the pharmacy setting; professional practice behaviour associated with T&CM; university education for pharmacy students; and continuing professional development for practicing pharmacists, including T&CM-drug interactions, interpreting T&CM research, T&CM-specific communication skills, T&CM use in pregnancy and breastfeeding, and efficacy and safety of T&CM in specific conditions.

CONCLUSION

Overall pharmacists are receiving limited T&CM education in undergraduate and continuing professional training and report a lack of resources to inform the advice they provide to consumers. The findings of this review can inform developments in T&CMs curriculum and accreditation standards that support the training needs of pharmacists who play a role in fostering the safe and appropriate use of these products.

The engagement of psychology with complementary medicine: A critical integrative review

Amidst the global rise in complementary medicine (CM) use for mental health, a substantial number of clients consulting a psychologist also utilise at least one form of CM. Yet, how psychologists should engage with CM in their clinical practice (e.g., how to respond to a client disclosing CM use or enquiries regarding CM products or services for mental health) remains contested and unclear. In response, a systematic integrative review was conducted to examine empirical literature reporting on one or more aspects of the relationship between psychology (incorporating clinical practice, professional associations and academia) and CM, and how that relationship may relate to or inform psychologists' engagement with CM in their clinical practice. Twenty-seven peer-reviewed articles met the specific inclusion criteria and quality appraisal was employed. Analysis shows a substantial number of psychologists are engaging with, or are interested in engaging with, CM in their clinical practice. Analysis identified a dissonance between psychologists' engagement with CM in clinical practice and the limited engagement of the broader discipline of psychology with CM. Further research is required to understand these differing types of engagement with a view to helping inform relevant policy and practice guidelines, and ultimately assist psychologists in navigating CM in their clinical practice.

Complementary and alternative medicine in oncology: knowledge, attitude and practice among Tunisian healthcare workers

PURPOSE

Over the past years, there has been a considerable increase in complementary and alternative medicine (CAM) use among cancer patients. However, guidance from health care workers (HCWs) is not always provided. We aimed to determine the knowledge, attitude and practice of Tunisian HCWs regarding the use of CAM in cancer patients.

METHODS

We conducted a multicenter cross-sectional study over 5 months from February to June 2022 among HCWs caring for cancer patients in the Tunisian center region. Data were collected using a self-administered questionnaire developed by our investigators.

RESULTS

The level of knowledge about CAM was declared limited by 78.4% of our population. The best known CAM therapies were herbal medicine and homeopathy while chiropractic and hypnosis where the least. HCWs who had sought information on CAM represented 54.3% of our sample and the main source of information was the Internet (37.1%). A positive attitude towards the use of CAM was found in 56% of HCWs. The integration of CAM into supportive care in oncology was approved by 78% of HCWs. Concerning training on CAM, 78% declared its necessity for HCWs and 73.3% expressed a desire to have it. A personal use of CAM was found in 53% of HCWs while 38.8% had previously used CAM in the treatment of their cancer patients.

CONCLUSION

The majority of HCWs had a positive attitude towards the use of CAM in oncology despite their poor knowledge about it. Our study emphasizes the need to train HCWs dealing with cancer patients on CAM.

Concurrent use of herbal and prescribed medicine by patients in primary health care clinics, South Africa

BACKGROUND

The use of herbal medicine (HM) as a self-management practice for treating various diseases has gained popularity worldwide. Consumers co-administer herbal products with conventional medicine without the knowledge of possible herb-drug interaction (HDI).

AIM

This study aimed to assess patients' perception and use of HM and their knowledge of HDI.

SETTING

Participants attending primary health care (PHC) clinics in three provinces (Gauteng, Mpumalanga and Free State), South Africa, were recruited.

METHODS

Focus group discussions comprising a total of thirty (N = 30) participants were conducted using a semi-structured interview guide. Discussions were audio-recorded and then transcribed verbatim. Data were analysed using thematic content analysis.

RESULTS

Reasons for using HM, sources of information on HM, co-administration of HM and prescribed medicine, disclosure of the use of HM, PHC nurses' attitudes and not having time to engage were frequently discussed. Respondents' lack of knowledge and perceptions about HDI and their dissatisfaction with prescribed medicine because of experienced side effects were also discussed.

CONCLUSION

Because of the lack of discussions and non-disclosure about HM in PHC clinics, patients are at risk of experiencing HDIs. Primary health care providers should regularly enquire about HM use on every patient, to identify and prevent HDIs. The lack of knowledge about HDIs by patients further compromises the safety of HM.Contribution: The results highlighted the lack of knowledge of HDI by patients thus assisting the healthcare stakeholders in South Africa to implement measures to educate patients attending PHC clinics.

Royal Jelly Increases Hematopoietic Stem Cells in Peripheral Blood: A Double-Blind, Placebo-Controlled, Randomized Trial in Healthy Subjects

Objectives

Royal jelly (RJ), produced by honeybees, influences stem cell functions, such as pluripotency maintenance of mouse embryonic stem cells and prevention of aging-related muscle stem cell functional deterioration. Thus, we hypothesized that RJ administration has various health-promoting effects based on stem cells. However, its effects are unknown in humans. In this study, we have attempted for the first time to clarify whether the administration of RJ in humans affects stem cells.

Materials and Methods

This randomized, double-blind, placebo-controlled study was performed on healthy subjects (n = 90) who received protease-treated RJ at a dose of 1200 mg/day or placebo daily for four weeks. Also, the participants with a low number of hematopoietic stem cells (HSCs) in peripheral blood were preferentially selected. HSC counts, endothelial progenitor cell (EPC) counts, blood cell counts in peripheral blood, cytokines in serum, and physical conditions were evaluated. Results and Conclusion. Eligible data from 86 subjects (placebo: 42, RJ: 44) who completed the study were analyzed. There were no significant differences between the two groups regarding the changes in peripheral HSC count (p=0.103), while diastolic blood pressure showed a significant improvement in the RJ group compared to that in the placebo group (p=0.032). The subgroup analysis excluded 14 subjects who complained of cold symptoms at baseline or within five days of the four-week study. The changes in the HSC populations were significantly higher in the RJ group than those in the placebo group (p=0.042). No adverse effects were observed in any of the groups. These results suggest that RJ administration affected the peripheral HSC count and may influence stem cell functions. Further research is needed to reveal the various health-promoting benefits of RJ based on stem cells.

Perception of integrating complementary and alternative medicine practice in patient's treatment among the healthcare practitioners: a systematic review

There is a growing trend in complementary and alternative medicine (CAM) usage among the population with medical conditions. However, there is hesitancy for medical practitioners to integrate its application with the current treatment modality, despite governance by the authority. Hence, our objective is to systematically evaluate the healthcare perception towards integrating CAM in their practices. We systematically searched three large and renowned databases i.e., Scopus, Web of Science and PubMed, regarding "Perception on Integrating CAM Usage in Patient's Treatment among Healthcare Practitioners" from 2016 until 2020. At least two independent reviewers comprehensively screened and extracted the data from the accepted articles. A total of 15 studies were included in the final qualitative synthesis following a strict and rigorous assessment checked using MMAT 2018 checklist. The studies included providing the richness of information due to the qualitative nature of the study design. There were three main domains extracted i.e. knowledge, attitude, and perspective of the healthcare practitioner towards CAM integration. Limited knowledge of CAM among healthcare providers may be the possible main reason for non-supportive attitude and negative perspective on CAM. However, those who showed an inclination towards CAM were found to be more open and ready to learn about CAM if it provides benefits to the patients. There is a heterogeneity of perception towards CAM integration from healthcare providers' point of view. A proactive and systematic CAM literacy awareness program may help to improve their understanding and possibly gain more trust in its application.

Knowledge, attitude and practice towards complementary and alternative medicine and associated factors among health care professionals in public health facilities of Hadiya Zone, South Ethiopia

Background

Even if modern medicine is becoming more widely available, a considerable portion of the world’s population continues to rely on complementary and alternative medicine. Complementary and alternative medicine is used by 80% of the population in developing countries for their health care. The study was conducted to assess Knowledge, Attitude and practice towards complementary and alternative medicine and associated factors among health care professionals in public health facilities of Hadiya Zone, South Ethiopia.

Methods

The study was conducted in Hadiya Zone from October 10 to October 30, 2019. A facility-based cross-sectional study design was employed using simple random sampling methods. Three hundred sixty six health care professionals were selected using a simple random sample method. The data were collected using a standardized self-administered and pre-tested questionnaire that was adapted from different literatures. We used descriptive statistics, as well as bivariate and multivariate logistic regression analysis. An association was determined using P-values less than 0.05 and 95 percent confidence intervals. The results of the study were presented using texts and tables.

Results

Three hundred and fifty-five respondents were interviewed, with a 97 percent respondent rate. Two hundred thirty-two (65.4%) of the study participants have good knowledge towards complementary and alternative medicine, 216 (60.8%) have a favorable attitude toward complementary and alternative medicine, and 182 (51.3%) have utilized it in the previous two years. Some of the factors associated with knowledge, attitude, and practice towards complementary and alternative medicine were health care professionals who have contact with patients who seek complementary and alternative medicine [AOR = 1.89(95% CI; 1.18, 3.03), female health care professionals [AOR = 2.43(95% CI; 2.68, 9.74), and more than six years work experience [AOR = 1.68(95% CI; 1.04, 2.71).

Conclusion

The knowledge, attitude, and practice of complementary and alternative medicine among health care professionals were low. Creating communication lines with patients and facilitating the integration of complementary and alternative medicine with modern medicine.

The knowledge and attitudes of health professionals working in mother-friendly hospitals about complementary therapy and supportive care methods

INTRODUCTION

It is important that the healthcare professionals who are with the mother at the moment of birth and afterwards, know and apply effective complementary treatment and supportive care methods, and also know their effects and limitations. The aim of this study is to determine the knowledge levels and attitudes of health personnel about complementary therapy and supportive care methods to be used in the management of labor pain and postpartum period.

METHODS

A cross-sectional study included 142 midwives/nurses and physicians working in the delivery room and maternity services of mother-friendly hospitals in Manisa, Turkey, between August 2018 and April 2019. The questionnaire consisting of 25 questions evaluated the knowledge and attitudes of the participants about complementary therapy and supportive care methods.

RESULTS

It was found that 30.6% of the healthcare professionals participating in the study used complementary treatment and supportive care methods in their patients. The least heard method was chiropractic (6.6%), the best-known method was hydrotherapy (water birth) (5.8%) and the most used method was massage (14.0%). It was determined that the mean total attitude score of the healthcare workers on complementary treatment and supportive care methods was 18.57 ± 5.12 (range: 8-40). It was found that the education levels of healthcare professionals (z= -2.144, p<0.05) and the institutions affect (χ2=23.417; p<0.05) the attitude scores.

CONCLUSIONS

One out of every two healthcare professionals did not have information about complementary treatment and supportive care methods. Healthcare professionals mostly have positive opinions about these methods.

Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature Review

Pelvic inflammatory disease (PID), a common infectious disease of the female reproductive tract, is mainly characterized by abdominal/pelvic pain and tenderness of the uterus, cervix, or adnexa on physical exam. In recent years, its incidence has gradually increased yearly due to numerous factors, including sexually transmitted diseases and intrauterine operations. Based on self-report of PID in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 survey, PID impacts approximately 2.5 million women in the US during their reproductive age. Although empiric treatments such as antibiotics or surgery could alleviate the related symptoms of PID, its unsatisfactory obstetric outcome and high relapse bring heavy physical and psychological burden to women. Complementary and alternative medicine (CAM), a complementary therapy other than Western medicine with a complete theoretical and practical system, has been attached to importance in the world due to its remarkable efficacy. More people are accepting and trying to use CAM to treat gynecological diseases, including infertility, polycystic ovary syndrome, and PID, but its efficacy and mechanism are still controversial. This article reviews the previous literature systematically focusing on the effectiveness, safety, and mechanism of CAM in the treatment of PID to provide an evidence-based basis for the clinical application of CAM in patients with PID.

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.

The Knowledge and Attitudes of The Non-Health Worker Citizens and Physicians About Traditional and Complementary Medicine: A Cross-Sectional Study

Aim: Healthcare professionals will set an example to society with their behaviors about Traditional and Complementary Medicine usage. We aimed to investigate and compare the knowledge and attitudes of society and physicians about Traditional and Complementary Medicine to create an infrastructure for medical training. Methods: In this cross-sectional descriptive study "Turkish Version of Complementary, Alternative and Conventional Medicine Attitude Scale" was used for data collection. Results: A total of 392 physicians and 438 citizens participated in the study. Among all participants, 36.9% had used a Traditional and Complementary Medicine method before and the most used method was phytotherapy. There was a significant difference between groups in terms of the level of knowledge. Surprisingly no significant difference was found between physicians and the public in the "Dissatisfaction with Modern Medicine" subgroup. Conclusion: Although there were differences in the level of knowledge between the public and physicians, it was seen that the behavioral patterns were similar to each other. This situation suggests that physicians are also influenced by the society they live in, rather than scientific data, in their decisions about Traditional and Complementary Medicine. Being as a role model to the public, physicians are responsible for providing evidence-based answers to questions about Traditional and Complementary Medicine and should receive adequate training about methods. Keywords: complementary medicine, therapeutic use, evidence-based practice, knowledge, physicians

The outcome of complementary and alternative medicine use among pregnant women in South-East Nigeria: a multi-centre prospective study

There is a global increasing trend of complementary and alternative medicine (CAM) use among pregnant women. This study aimed at determining the maternal and perinatal outcome of CAM use among the pregnant women in South-East Nigeria. This was a prospective study in which self-administered semi-structured questionnaires were used to collate information from the consenting pregnant women who use CAM and those who did not use CAM from the gestational age of 36 weeks at four hospitals in South-East Nigeria. Both groups were matched for age, parity and address. Every participant was followed up until delivery. Data were analysed using SPSS version 23 (SPSS Inc., Chicago, IL). This study's ethical clearance number was NHREC/05/01/2008B-FWA00002458-1RB00002323 and it was obtained at UNTH and on February 15 2019. CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of babies when compared with non-CAM users (p value= <.05). In conclusion, CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them.Impact StatementWhat is already known on this subject? There is an increasing trend of CAM use among pregnant women in the world. Pregnancy is associated with certain conditions that predispose women to CAM use. The clinical indications for CAM use by the pregnant women are nausea and vomiting, labour pain, induction of labour, pedal oedema and waist pain.What the results of this study add? CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of the babies when compared with non-CAM users.What the implications are of these findings for clinical practice and/or further research? CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them.

Challenges in the provision of natural medicines by community pharmacists in East Java Province, Indonesia

OBJECTIVES

Community pharmacist has been widely known as a health professional who can be easily accessed to provide medicines and reliable medicine information. However, this was not always in the case of dispensing natural medicines. Several international studies revealed that community pharmacists were less likely to deliver natural medicines accompanied with detailed information. Therefore, this study aimed to investigate factors influencing Indonesian community pharmacists in the supply of, delivery of, and provision of information about natural medicines.

METHODS

A qualitative study with purposively selected community pharmacists in four areas (district or municipality) in East Java Province was designed. In-depth, semi-structured interviewed were conducted using a Capability-Opportunity-Motivation-Behaviour approach. All interviews were audio-recorded, transcribed ad verbatim, and thematically analysed.

RESULTS

Data saturation was reached after interviewing 14 community pharmacists. All informants reported dispensing non-prescribed natural medicines. Nine had experienced dispensing prescribed natural medicines, mainly fulfilling paediatricians' requests. The most common information given was about product usage, while information about safety (i.e. side effects, interaction) was rarely provided. Although numerous registered natural medicines have been available, informants had low motivation to supply a variety of types, primarily because little opportunity to receive requests from doctors and the community. Limited capability due to a lack reliable source of information about natural medicines was another reason.

CONCLUSIONS

Poor motivation to supply natural medicines was because community pharmacists had little opportunity for such requests and limited capability due to scarcity of information. This indicated support from natural medicine manufacturers, researchers, and the government is highly required.

The Treatment of Complementary and Alternative Medicine on Premature Ovarian Failure

It has been confirmed by growing evidence that common hormone replacement therapy is associated with an increasing risk of causing cardiovascular disease and cancer, while complementary and alternative medicine (CAM) is gaining popularity and application in more and more patients with premature ovarian failure (POF). Although there is little data concerning the clinical safety and efficacy of CAM, the literature includes application studies on the phytoestrogen-rich herbal, acupuncture treatment and intervention therapy. This article reviews recent literature on CAM therapy for POF, aiming to provide theoretical support for clinical application.

A qualitative exploration of the norms and intentions of nurses toward the clinical use of herbal medicine in Ghana

PURPOSE

The purpose of the study was to determine the norms and intentions of nurses towards the clinical use of herbal medicine.

METHOD

Information on nurses' demographics, norms and intentions was gathered through individual face-to-face interviews. Interviews were analysed using the process of content analysis.

RESULTS

Beliefs of the nurses and motivational factors formed their norms. The nurses believed herbal medicine was God-given and was used by their ancestors with good outcomes. Some were self-motivated to serve herbal medicine while others counted on patient's recovery upon the use of herbal medicine to motivate them. Positive and negative intentions were discovered; thus, preparedness and unpreparedness to serve herbal medicine in the future.

CONCLUSIONS

Though some nurses believe herbal medicine is God-given, used by their ancestors and motivated to serve, others were unwilling because of inadequate training. Training of professional nurses on herbal medicine may improve their negative intentions.

Analysis of Health Care Personnel's Attitudes Toward Complementary and Alternative Medicine and Life Satisfaction due to COVID-19 Pandemic

This study was conducted to analyze health care personnel's attitudes toward traditional and complementary medicine (TCM) and life satisfaction due to coronavirus disease-2019 (COVID-19) pandemic. This cross-sectional descriptive study was conducted between April 2 and 9, 2020. The Questionnaire form was sent to health care personnel online. A total of 560 individuals who answered the questionnaires were included in the study. The data were collected by using the Personal Information Form, Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and Life Satisfaction Scale (LSS). Average age of the participants was 30.88 ± 7.68 years, 82.5% were male, and 65.5% were working as nurses. It was found that 45.5% of the participants used TCM methods for COVID-19 during the last month; 48.7% of the health care personnel stated that they used TCM methods to strengthen their immune system. The HCAMQ total average score was 27.96 ± 5.49; the holistic health subdimension total average score was 9.59 ± 3.04; the complementary and alternative medicine subdimension total average score was 18.37 ± 3.58; and the LSS total average score was 20.78 ± 6.32. A positive weak statistically significant association was found between the HCAMQ and complementary and alternative medicine subdimension and the LSS (P < .05). Participants had moderately positive attitudes toward TCM and life satisfaction. As the participants' positive attitudes toward TCM increased, their life satisfaction was also found to increase.

Complementary and integrative medicine: An observational study on pediatric clinicians' knowledge, beliefs and practices

OBJECTIVE

Complementary and Integrative Medicine (CIM) is a group of diverse health care therapies that often serve as adjuncts to conventional medical treatments. Our aim for this study was to evaluate the current knowledge, beliefs and practices of pediatric clinicians regarding CIM.

METHODS

Clinicians from the pediatric unit of a large US based teaching hospital in Connecticut were surveyed, through self-administered questionnaires.

RESULTS

We sampled 70 participants with a response rate of 99 %. Of the 70, 32 were Registered Nurses, 9 were Attendings, 7 were Fellows, 15 were Residents and 4 were Nurse Practitioners. Regarding use, 24 % had referred a patient to a CIM practitioner, 43 % reported using CIM while 47 % had a family member who had used CIM in the past year. Respondents were most familiar with massage (70 %) and yoga (69 %) least familiar with Ayurvedic medicine (20 %) and Qi Gong (24 %). Regarding attitude, 67 % believed that some CIM therapies hold promise for the treatment of symptoms while 59 % believed that incorporation of CIM would increase patient satisfaction. Most of the respondents indicated that they did not have easy access to clinical information on many CIM treatment modalities. Nurses were more familiar (p = 0.024), had more positive attitudes and beliefs (p = 0.001) and thought CIM therapies had a higher impact (p = 0.002) on patient care compared to physicians, even when controlled for gender.

CONCLUSION

This study highlights the need to bridge the gap in evidence based medicine and clinician's knowledge with the rise in CIM use. It also stresses the need for standardized learning competencies in the field of PIM.

The use of complementary and alternative medicine among hypertensive and type 2 diabetic patients in Western Jamaica: A mixed methods study

BACKGROUND

The simultaneous or intermittent use of alternative treatments and prescription medications for hypertension and type 2 diabetes mellitus can have adverse health effects.

OBJECTIVES

To identify beliefs and practices associated with the use of alternative treatments for hypertension and type 2 diabetes mellitus among patients.

METHODS

A mixed-methods study including an investigator-administered survey and focus group discussion sessions using convenience sampling was conducted among patients aged ≥18 years during May to August 2018. Descriptive statistics were used to describe and compare demographic characteristics among groups of survey participants using JMP Pro 14.0. Thematic analysis was conducted to analyze the qualitative data using NVivo.

RESULTS

Most study participants (87-90%) were on prescription medication for their condition. Of survey participants, 69% reported taking their medication as prescribed and 70% felt that prescription medicine was controlling their condition. Almost all participants (98%) reported using alternative treatments, mainly herbal medications, and 73-80% felt that herbal medicines controlled their conditions. One-third believed that herbal medicines are the most effective form of treatment and should always be used instead of prescription medication. However, most participants (85%) did not believe that prescription and herbal treatments should be used simultaneously. Most (76-90%) did not discuss herbal treatments with their healthcare providers. Four themes emerged from the focus group sessions: 1) Simultaneous use of herbal and prescription medicine was perceived to be harmful, 2) Patients did not divulge their use of herbal medicine to healthcare providers, 3) Alternative medicines were perceived to be highly effective, and 4) Religiosity and family elders played key roles in herbal use.

CONCLUSIONS

This study provides useful insights into perceptions and use of alternative treatments by patients that can be used by healthcare providers in developing appropriate interventions to encourage proper use of prescription medicines and alternative medicines resulting in improved management of these chronic diseases.

Knowledge, attitudes and practices among healthcare professionals regarding complementary alternative medicine use by patients with hypertension and type 2 diabetes mellitus in Western Jamaica

Objectives:

This study investigated the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding CAM use for Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM) among patients in western Jamaica, and to determine HCPs’ perceptions of the need for training on CAM.

Design:

A cross-sectional study was conducted from May to August 2019.

Setting:

HCPs serving patients with HTN and T2DM in chronic disease clinics in western Jamaica completed a self-administered questionnaire that provided data on their sociodemographic characteristics, training, and KAP of CAM.

Main outcome measure:

The data identified factors associated with discussion and recommendation of CAM to patients and personal use of CAM by HCPs.

Results:

Type of profession (physicians vs nurses OR = 2.17; 95 % CI = 1.07–4.42 and pharmacists vs nurses OR = 8.67; 95 % CI = 2.83–26.57) was significantly associated with discussion of CAM. Training on CAM was significantly associated with discussion (OR = 2.36; 95 % CI = 1.26–4.42), recommendation (OR = 2.72; 95 % CI = 1.36–5.42), and personal use of CAM (OR = 2.90; 95 % CI = 1.69–4.97). Dieticians and nutritionists had 4.56 higher odds of personal use of CAM (95 % CI = 1.16–17.86), and personal use of CAM was significantly associated with discussion (OR = 8.94; 95 % CI = 4.76–16.80) and recommendation (OR = 7.17; 95 % CI = 3.54–14.51) of CAM. The majority of HCPs (70–89 %) agreed that there is a need to include CAM in professional training programs.

Conclusion:

The results of this study can be used to guide development of programs for training HCPs on knowledge and safe use of CAM so that they can better serve their patients.

Perspectives of physicians on medical acupuncture in Lebanon: a preliminary study

OBJECTIVES

There are no regulations governing the practice of acupuncture in Lebanon as it is not yet registered as a profession. To our knowledge, no studies have ever been conducted in Lebanon regarding the practice of acupuncture. The purpose of this preliminary study was to explore the knowledge of Lebanese physicians about acupuncture, with the intent of conducting larger scale studies and developing strategies aimed at refining this knowledge in the future, and the ultimate goal of setting guidelines for acupuncture practice in Lebanon.

METHODS

An online survey looking into physicians' knowledge of acupuncture, its mechanisms of action, effectiveness, indications and safety, and physicians' understanding of its concepts, was circulated to 4651 physicians registered in the Lebanese orders of physicians.

RESULTS

One hundred forty-nine physicians (3.2%) completed the survey. Most study respondents stated that they were unaware of the difference between traditional Chinese acupuncture (TCA) and Western medical acupuncture (WMA). Overall, 30% of respondents had personally used and/or referred patients for acupuncture. Physicians who had personally tried acupuncture were more likely to refer patients for acupuncture (p < 0.001). Those who know the difference between WMA and TCA were more likely to have tried or referred for acupuncture (p = 0.004). 72% believed that acupuncture and other integrative medicine modules should be introduced in medical curricula in Lebanon.

CONCLUSION

Interest in acupuncture among physicians in Lebanon appears to be limited, based on the low response rate. Among respondents, physicians who had tried or referred patients for acupuncture appeared to be more well informed about different acupuncture styles.

Anxiety Symptoms, Depressive Symptoms, and Traditional Chinese Medicine Use in U.S. Chinese Older Adults

This study examined the association between anxiety symptoms, depressive symptoms, and Traditional Chinese Medicine (TCM) use among U.S. Chinese older adults. Data was obtained from the Population Study of Chinese Elderly in Chicago (N = 3157; mean age = 72.8). Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS-A). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). TCM modalities included herbal products, acupuncture, massage therapy, Taichi, and other types of TCM. Although not significant, there was a trend indicating that higher levels of anxiety symptoms showed a higher rate of acupuncture use and massage therapy. Older Chinese Americans with depressive symptoms were more likely to use acupuncture and massage therapy; and they were less likely to use other TCM. Future research is needed to identify reasons for TCM use; and how these factors mediate or moderate the relationship between psychiatric symptoms and TCM use.

Knowledge, attitude, and practice of complementary and alternative medicine: a survey of Iranian nurses

Background

Development of complementary and alternative medicine (CAM) usage makes it necessary for nurses to be up to date about these treatments. However, much information is needed about the level of knowledge, attitude and practice of nurses in this field.

Aims

The present study was conducted to determine the level of knowledge, attitude and practice of CAM in nurses working in Iranian hospitals.

Methods

It was a descriptive study. A researcher-made questionnaire was completed by nurses working in four hospitals. Descriptive statistics were used to analyse the data.

Results

Two hundred and thirty-three nurses completed the questionnaire (response rate = 83.8%). Most nurses had little knowledge of CAM. The most familiar methods were Nutrition, Massage Therapy and Herbal Medicine. Of the nurses, 71.1% believed that CAM would be effective in disease treatment, showing their positive attitude toward CAM; 1.56% of nurses used CAM, and most nurses did not use CAM in clinical settings.

Conclusions

Although nurses have a positive attitude toward CAM, their knowledge level is low. Regarding nurses' role in patients' treatment and the importance of their capability to treat, the need to increase nurses' knowledge of CAM is felt, and its education should be included in the nursing curriculum.

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.

Traditional and complementary medicine in a nephrology department: practitioner knowledge and advice

BACKGROUND

Knowledge of traditional and complementary medicine (TCM) and its use by patients are essential for patient safety.

AIMS

To examine knowledge of TCM among practitioners in a nephrology unit and their advice to patients.

METHODS

This was a descriptive, observational, cross-sectional study. Sociodemographic data were collected and an ad hoc closed response survey was used.

FINDINGS

This study included 62 practitioners, of whom: 32.26% had been trained in TCM, with no significant differences between professional groups; 41.93% used TCM and 67.74% recommended TCM to patients, with no significant difference between personal use and training received. The majority (62.90%) approved of TCM being included in clinical practice, 77.42% were in favour of it being included in formal health teaching programmes, 27.42% said patients had requested information on TCM and 50% knew it could interact with conventional treatment.

CONCLUSION

Although the majority of practitioners had not been trained in TCM, they were interested in including such treatments in clinical practice. They recommended TCM to patients, but neither training nor personal experience were significant factors in relation to these recommendations. Training in TCM is required to ensure advice is safe.

Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon

INTRODUCTION

Pharmacists are uniquely positioned to provide patients with evidence-based information in order to ensure effective and safe use of Complementary and alternative medicine (CAM) products.

OBJECTIVE

Assess beliefs, practices and knowledge related to CAM products among community pharmacists in Lebanon.

DESIGN, METHODS AND SETTING

Using stratified random sampling, a nationally representative survey was conducted among community pharmacists in Lebanon. Through face-to-face interviews, pharmacists completed a multicomponent questionnaire consisting of four sections: (1) sociodemographic characteristics; (2) beliefs related to regulation of CAM products, role of media in promoting their safe use, availability of resources and continuing education; (3) practices including selling CAM products, providing advice for patients and reporting adverse effects and (4) knowledge about specific CAM products, their uses, side effects and interactions.

RESULTS

A total of 341 pharmacists agreed to participate (response rate: 86%). Only pharmacists with complete data were included in this study (n=310). Pharmacists agreed that CAM products are effective (63.8%) and that they should be exclusively sold in pharmacies (80.3%), but disagreed that commercially marketed CAM products are well regulated (63.5%) and that media plays a positive role in educating users about these products (55.8%). As for practices, 64.5% of pharmacists were always or often advising patients on safe use; however, 74.2% of participants rarely or never reported adverse effects. Regarding knowledge, although the majority of pharmacists were aware of the uses of CAM products, fewer knew about their side effects and their interactions with drugs. After adjustment for covariates, receiving education/training on CAM products during university was the sole predictor of higher knowledge score (ß=0.68, 95% CI 0.29 to 1.07).

CONCLUSIONS

This study revealed positive beliefs of pharmacists in Lebanon towards CAM products and indicated important gaps in their practice and knowledge. Deliberate efforts to enhance the education of pharmacists are warranted to ensure the safe integration and use of CAM products in Lebanon.

Health-care providers' perspectives on traditional and complementary alternative medicine of childhood cancer in Kenya

PURPOSE

Traditional and complementary alternative medicine (TCAM) use is rising globally. In many African countries, TCAM has been a way of life as the first and last resort remedy for many ailments, including cancer. Health-care providers (HCP) should address this need properly. This study explores HCP perspectives on TCAM in Kenya.

METHODS

This cross-sectional study used questionnaires. HCP involved in the care of children with cancer at a Kenyan academic hospital were interviewed.

RESULTS

In total, 155 HCP (response rate 79%) participated. Only 18% of HCP were positive about TCAM use. However, most HCP (85%) use TCAM themselves. More doctors (90%) than other HCP (56%) think that chemotherapy can cure cancer (P < 0.001).Thirty-three percent of HCP believe a combination of TCAM and chemotherapy is the best way to cure cancer, while 56% think that usefulness of TCAM is underestimated in conventional medicine. Self-prayer is regarded as most effective (58%) and safe (76%). Most harmful is witchcraft (80%). Most HCP (71%) think their knowledge about safety and efficacy of TCAM is inadequate. HCP think that their cancer patients use TCAM (97%) and that it is important that parents inform them about this (97%). However, only 5% of HCP always openly discuss TCAM with parents.

CONCLUSIONS

HCP need to improve their knowledge of TCAM and facilitate open communication about TCAM with families so parents feel safe to discuss their interest in it.

Perceptions of traditional Chinese medicine for chronic disease care and prevention: a cross-sectional study of Chinese hospital-based health care professionals

Background

In China, demands for disease prevention and health care and the prevalence of chronic non-communicable diseases have increased. TCM and general hospitals are increasingly utilizing TCM strategies for chronic non-communicable disease care and prevention. This study aimed to investigate health care professionals’ (HCPs’) perceptions of TCM for prevention, their TCM knowledge, and their abilities to provide such services in TCM and general hospitals.

Methods

This cross-sectional study investigated Chinese medicine hospitals and Chinese medicine departments in general hospitals in five Chinese cities. A self-designed questionnaire used to study 400 HCPs focused on basic demographic data, the demand for and effects of TCM for prevention and treatment, and their perceptions of such service implementation. The data analysis included chi-squared tests and descriptive and multi-factor analyses.

Results

The 335 HCP respondents comprised 230 (68.7%) females and 105 (31.3%) males, 75.5% of whom overall had knowledge of TCM preventive and health care services. Respondents older than 40 years (28.6%) had greater knowledge of and satisfaction with TCM for preventive and health care services than younger respondents. Moreover, 97.7% of the older respondents were clearly willing to provide TCM preventive services for chronic diseases, 67.8% of whom indicated that their hospitals already provided TCM for prevention and treatment. According to the chi-squared test results, the TCM service characteristics in hospitals, hospital outlooks regarding TCM and TCM development in hospitals were the primary factors affecting the respondents’ perceptions of TCM for chronic disease care and prevention. The multivariate analysis showed high satisfaction as significantly associated with older providers and those with lengthier work experience, particularly among those who worked in hospitals that provided typical TCM services and had positive attitudes towards TCM.

Conclusion

The study HCPs had relatively satisfactory knowledge of and positive attitudes towards TCM for chronic disease care and prevention and would use it in practice. Their perceptions and satisfaction levels correlated closely with the successful application of TCM for preventive care and treatment in hospitals. While the use of TCM for prevention and treatment was well developed in some hospitals, further improvements are warranted.

Prevalence, patterns, and perceived value of complementary and alternative medicine among HIV patients: a descriptive study

BACKGROUND

Use of complementary and alternative medicine (CAM) is widespread among different patient populations despite the availability of evidence-based conventional medicine and lack of supporting evidence for the claims of most CAM types. This study explored the prevalence, patterns, and perceived value of CAM among human immunodeficiency virus (HIV) patients.

METHODS

This quantitative descriptive study was conducted between November 1, 2014 and March 31, 2015 among a cross-sectional, convenience sample of attendees of the HIV clinic of a public tertiary health care institution. Face-to-face interviews using a 34-item questionnaire were conducted. Data analysis included descriptive statistics, chi-square tests, and binary logistic regression analysis.

RESULTS

CAM was used by 113 (32.8%) of a total of 343 HIV patients, but <1% informed their health care providers of CAM usage. Medicinal herbs were the most common type of CAM used (n = 110, 97.3%) followed by spiritual therapy (n = 56, 49.6%), including faith healing/prayer and meditation. The most used medicinal herbs were Aloe vera (n = 54, 49.1%), ginger (n = 33, 30.0%), and garlic (n = 23, 20.9%). The most used vitamins were complex B vitamins (n = 70, 61.9%), followed by vitamin A (n = 58, 51.3%), vitamin E (n = 51, 45.1%), and vitamin D (n = 42, 37.1%). Most CAM users continued using conventional medicine in addition to CAM and were willing to use CAM without supervision and without informing their health care provider. Patients were generally satisfied with CAM therapy (n = 91, 80.5%). The main reasons for CAM use were the desire to take control of their treatment (8.8%) or just trying anything that could help (18.8%). Main influences were the mass media (32.7%) and non-hospital health personnel (19.5%). Predictors of CAM use were being 30-50 years, married and having a secondary school education.

CONCLUSION

About one-third of HIV patients used CAM, but virtually none informed their healthcare provider. Medicinal herbs were the most common type of CAM, followed by spiritual therapy and vitamins. A patient's decision to use CAM was influenced for the most part by the mass media and non- hospital health care personnel.

Herbal Medicines: Personal Use, Knowledge, Attitude, Dispensing Practice, and the Barriers among Community Pharmacists in Gondar, Northwest Ethiopia

Background

Herbal medicine use is increasing and the global market is estimated to be US$107 billion by the year 2017.

Objectives

This study aimed at assessing community pharmacists' personal use, knowledge, attitude, dispensing practice, and the barriers regarding herbal medicines.

Methods

Institution based cross-sectional study was conducted among 47 community pharmacists in Gondar, Northwest Ethiopia, using a structured interviewing questionnaire.

Results

Nearly half of the respondents (n = 22, 46.8%) sometimes use herbal medicines. Although knowledge related to such preparations was self-rated as poor/acceptable (n = 34, 72.4%), majority (n = 44, 93.7%) of community pharmacists agree/strongly agree that herbal medicines have beneficial effects. Only 6 (12.7%) of them are sometimes/often engaged in dispensing herbal medicines and most of them (n = 34, 72.3%) rarely/never counseled clients regarding these preparations. Limited knowledge on and access to information regarding herbal medicines are the main barriers to the pharmacists' practice.

Conclusion

Although community pharmacists in Gondar, Northwest Ethiopia, commonly use and demonstrated good attitude towards herbal medicines, they are less involved in dispensing such products. They are also challenged with limited knowledge on and access to herbal medicine information. Thus, pharmacy educators, professional organizations, and the government shall pay more attention to solve the problem. Regulatory provisions on herbal medicine dispensing must be enacted and communicated very well.