Prevalence and reasons for intentional use of complementary and alternative medicine as an adjunct to future visits to a medical doctor for chronic disease

Operational definition of complementary, alternative, and integrative medicine derived from a systematic search

BACKGROUND

Identifying what therapies constitute complementary, alternative, and/or integrative medicine (CAIM) is complex for a multitude of reasons. An operational definition is dynamic, and changes based on both historical time period and geographical location whereby many jurisdictions may integrate or consider their traditional system(s) of medicine as conventional care. To date, only one operational definition of "complementary and alternative medicine" has been proposed, by Cochrane researchers in 2011. This definition is not only over a decade old but also did not use systematic methods to compile the therapies. Furthermore, it did not capture the concept "integrative medicine", which is an increasingly popular aspect of the use of complementary therapies in practice. An updated operational definition reflective of CAIM is warranted given the rapidly increasing body of CAIM research literature published each year.

METHODS

Four peer-reviewed or otherwise quality-assessed information resource types were used to inform the development of the operational definition: peer-reviewed articles resulting from searches across seven academic databases (MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, Scopus and Web of Science); the "aims and scope" webpages of peer-reviewed CAIM journals; CAIM entries found in online encyclopedias, and highly-ranked websites identified through searches of CAIM-related terms on HONcode. Screening of eligible resources, and data extraction of CAIM therapies across them, were each conducted independently and in duplicate. CAIM therapies across eligible sources were deduplicated.

RESULTS

A total of 101 eligible resources were identified: peer-reviewed articles (n = 19), journal "aims and scope" webpages (n = 22), encyclopedia entries (n = 11), and HONcode-searched websites (n = 49). Six hundred four unique CAIM terms were included in this operational definition.

CONCLUSIONS

This updated operational definition is the first to be informed by systematic methods, and could support the harmonization of CAIM-related research through the provision of a standard of classification, as well as support improved collaboration between different research groups.

Effects of the Healing Beats Program among University Students after Exposure to a Source of Psychological Stress: A Randomized Control Trial

This study is a randomized pre- and post-controlled trial to determine the effects of the Healing Beats program on anxiety, autonomic nervous balance, Bispectral (BIS) index, and heart rate among university students after exposure to a source of mental stress. Data were collected from candidates who volunteered from November 2018 to May 2019 in response to recruitment announcements. The analysis was performed using data of 99 participants in three groups: 32 in an experimental group, 35 in a placebo group, and 32 in a control group. The experimental group who received treatment via the Healing Beats program exhibited a significant effect on calming anxiety, autonomic nervous balance, BIS index, and heart rate, compared with the placebo group and the control group. The group interaction also showed a significant difference. The Healing Beats program can be used as an effective intervention for sedation in clinical situations or calmness in stressful situations in everyday life. Specifically, the Healing Beats program could serve as basic data for nursing interventions, according to the stability effect in stressful situations; it can also be applied to effective nursing practice as an initial study to confirm theoretical and practical indicators.

What influences complementary medicine use for children with eosinophilic esophagitis? Findings from a cross-sectional survey

BACKGROUND AND PURPOSE

Utilization of complementary medicines (CMs) amongst children with eosinophilic esophagitis (EoE) in Australia is high. Carers' beliefs, perceptions and use of CM can influence the decision to use CM in children in their care. This study explores the factors influencing the use of CM for a child's EoE when the carer also uses CM.

MATERIALS AND METHODS

Carers of children aged 0-18 years with EoE participated in a national cross-sectional online survey, conducted in Australia between September 2018 and February 2019. Data analysis included bivariate analysis, Cramer's V, backwards stepwise logistic regression and binomial logistic regression.

RESULTS

Of the 181 total survey responses, 165 (91.2 %) respondents indicated they had utilized some form of CM for themselves. Children whose carer had used some form of CM for themselves were more likely to have used CM than children whose carer had not used CM (OR 4.6; p = 0.001). Of the CM self-using carers, 125 (75.8 %) had also chosen to utilize CM for their child's EoE. Use of CM in children was more likely amongst children who had used a pharmaceutical for their EoE (OR 7.51; p = 0.010), and those whose carer had consulted with "other health practitioners or health workers" for their child's EoE (OR 5.34; p < 0.001) or had consulted with a chiropractor for themselves (OR 2.70; p = 0.029).

CONCLUSION

High CM self-use amongst carers is associated with their decision to also use CM for their child's EoE, a concern given the absence of evidence for CM's safety and efficacy in this population. CM use in this population warrants further attention. Effective conventional medicines for EoE are limited and utilization of CM amongst children with EoE in Australia is high. The recommendation of CM for children with EoE warrants further attention given the substantial concomitant pharmaceutical care, and the absence of evidence for CM's safety and efficacy in this population. Further research into the role of CM practitioners, products, and therapies in an integrative model between CM and conventional healthcare must be undertaken.

Insight into the characteristics of research published in traditional, complementary, alternative, and integrative medicine journals: a bibliometric analysis

BACKGROUND

Traditional, complementary, alternative and integrative medicine (TCAIM) can be described as diverse medical and healthcare interventions, practices, products, or disciplines that are not considered as part of conventional medicine. Inherent in its definition, TCAIMs are comprised of a wide variety of therapies with highly variable safety and effectiveness evidence profiles. Despite this, the use of many TCAIMs is highly prevalent among patients globally. The present study consists of a bibliometric analysis of TCAIM journals.

METHODS

A single search of all International Standard Serial Number (ISSNs) of all journals categorized as "complementary and alternative medicine" (code 2707) based on the All Science Journal Classification (ASJC) was run on Scopus on April 17, 2021. All publication types were included; no further search limits were applied. The following bibliometric data were collected: number of publications (in total and per year), authors and journals; open access status; journals publishing the highest volume of literature and their impact factors; language, countries, institutional affiliations, and funding sponsors of publications; most productive authors; and highest-cited publications. Trends associated with this subset of publications were identified and presented. Bibliometric indicators of production were calculated, and bibliometric networks were constructed and visualized using the software tool VOSviewer.

RESULTS

A total of 172,466 publications (42,331 open access), were published by 219,680 authors in 143 journals from 1938 to 2021. Since the 1940s, an upward trend with respect to the volume of publications can be observed, with a steep increase observed between the mid-2000s and mid-2010s. The journal that published the largest number of publications was the Journal of Natural Products (n = 15,144). The most productive countries included China (n = 45,860), the United States (n = 29,523), and Germany (n = 10,120); a number of the most common institutional affiliations and funding sponsors also originated from these three countries.

CONCLUSIONS

The number of publications collectively published in TCAIM journals follows an upward trend. Given a high prevalence of TCAIM use among patients, increased acceptance of TCAIM among conventional healthcare providers, and growing interest in the research of TCAIM, future work should continue to investigate and track changes in the publication characteristics of the emerging research on this topic.

Therapeutic use of Guggulsterone in COVID-19 induced obesity (COVIBESITY) and significant role in immunomodulatory effect

COVID-19 has emerged as a major cause of health crisis around the world. Psychosocial, Behavioral and metabolic changes especially weight gain, among variety of population was produced in this pandemic, through variety of mechanisms. Hyperlipidemia is one of the major issues that result in serious cardiovascular complications. Governmental strategies to minimize the spread of COVID-19 through closures, lockdowns, and alterations in social interaction have complicated weight management efforts. And immunity being the need of the hour has to be improved to prevent the infection. Guggulsterone (GS) isomers are major bioactive compounds present in Commiphora mukul and Commiphora wighti. Guggulsterone shows anti-hyperlipidemic, anti-oxidant, anti-inflammatory, immunomodulatory and appetite regulating activity due to its peculiar characteristics. On the basis of clinical evidence, Guggulsterone seems to possess good cholesterol lowering, appetite regulating as well as immunomodulatory activity which can be beneficial during the pandemic of COVID-19.

Willingness to pay for traditional, complementary and alternative medicine (TCAM) among Malaysian adults

Purpose

Health plays a crucial role in the daily lives and supporting health is the important role of medicine. With the availability of traditional, complementary and alternative medicine (TCAM), the demands and willingness to pay among users are increasing. Hence, this study aims to determine the psychological factors influencing the willingness to pay for TCAM among Malaysian adults.

Design/methodology/approach

In total, 300 completed self-administered questionnaires were collected from Malaysian adults using a purposive sampling method through intercepts at public health-care facilities. A structural equation modelling approach using partial least square was used to test the hypotheses.

Findings

The findings show that attitude, subjective norms, perceived price and knowledge have a significant impact on willingness to pay for TCAM. Surprisingly, there was no relationship found between perceived behavioural control and health consciousness on willingness to pay for TCAM.

Originality/value

The findings of this study are expected to provide better insights into TCAM use among Malaysian adults. The results are also important to encourage health-care institutions and practitioners to educate the general public on the safety of TCAM to ensure more health benefits to the users.

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.

The feasibility and acceptability of hypnotherapy among overweight and obese individuals in a Malaysia's public university

OBJECTIVES

The global epidemic of overweight and obesity presents a major challenge in the health status of the society. Their prevalence is at an alarming rate worldwide due to poor compliance with conventional treatment and high rates of relapse, thus increasing demand for an effective and safe alternative approach such as hypnotherapy. This study aimed to evaluate the feasibility and acceptability of hypnotherapy for weight loss and to compare these among selected socio-demographics.

METHODS

A cross-sectional study was conducted among 30 students and staff of a public university in Terengganu, Malaysia using convenience sampling. Data analysis was carried out using SPSS 23.0.

RESULTS

Among the respondents (age = 26.17 ± 8.23 years; female = 66.7%; students = 63.3%), 40.0% were overweight and 60.0% were obese. Results indicated excellent feasibility as determined by participants' satisfaction towards the clarity of hypnotherapist's voice (93.3%), the suitability of content (86.7%) and time spent for the session (90.0%). Good overall acceptability (>60.0%) was also reported regarding hypnotherapist professionalism, the environment and perceived usefulness of hypnotherapy. Obese individuals were significantly more satisfied towards the hypnotherapist environment than overweight respondents (p=0.015). Additionally, no adverse effects were reported after the intervention.

CONCLUSIONS

This evidence signalled that hypnotherapy is a promising alternative tool in assisting overweight and obese individuals to lose weight. Extensive research is needed to substantiate its role in weight management programs for its full benefits.

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

OBJECTIVES

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

METHODS

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

KEYWORDS

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

RESULTS

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

CONCLUSIONS

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

A study on the motivation of Indian patients to consult complementary and alternative medicine practitioners to treat coronary artery disease

BACKGROUND

In India, the use of traditional medicine for health problems is a part of the cultural discourse on treatment, but the introduction of Western medicines has adversely affected their popularity. However, with the rapid spread of chronic diseases like coronary artery disease (CAD), many Indians are reverting to complementary and alternative medicine (CAM) treatments. Although previous literature has identified several motivational factors underlying CAM usage, we know little from the perspective of its practitioners.

AIM

The aim of the present study was to investigate the motivations behind the use of CAM treatments among Indian patients with CAD.

METHOD

Using semi-structured interviews, we collected data from 15 CAM practitioners and 14 CAD patients utilising CAM treatments alongside conventional biomedical (BM) treatment. We used the Clarke and Braun (2006) method of thematic analysis.

RESULT AND CONCLUSION

Our findings suggest that the use of CAM treatments depends on various factors working at multiple levels viz., personal factors, disease' characteristics, perceived treatment characteristics (positive attributes of CAM and negative attributes of BM) and external facilitators. Furthermore, our analysis also identifies the role of two underlining forces-push and pull-in motivating CAD patients to choose CAM treatments. The push force comprises factors that participants found to have a repelling nature, whereas pull forces were regarded as advantageous for CAM usage. Although some reasons behind the usage of CAM treatments according to patients and practitioners were overlapping, both groups also provided many distinct insights into the studied health behaviour.

The impact of uncertainty in society on the use of traditional, complementary and alternative medicine: a comparative study on visits to alternative/traditional/folk health care practitioners

Background

While traditional, complementary and alternative medicine (TCAM) is gaining increased interest worldwide, the structural factors associated with the usage of TCAM at the social level have not been sufficiently explored. We aim to understand the social structure of uncertainty in society that affects the TCAM usage for men and women.

Methods

We studied 32 countries using data from the International Social Survey Programme and the World Bank. In this study, we defined TCAM usage as visits to an alternative/traditional/folk health care practitioner during the past 12 months. We performed a correlation analysis and used a generalized linear model .

Results

The prevalence of TCAM usage in terms of visits to practitioners was 26.1% globally, while usage varied across the 32 countries. Generalized linear models showed that unemployment rate was associated with the prevalence of TCAM usage in terms of visits to practitioners.

Conclusions

At the social-structural level TCAM usage involving visits to practitioners was related to job insecurity. Job insecurity led to a decrease in TCAM usage regarding visits to practitioners. These findings suggest that it is necessary to consider the social-structural factors of uncertainty in society when designing health policies related to TCAM.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2662-x) contains supplementary material, which is available to authorized users.

The use of complementary and alternative medicine in Iceland: Results from a national health survey

Background: The use of complementary and alternative medicine (CAM) has increased in Western societies in recent years. In a national health survey conducted in 2006 in Iceland, 31.8% of the population had used CAM in the past 12 months; however, the trend of CAM use since then is unknown. This study’s aim was to describe participants’ use of CAM providers in Iceland in 2015 and compare it to the results of the previous survey. The current study explored the relationship between the participants’ use of CAM and their background, religiosity, healthcare attitudes, mental and physical health, and physician visits. Methods: The study was based on a national health survey conducted in the Spring of 2015. The questionnaire was mailed to a random sample of Icelandic adults, aged 18–75. Altogether 1599 respondents returned valid questionnaires (response rate 58%). The standardized questions were developed and tested in previous health surveys. Results: Nearly 40% of respondents had used CAM in the past 12 months. This is an estimated 8.4% increase since 2006. Women and people with more education were more likely than other participants to use CAM. Repeated physician visits were related to increased likelihood of CAM use. Individuals with high anxiety were more likely than others to use CAM. Conclusions: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. Most CAM users appear to use CAM to complement care received in the general health system.

A Pilot Study of Partner Chair Massage Effects on Perinatal Mood, Anxiety, and Pain

BACKGROUND

Women worldwide experience perinatal mood, anxiety, and pain contributing to pregnancy and birth challenges, maternal and infant bonding, and childhood development. Perinatal women seek massage therapy for relaxation, pain management, and emotional support, but may encounter socioeconomic barriers. Prior studies demonstrated improved perinatal health by teaching partners of pregnant women a side-lying massage.

PURPOSE

This study examined health effects to perinatal mood, anxiety, and pain, by teaching partners of pregnant (PG) women a chair massage.

SETTING

Participant's homes in Tucson, Arizona, USA.

PARTICIPANTS

Twelve PG women with minor mood, anxiety, and pain: 67% white, 33% Hispanic, college educated, married, aged 32 years (± 3.86 SD), 67% expecting a first child, annual incomes ≤ $50,000 (33%), > $50,000 (67%).

RESEARCH DESIGN

A pre/postintervention pilot study in a single group for eight weeks.

INTERVENTION

Twice weekly partner-delivered chair massage and its relation to perinatal mood, anxiety, and pain.

MAIN OUTCOME MEASURES

Pre/poststudy perinatal massage effects were measured with the Edinburgh Depression Scale (mood), the STAI-AD (anxiety), and the VAS (pain). Weekly text messaging tracked dose and frequency, follow-up surveys measured sustainability, and birth outcomes were acquired by texting.

RESULTS

Study retention was 86%, protocol compliance 94%, with couples averaging 10-minute, twice weekly chair massage over the eight-week study period. Paired-sample t tests indicated statistically significant improvements to perinatal mood and anxiety, Cohen's d, a large strength of effect size (p = .012, d = 0.87; p = .004, d = 1.03). A trend was observed for reduced pain, with a medium strength of effect size (p = .071; d = 0.58). Follow-up surveys indicated most couples were sustaining at least weekly massage. Birth outcomes showed healthy infants with no complications, mean birth weight of 7.26 pounds, and mean gestation of 39 weeks.

CONCLUSION

This is the first evidence of partner chair massage as safe and effective complementary home management of perinatal mood, anxiety, and pain.

Clients of UK healers: A mixed methods survey of their demography, health problems, and experiences of healing

BACKGROUND

Healing has not been well researched, and very little is known about who goes to healers, and what they experience.

METHODS

A survey of UK-based healers was undertaken with the help of The Confederation of Healing Organisations, asking healers to report on up to 20 consultations. Forms asked about the demography of healer and client, reasons for the consultation, type of healing, and outcomes. Both quantitative and qualitative data were analysed.

RESULTS

278 returned forms from 39 healers (average age 58) were analysed. Healing was described as Spiritual (69%), Reiki (15%) or Energy (10%). The clients had an average age of 57, and 76% were women. The most common reasons for consulting were mental health problems and pain. 93% of the clients reported experiencing immediate benefits. Relaxation, improved wellbeing and relief of pain were often reported. In addition, 76 (27%) had some unusual sensory experiences during the session, such as feelings of warmth, seeing coloured lights, or tingling sensations. The majority of general comments about the experience were positive, and 68% made another appointment.

CONCLUSIONS

Older people, particularly older women, are the main recipients of healing in the UK, and they go for help with many problems, particularly mental health issues and pain. The majority have a positive experience, and come back for more. In addition to relief of symptoms, many have sensory experiences which could indicate that some special type of interaction was taking place between healer and healee.

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

Introduction:

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

Methods:

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

Results:

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

Conclusions:

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