Use of complementary and alternative medicine among family practice patients in south Texas

The roles of health literacy in parents' honey use and the use of complementary alternative medicine in a Turkish population

BACKGROUND

As a biologically based therapy, honey is used by parents in many parts of the world as a home remedy for their children. While information exists regarding the traditional use of honey for health issues in children, data regarding its relationship with health literacy is lacking. The aims of this study were to determine the use of honey to address children's health issues among parents of children aged 0-72 months and to explore the relationship between the use of complementary and alternative medicine (CAM) and health literacy.

METHODS

The data for this descriptive, cross-sectional study were collected between October and November 2022 via an online survey of 907 parents of children aged 0-72 months. A sociodemographic data collection form, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and the Turkey Health Literacy Scale-32 (THLS-32) were used to collect the data. A t-test, one-way analysis of variance, and Pearson correlation analysis were used to analyze the data.

RESULTS

The majority (86.5%) of the parents used honey for their children's health problems. Among the parents, 83.1% utilized honey as a remedy for alleviating cough symptoms, 10.4% employed it as a treatment for diarrhea, and 14% administered it for the management of oral mucositis. The mean THLS-32 and HCAMQ scores of the parents were 29.39 and 21.31, respectively, and there was a moderate correlation between the parents' THLS-32 and HCAMQ mean scores (r = 0.662, p < 0.001).

CONCLUSION

This study revealed that a significant proportion of parents who used honey to alleviate their children's health issues displayed positive attitudes toward complementary and alternative medicine (CAM) while concurrently exhibiting insufficient or limited health literacy levels. Therefore, it is advisable to enhance health literacy regarding the proper and safe utilization of honey, which functions as a biologically based CAM therapy.

Hypertension Prevalence, Health Service Utilization, and Participant Satisfaction: Findings From a Pilot Randomized Controlled Trial in Aged Chinese Canadians

Responding to high prevalence of hypertension and patients' preference of integrating traditional Chinese medicine for blood pressure control, the Dietary Approach to Stop Hypertension With Sodium Reduction for Chinese Canadian (DASHNa-CC) intervention was newly designed as a culturally sensitive dietary educational intervention to facilitate middle-aged and senior Chinese Canadians' blood pressure control in community. The aim of this study was to report the hypertension prevalence rate according to the data from blood pressure screening events, to describe the characteristics of health service utilization among aged Chinese Canadians, and to report the evaluation of participant satisfaction to the DASHNa-CC intervention. This study was designed as a pilot randomized controlled trial with a sample size of 60. Among 618 Chinese Canadians participated in blood pressure screening events, 54.5% (n = 337) having various levels of hypertension. Across 2 months, 38 (63.3%) participants made a total of 47 visits to see their family physicians; 20 (33.3%) participants consulted their family members 224 times for lifestyle modifications and hypertension self-management. Various forms of Chinese media were frequently used as sources of health care information, and English media were rarely accessed. Participants highly satisfied with the contents, delivery approaches, and integration of traditional Chinese medicine in the intervention. Results indicated that middle-aged and senior Chinese Canadians have high hypertension prevalence and specific characteristics of health service utilization. It is important to implement interventions, which are culturally tailored, language appropriate, using proper technology and incorporating traditional Chinese medicine, in Chinese Canadian community for hypertension control.

A systematic review of the prevalence of herb usage among racial/ethnic minorities in the United States

Clinical studies display a wide range of herb use prevalence among racial/ethnic minorities in the United States. We searched databases indexing the literature including CINAHL, EMBASE, Global Health, CAB Abstracts, and Medline. We included studies that reported herbal medicine prevalence among ethnic minorities, African American, Hispanic, or Asian adults living in the United States. Data from 108 included studies found the prevalence of herb use by African Americans was 17 % (range 1-46 %); for Hispanics, 30 % (4-100 %); and for Asians, 30 % (2-73 %). Smaller studies were associated with higher reported herb use (p = 0.03). There was a significant difference (p = 0.01) between regional and national studies with regional studies reporting higher use. While herb usage surveys in racial/ethnic minorities show great variability, indications suggest high prevalence. More research is needed to understand herb use among ethnic/racial minorities, reasons for use, and barriers to disclosure of use to clinicians.

Elders' use of folk medicine and complementary and alternative therapies: an integrative review with implications for case managers

PURPOSE OF STUDY

The purpose of this study was to determine the prevalence of complementary and alternative medicine (CAM), folk medicine, and other nontraditional therapy use by the elderly population.

PRIMARY PRACTICE SETTING

For all case managers who coordinate health care for the elderly as they transition from one setting to another and participate in health promotion and prevention activities.

METHODOLOGY AND SAMPLE

A computerized database search of MEDLINE, CINAHL, ProQuest, and PsycINFO was completed before writing the integrative review. Six hundred ninety-seven abstracts were identified. Forty-five articles were further screened. Twenty-five articles met the criteria for inclusion.

RESULTS

The integrative review is composed of 25 articles. Support for folk medicine and CAM use by older adults is located at Levels 5 and 6 of Melynk and Fine-Overholt's Hierarchy of Evidence.

IMPLICATIONS FOR CASE MANAGEMENT PRACTICE

Folk medicine and CAM are used by the elderly for self-care purposes. A combination of both nontraditional and traditional medical interventions is used by the elderly. Although the choice to use folk medicine and CAM seems to transcend culture, the specific therapies chosen often emerge from the individual's cultural or ethnic heritage. Traditional health care providers may be unaware of elders' use of CAM or folk medicine alternatives. Case managers as coordinators of care across the health continuum are in a unique position to encourage, support, and enhance the use of folk medicine and CAM that complements traditional medical interventions for the elderly.

Communication and culture: predictors of treatment adherence among Mexican immigrant patients

This study examined communication and culture in clinicians' interactions with Mexican immigrants in Texas. Specifically, we explore the unique interplay among levels of acculturation, beliefs about culturally-based medical practices, perceptions of medical encounters, and the likelihood of adherence to medical therapy recommendations from US providers. Results suggest that: (a) acculturation predicts perceptions of out-group membership in the patient-provider interaction; (b) beliefs about complementary and alternative medicine are negatively related to medical adherence; (c) quality of care mediates the relationship between physician accommodation and medical adherence; and (d) there exists a complex relationship between out-group perceptions and adherence.

Use of complementary and alternative medicine for treatment among African-Americans: a multivariate analysis

BACKGROUND

The use of complementary and alternative medicine (CAM) is substantial among African-Americans; however, research on characteristics of African-Americans who use CAM to treat specific conditions is scarce.

OBJECTIVE

To determine what predisposing, enabling, need, and disease-state factors are related to CAM use for treatment among a nationally representative sample of African-Americans.

METHODS

A cross-sectional study design was employed using the 2002 National Health Interview Survey (NHIS). A nationwide representative sample of adult (> or =18 years) African-Americans who used CAM in the past 12 months (n=16,113,651 weighted; n=2,952 unweighted) was included. The Andersen Health Care Utilization Model served as the framework with CAM use for treatment as the main outcome measure. Independent variables included the following: predisposing (eg, age, gender, and education); enabling (eg, income, employment, and access to care); need (eg, health status, physician visits, and prescription medication use); and disease state (ie, most prevalent conditions among African-Americans) factors. Multivariate logistic regression was used to address the study objective.

RESULTS

Approximately 1 in 5 (20.2%) who used CAM in the past 12 months used CAM to treat a specific condition. Ten of the 15 CAM modalities were used primarily for treatment by African-Americans. CAM for treatment was significantly (P<.05) associated with the following factors: graduate education, smaller family size, higher income, region (northeast, midwest, west more likely than south), depression/anxiety, more physician visits, less likely to engage in preventive care, more frequent exercise behavior, more activities of daily living (ADL) limitations, and neck pain.

CONCLUSIONS

Twenty percent of African-Americans who used CAM in the past year were treating a specific condition. Alternative medical systems, manipulative and body-based therapies, and folk medicine, prayer, biofeedback, and energy/Reiki were used most often. Health care professionals should routinely ask patients about the use of CAM, but when encountering African-Americans, there may be a number of factors that may serve as cues for further inquiry.

The effect of Chinese food therapy on community dwelling Chinese hypertensive patients with Yin-deficiency

OBJECTIVES

The objectives of this study are to evaluate the effectiveness of Chinese food therapy in correcting the Yin-deficiency and to examine its impact on the patients' quality of life and hypertension control.

BACKGROUND

Epidemiological studies have shown 14-50% of people with hypertension have Yin-deficiency. Whether restoring the Yin-Yang balance by means of Chinese food therapy can help to better manage patients with hypertension has yet to be examined.

DESIGN

Two groups randomised controlled trial.

METHODS

Eighty-five hypertensive patients recruited from two community health service centre were divided into two groups. The intervention group (n = 48) received specific dietary instructions and corresponding management of their antihypertensive medication if indicated and brief health education, whilst the control group (n = 37) received routine support involving only brief health education. Data were collected at baseline, after intervention at four, eight, 12 and 16 weeks follow-up. Comparisons were made to examine the effects of Chinese food therapy on Yin-deficiency symptoms, blood pressure and quality of life of hypertensive patients.

RESULTS

The intervention group had reduction in the numbers of antihypertensive medication taken as well as improvement in most of the Yin-deficiency symptoms after 12 weeks of Chinese food therapy and mean scores of several SF-36 dimensions were higher than that of in the control group after 12 and 16 weeks follow-up. Significant difference was found in systolic blood pressure in the intervention group when it was compared from baseline to after four and eight weeks respectively.

CONCLUSION

Chinese Food Therapy can restore body constitution with Yin-Yang imbalance and may potentially improve hypertensive patients' quality of life. It is also beneficial in controlling blood pressure in hypertensive patients.

RELEVANCE TO CLINICAL PRACTICE

Chinese food therapy may become a complementary therapy in health care and it should be a component of nursing education and health education.

South Texas Mexican American Use of Traditional Folk and Mainstream Alternative Therapies

A telephone survey was conducted with a large sample of Mexican Americans from border ( n = 1,001) and nonborder ( n = 1,030) regions in Texas. Patterns of traditional folk and mainstream complementary and alternative medicine (CAM) use were analyzed with two binary logistic regressions, using gender, self-rated health, confidence in medical doctors, income, education, and acculturation as predictors. Approximately 45% of respondents were CAM users within the last 12 months. Users of both types of CAM were likely to be women and to have a high education level. Compared to nonusers, traditional folk CAM users were found to have lower self-rated health, less confidence in medical doctors, and lower acculturation. Mainstream CAM users had higher income and self-rated health than nonusers.

Integrating complementary and alternative medicine into conventional primary care: the patient perspective

OBJECTIVE

The aim of this study was to explore perspectives on integrating complementary and alternative medicine (CAM) into the conventional primary care setting among patients treated at a large academic family medicine clinic in Texas.

METHODS

We developed and administered a multiple choice questionnaire to evaluate perspectives of 502 patients on integrating CAM into the conventional primary healthcare system. All collected data were statistically analyzed to evaluate responses.

RESULTS

Among study participants, 66% indicated that they had used CAM treatments during the past year, 77% responded that they would be interested in using CAM during the next year, and 55.4% replied that they would like CAM therapies to be provided in their primary care clinic.

CONCLUSION

The use of CAM in primary care settings in southern Texas is widespread. However, in this primary care setting, patients would like their family physician to provide and supervise these therapies.

PRACTICE IMPLICATIONS

Patients believe that there is an increased need for family physician involvement in providing and supervising CAM treatments. Our findings are preliminary but can provide a basis for multicenter, cross-cultural studies to further evaluate the patient perspective on the process of integrating CAM into the conventional primary healthcare system so that healthcare policy makers can better address public need.

Folk and traditional medicine use by a subset of Hispanic adolescents

Rates of Folk and Traditional Medicine (FTM) use are high among Hispanic adults. No data have been published on FTM use among the rapidly growing Hispanic adolescent population.

OBJECTIVES

To determine the prevalence of and personal factors associated with FTM use among Mexican-American adolescents.

STUDY GROUP

182 Mexican-American adolescents (14-19 years) from community-based organizations.

METHODS

We conducted a cross-sectional survey using a self-report instrument available in English and Spanish.

RESULTS

In the past year, 49 (26.9%) subjects reported FTM use, all prompted by illness: 43 (23.6%) used herbal remedies, and 8 (4.4%) used traditional healers. Five subjects reported using dangerous herbs. Among herbal users, 56.3% did not disclose FTM use to medical providers, largely due to the providers' lack of inquiry. Logistic regression comparing herbal users with non-FTM users found subjects dissatisfied with their most recent medical visit (AOR = 10.6; 95% CI = 2.8-40.7) and subjects endorsing family FTM use (AOR = 8.4; 95% CI = 4.0-30.2) were more likely to use herbal remedies. Acculturation, insurance status, socioeconomic status, and having a personal healthcare provider were not related to herbal use.

CONCLUSIONS

The use of practitioner-based FTM modalities was rare among this convenience sample of Mexican-American adolescents. Self-treatment with herbal use was common; harmful herbs were used infrequently. Access to care does not appear to motivate herb use. The high rates of herb use by dissatisfied patients, paired with high rates of non-disclosure and lack of provider inquiry, suggests that efforts to provide more culturally sensitive care, including routine inquiry about FTM use in Mexican-American adolescents, are needed. Patterns of complimentary and alternative medicine (CAM)/FTM use vary between age and ethnic cohorts.

The profiles of adults who consult alternative health practitioners and/or general practitioners

OBJECTIVE

To compare the profiles of people visiting only a general practitioner (GP), those visiting only a practitioner of complementary and alternative medicine (CAM), and those visiting both (GP&CAM).

DESIGN

A comparative total population health survey in central Norway (HUNT 2).

SUBJECTS

A total of 54,448 persons 20 years of age and over who answered questions about their use of health services during the previous 12 months.

VARIABLES

Sociodemographic characteristics, self-perceived health, subjective health complaints, and a variety of common diseases.

RESULTS

Some 34,854 (64.0%) of those who answered the health service use question had visited only a GP, 837 (1.5%) only a CAM practitioner, and 4563 (8.4%) both during the last 12 months. The likelihood of being a CAM-only user as compared to a GP-only user was significantly increased (p < 0.005) if the participant was male; aged between 30 and 69; and without cardiovascular disease. The likelihood of being a GP&CAM user compared with a GP-only user was significantly increased (p < 0.005) for those who were female; aged between 30-59; had a higher education level; were non-smokers; had lower perceived global health; had a limiting chronic complaint; had experienced a health complaint during the last 12 months; had musculoskeletal disease; had a psychiatric complaint; and had hay fever.

CONCLUSION

There were few CAM-only users and they differ from GP-only users by being male, aged 30-69, and without cardiovascular disease. Users of both GP&CAM were less healthy with more complaints and poorer self-reported health than GP- and CAM-only users.

Complementary and alternative medicine use among US Navy and Marine Corps personnel

Background

Recently, numerous studies have revealed an increase in complementary and alternative medicine (CAM) use in US civilian populations. In contrast, few studies have examined CAM use within military populations, which have ready access to conventional medicine. Currently, the prevalence and impact of CAM use in US military populations remains unknown.

Methods

To investigate CAM use in US Navy and Marine Corps personnel, the authors surveyed a stratified random sample of 5,000 active duty and Reserve/National Guard members between December 2000 and July 2002. Chi-square tests and multivariable logistic regression were used to assess univariate associations and adjusted odds of CAM use in this population.

Results and discussion

Of 3,683 service members contacted, 1,446 (39.3%) returned a questionnaire and 1,305 gave complete demographic and survey data suitable for study. Among respondents, more than 37% reported using at least one CAM therapy during the past year. Herbal therapies were among the most commonly reported (15.9%). Most respondents (69.8%) reported their health as being very good or excellent. Modeling revealed that CAM use was most common among personnel who were women, white, and officers. Higher levels of recent physical pain and lower levels of satisfaction with conventional medical care were significantly associated with increased odds of reporting CAM use.

Conclusion

These data suggest that CAM use is prevalent in the US military and consistent with patterns in other US civilian populations. Because there is much to be learned about CAM use along with allopathic therapy, US military medical professionals should record CAM therapies when collecting medical history data.

Complementary and alternative medicine use among Hispanics in the United States

OBJECTIVE

To review the use of complementary and alternative medicine (CAM) in Hispanics in the US and highlight the modalities most likely to be unfamiliar to healthcare practitioners.

DATA SOURCES

A search of the literature published in English and a subsequent bibliographic search were conducted using MEDLINE, International Pharmaceutical Abstracts, EMBASE, Cumulative Index of Nursing and Allied Health Literature, and Manual Alternative and Natural Therapy Index System (1980-March 2007). Primary search terms included, but were not limited to, Hispanic, Latino, complementary and alternative medicine, and dietary supplements. Studies that assessed or evaluated the use of CAM in the Hispanic population were reviewed. Articles that included both Hispanics and non-Hispanics were also included.

STUDY SELECTION AND DATA EXTRACTION

The literature search yielded 42 articles focused on the use of CAM by Hispanics. Survey was the most common method used in these studies, although some hybrid interviews were also conducted.

DATA SYNTHESIS

Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Some trials examined overall CAM use, whereas others looked at specific dietary supplements and herbs. Most reports found a higher than expected rate of CAM use in Hispanics (50-90%). A number of products potentially unfamiliar to healthcare practitioners, such as linden, sapodilla, and star anise, were reported as commonly used in several studies. Many studies were limited by the sample size or use of only one Hispanic subgroup.

CONCLUSIONS

Hispanics use a wide range of CAM therapies, including several that may be unfamiliar to healthcare practitioners. Understanding the rationale, motivations, and history of Hispanics' use of CAM will enhance the cultural competence of healthcare professionals and help address these patients' medical needs.

Complementary and alternative medicine and adherence to care among HIV-positive Latino gay and bisexual men

The purpose of this study was to examine the degree to which HIV-positive Latino gay and bisexual men utilized complementary and alternative medicine (CAM), and to explore the relationship between CAM use and adherence to treatment. The sample consisted of 152 HIV-positive Latino gay and bisexual men. Eighty percent of participants reported use of some form of CAM. Asian CAM was most commonly used, followed by herbal remedies and Latino CAM. Adherence to Western medical care was also explored, with more than two-thirds of the sample adhering completely to recommendations concerning seeing the doctor, taking medications and following instructions. The relationships between CAM use and Western medical care were examined with logistic regressions. Those who used Latino CAM were less likely to keep doctors' appointments, follow physicians' recommendations and adhere to the prescribed medication regimen in the past three days. Plant-based CAM was also significantly related to non-adherence to Western medicine.