Public knowledge, attitudes, and practices towards herbal medicines; a cross-sectional study in Western Saudi Arabia

BACKGROUND

Herbal medicines, derived from medicinal plants, are among the most popular alternative remedies around the globe. In Saudi Arabia, herbal medicines are extensively used by public as part of the culture as well as religious norms. Therefore, this study aimed to evaluate knowledge, attitudes, and practices regarding herbal medicines among the general population in Saudi Arabia.

METHODS

A descriptive cross-sectional survey study was conducted on the general population of Jeddah city with the help of a validated and self-administered questionnaire. Sample size was calculated to be 450 with subjects between 20 and 60 years of either gender. Descriptive and inferential statistical analysis was performed using SPSS.

RESULTS

Results of our data showed that 173 (42.2%) of the total participants used herbal medicines, however, significant association was found between female gender and the usage of herbal medicines (p < 0.001). Approximately, more than half (56.0%) of the respondents agreed that herbal medicines could be used to promote health and treat illnesses, and 45% respondents agreed that herbal medicines are safe. 153 (37.4%) of the participants opined that herbal medicines could be taken with conventional or allopathic medicine. The data also showed a significant (p < 0.05) association between knowledge about the source of herbal medicine and gender where females were found to have more knowledge compared to males. Moreover, a significantly higher number of chronic disease patients were using herbal medicines compared to individuals with no medical problems (p < 0.001). Strikingly, majority (n = 204; 49.9%) of the respondents used herbal medicines as a first choice when sick, while a good number (n = 172; 42.1%) of respondents did not consult doctors before taking herbal medicines.

CONCLUSION

The use of herbal medicines is common among the general population of Jeddah. Although most of the participants believed that the herbal medicines are safe and do not require consultation, there is a dire need to increase awareness as well as to establish effective strategies to evaluate the safety, efficacy and quality of the herbal medicines for propitious consequences of this commonly used entity in the local society.

Perceptions of Complementary and Alternative Medicine Amongst Medical Students in Singapore – a Survey

Background

In view of the current upsurge of interest in, practice of, and research into, complementary and alternative medicine (CAM) worldwide and locally, a survey was conducted to gauge the understanding, interest and knowledge of CAM amongst medical students in a local university.

Methods

A total of 555 first to fifth year medical students completed a questionnaire (54% response rate) designed to assess their knowledge, beliefs and attitudes to CAM in general and 16 common CAM therapies.

Results

Acupuncture was the best known therapy, with 57% claiming to know at least something about it. No students claimed they knew a lot about chiropractic, osteopathy, Ayuverdic medicine, homeopathy and naturopathy, and many had not ever heard of these therapies. Knowledge of commonly held beliefs about the 16 CAM modalities was generally poor, even for modalities which students claimed to know most about. A significant number of students had knowledge about CAM that was erroneous. Lack of scientific support was considered to be the main barrier to implementation of CAM. Attitudes to CAM were positive, with 92% believing that CAM includes ideas and methods from which conventional medicine can benefit, 86% wishing to know more about CAM and 91% stating that CAM would play an important role in their future medical practice.

Conclusion

As the public's use of various healing practices outside conventional medicine accelerates, ignorance about these practices by the country's future medical practitioners risks broadening the communication gap between the public and the profession that serves them. The majority of medical students recognise this risk and are keen to bridge this gap.

Use of herbs or vitamin/mineral/nutrient supplements by pediatric oncology patients

Use of complementary and alternative medicine (CAM) is widespread and increasing. We sought to study the frequency and factors affecting of its use in children with cancer. We designed a questionnaire that was administered to the parents of children between September 2013 and March 2014. A total of 74 patients were enrolled into the study. Fifty patients (67.5%) had used one or more than one type of herbs or vitamin/mineral/nutrient. The most commonly used CAM treatment was grape molasses (36.6%). The main source of information to families was the internet. No correlation found between the use of CAM and parents' education status, the level of income, socioeconomic status, chemotherapy treatment. Patients with cancer highly tended to use CAM treatment without informing healthcare professionals. The integration of complementary methods to the conventional treatments is interesting and seem to respond to the needs of patients allowing a more comprehensive approach to care.

Resourcing the clinical complementary medicine information needs of Australian medical students: Results of a grounded theory study

The aim of this study was to identify Australian medical students' complementary medicine information needs. Thirty medical students from 10 medical education faculties across Australian universities were recruited. Data were generated using in-depth semi-structured interviews and constructivist grounded theory method was used to analyze and construct data. Students sought complementary medicine information from a range of inadequate sources, such as pharmacological texts, Internet searches, peer-reviewed medical journals, and drug databases. The students identified that many complementary medicine resources may not be regarded as objective, reliable, differentiated, or comprehensive, leaving much that medical education needs to address. Most students sought succinct, easily accessible, evidence-based information to inform safe and appropriate clinical decisions about complementary medicines. A number of preferred resources were identified that can be recommended and actively promoted to medical students. Therefore, specific, evidence-based complementary medicine databases and secondary resources should be subscribed and recommended to medical schools and students, to assist meeting professional responsibilities regarding complementary medicines. These findings may help inform the development of appropriate medical information resources regarding complementary medicines.

Use of Complementary and Alternative Medicine Among Dermatology Outpatients: Results From a National Survey

BACKGROUND

Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia.

METHODS

This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained.

RESULTS

Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists.

CONCLUSIONS

There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM.

Survey based investigation into general practitioner referral patterns for spinal manipulative therapy

Background

In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown.

Method

A short questionnaire was designed and piloted. Demographic information, patient referral to SMT and the GPs own personal utilisation of SMT were obtained. 385 GP’s were contacted representing approximately 20% of the GP’s in Wales Autumn 2007.

Results and discussion

182 (50.8%) completed questionnaires were returned.

Profile characteristics: 2/3 of respondents were male, 79% were 40 years old or older (statistically reflective of the total population of GPs in Wales at that time) and 62% had 20 years or less in practise. Personal use of SMT by GP’s: 48 respondents had sought SMT treatment and a further 56% of those that had not previously sought SMT indicated that they would consider doing so. Patient referral to SMT by GP’s: 131 respondents (72%) had referred patients to SMT and of those who had not a further 13% would consider referring. The general referral pattern and utilisation pattern was Physiotherapy: Osteopathy: Chiropractic. 21% who had never referred patients neither had, nor would consider it for themselves. A small subgroup appeared to manage personal choice differently from patient referral: 5 individuals who had not referred patients either had or would consider it for themselves and 23 of the group that would refer patients neither had nor would seek it for themselves.

Conclusions

This limited investigation indicates that GP’s do practise consistently with guidelines on back pain and utilise SMT as a care option. Although the main option for referral was physiotherapy, slightly over 40% of respondents who expressed a preference would refer to either osteopathy or chiropractic, or both in preference to physiotherapy. There was a small proportion that did not and would not refer patients for SMT regardless of personal use of SMT; these suggested use of acupuncture. Further investigation is needed to determine the alternatives to SMT offered to patients and the decision-making criteria for patient referral to subtypes of SMT practitioner.

Status of complementary and alternative medicine in the curricula of health colleges in Saudi Arabia

OBJECTIVES

To assess the status of complementary and alternative medicine (CAM) education in health colleges in Saudi Arabia.

METHODS

A cross sectional descriptive study was conducted including all medical, dentistry, pharmacy, nursing, allied medical science, and health colleges in Saudi Arabia. A semi- structured questionnaire was designed to collect information covering CAM tracks, courses and contents in the college's curricula, available postgraduates programs, continuing medical education activities, number of colleges staff members specialized or interested in CAM.

RESULTS

Out of 110 health colleges in Saudi Arabia, 90 (81.1%) participated in the survey. There is no CAM specialized track or postgraduate education in any health college. Eleven (12.2%) colleges are teaching CAM courses in their curricula. Fifteen (16.7%) colleges are teaching topics related to CAM in different study subjects. Five (5.6%) colleges conducted continuing medical education (CME) activities related to CAM. Among faculty members, there are only 16 CAM specialists working in 7 colleges and 84 interested staff members, working in 20 colleges. Colleges of pharmacy are more interested in CAM education compared to other colleges with 42.9% (6/14) of them have CAM courses in their curricula, (p=0.006). Also, they have more faculty CAM specialists (p=0.026) compared to other colleges.

CONCLUSION

There is a low and diverse attention given to CAM in medical education in Saudi Arabia. There is a need for a national plan to review health colleges curricula to prepare health care providers for the integration of evidenced based CAM practices.

Should complementary and alternative medicine familiarisation modules be taught in African medical schools?

Complementary and alternative medicines (CAMs) are household sources of therapy in African communities. A large percentage of the African population uses CAMs as an alternative to mainstream medicine. This is partly due to tradition, and partly because of inability to afford conventional treatments. In the developed countries, the use of CAMs is gradually on the increase. As a result, certain medical schools in these countries are incorporating CAM familiarisation modules into their undergraduate medical curricula. In Africa, most medical schools have not taught CAM yet. However, in view of the rising use of CAMs by the African populace, and the potential CAM-conventional therapy interactions, there is the need for physicians to get familiar with those CAMs in common use. To achieve this, it is recommended that African medical schools introduce CAM familiarization modules into the undergraduate medical curricula. This would fully prepare the 21st century doctors to deliver holistic medical treatment, and thus be at par with the global trend.