Prevalence and correlates of selected alternative and complementary medicine in adult renal transplant patients.

BACKGROUND/SIGNIFICANCE: The use of complementary and alternative medicine (CAM) has increased considerably in the general population in recent decades. However, the prevalence of CAM use in renal transplant patients has not yet been assessed. AIM: To determine the prevalence and correlates of CAM use among renal transplant patients (RTX) who are more than one year post transplant. METHODS: This secondary data analysis used data from Part 1 of the Supporting Medication Adherence in Renal Transplantation (SMART) study, which tested prevalence, determinants and consequences of non-adherence regarding immunosuppressive medication in kidney transplant (renal TX) patients. The study's convenience sample consisted of 356 patients recruited from two Swiss outpatient transplant clinics during their annual examination visits (mean age: 53+/-13; male: 58%). The use of CAM as well as the specific kind of CAM used was assessed through structured interviews. Assessed CAM use correlates were age, gender, education, depressive symptomatology, comorbidity and smoking status. Relationships between CAM use and candidate correlates were explored using multiple logistic regression. RESULTS: The prevalence of CAM use in this sample of renal TX patients was 11.8%. Most frequently used alternative medicines were Homeopathy (42.9%) and Chinese medicine (23.8%). Two patients used St John's wort. The percentage of patients using Homeopathy (5.1%) and herbal medicine (2%) was similar to that of the general Swiss population (HO: 6.1% & HM: 2.6%). Significant correlates for CAM use were younger age (p=0.017; OR=0.96; 95%CI=0.93-0.99) and female gender (p=0.035; OR=2.13; 95%CI=1.05-4.3). CONCLUSION: Every eighth renal transplant recipient in this sample used some form of CAM. Of these, some used herbal medicines, of which some are known to interfere with certain immunosuppressive treatment (St John's wort/Chinese medicines). These findings indicate that it is important for health care providers working in renal TX to assess CAM use.

Use of diagnostic self-tests on body materials among Internet users in the Netherlands: prevalence and correlates of use.

BACKGROUND: A range of self-tests on body materials has become available to the general public, but the extent of their use has hardly been studied. This study examined how many people use diagnostic self-tests on body materials such as blood or urine, as well as the type of tests that are used, and factors associated with their use. METHODS: Cross-sectional survey. Participants were recruited from an existing Dutch Internet panel of 12,529 persons, and information was collected by means of a structured Internet-based questionnaire. Multiple logistic regression analyses were used to assess correlates of self-test use. RESULTS: Response to the survey was 63%. Sixteen percent of the respondents said they had ever used at least one self-test, with a mean of 2.1 tests per self-tester. The most frequently reported self-tests were those for diabetes and cholesterol. Self-testers generally reported lower health status and had a higher BMI than non-testers. On the other hand, they were more likely to engage in health-related behaviour such as the use of dietary supplements and homeopathic medicine. CONCLUSION: Self-testing proved to be relatively prevalent among Dutch Internet users. We therefore think that it is essential to develop appropriate information for consumers, health care providers and policymakers, about the pros and cons of self-testing and specific self-tests. More test-specific research is needed.

CAM use among older adults age 65 or older with hypertension in the United States: general use and disease treatment.

OBJECTIVES: Hypertension (HT) is a common condition among older adults that greatly increases morbidity and mortality risk. Although a number of antihypertensive therapies are currently available, adherence and control are low. The purpose of this study was to assess the use of complementary and alternative medicine (CAM) among older adults with HT. DESIGN: Using a nationally representative cross-sectional survey, the authors examined the prevalence of CAM use among older adults with and without diagnosed HT and the degree to which CAM is used specifically for HT treatment. SUBJECTS: Subjects were 5821 adults age > or = 65 who participated in the 2002 National Health Interview Survey (NHIS), including the Alternative Health supplement. OUTCOME MEASURES: HT status was assessed by self-report. CAM use was classified as any CAM use, use of four CAM modalities, and specific CAM therapies. RESULTS: Any CAM use was higher for persons with HT compared to those without diagnosed HT (69.5% versus 65.6%). Only 7.8% of CAM users reported using CAM to treat HT. Homeopathic treatment (16.7%), healing ritual (14.5%), and diet-based therapies (13.0%) were the most common HT therapies. Frequency of use of specific types of CAM therapies did not differ by HT status other than for biologically based therapies, which were used less often by those with HT. CONCLUSIONS: CAM use is high among older adults with HT, but the vast majority of CAM is used for treating or preventing other conditions. Healthcare providers treating patients with HT should be aware of CAM among their patients.

National patterns and correlates of complementary and alternative medicine use in adults with diabetes.

OBJECTIVE: The aim of this study was to determine national patterns and correlates of complementary and alternative medicine (CAM) use among adults with diabetes. METHODS: The authors compared CAM use in 2474 adults with and 28,625 adults without diabetes who participated in the most comprehensive national survey on CAM use (2002 National Health Interview Survey). Eight CAM use categories were created, including dietary, herbal, chiropractic, yoga, relaxation, vitamin, prayer, and other (acupuncture, Ayurveda, biofeedback, chelation, energy healing or Reiki therapy, hypnosis, massage, naturopathy, and homeopathy). An overall CAM use category also was created that excluded vitamins and prayer. Patterns of use were compared with chi-square and independent correlates of CAM use with multiple logistic regression controlling for relevant covariates. STATA was used for analysis to account for the complex survey design. RESULTS: Prevalence of overall use of CAM did not differ significantly by diabetes status (47.6 versus 47.9%, p = 0.81). Diabetes was not an independent predictor of overall use of CAM (OR 0.93, 95% confidence interval [CI] 0.83, 1.05). However, persons with diabetes were more likely to use prayer (OR 1.19, 95% CI 1.05, 1.36), but less likely to use herbs (OR 0.86, 95% CI 0.75, 0.99), yoga (OR 0.56, 95% CI 0.43, 0.72), or vitamins (OR 0.82, 95% CI 0.72, 0.93) than people without diabetes after controlling for relevant covariates. Independent correlates of overall use of CAM differed by age, income, employment, comorbidity, and health status between people with and without diabetes. CONCLUSIONS: This study found that there has been a dramatic increase in overall use of CAM in adults with diabetes; diabetes was not an independent predictor of overall use of CAM; and people with diabetes were more likely to use prayer, but less likely to use herbs, yoga, or vitamins compared to persons without diabetes.

[Use of alternative therapies by nursing teachers]. / O uso das terapias alternativas por enfermeiros docentes.

The necessity of the health professionals to understand the health illness process in a different paradigm of the valid bio-medical model is more and more present. The objective of this work was verify what are the alternatives practices utilised for Nursing teachers for themselves and/or in their respective family relatives and if these teachers have been utilised the practices and if they talk about this subject with their students. The population of this study were 59 Nursing graduate teachers from São Paulo City placed in four different teaching institutions that answered a questionnaire. The people that answered the questionnaire were chosen at random and the data were collected in October, 1996. Among the results, we verified that 39 (66.1%) of them referred that they used the APH, in fact, the more usual alternative practice is the homeopathy (24 times), floral (21) and the eastern massage (13). The people did not use the APH are for its use in specific situations; 56 (94.9%) teachers were for its teaching, but only 31 (52.5%) talk about APH to their students.

Patient activation measures in a government homeopathic hospital in India.

The American Patient Activation Measure-22 questionnaire (PAM-22) quantifies the knowledge, skills, and confidence essential to manage own health and health care. It is a central concept in chronic illness care models, but studied sparsely in homeopathic hospitals. PAM-22 was translated into Bengali and a cross-sectional study was undertaken in chronically ill 417 patients visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, India. Response rate was 90.41%. Data were analyzed using Rasch rating scale model with Winsteps. Activation score was 54.7 ± 8.04 or 62.13% of maximum score. PAM scores differed significantly by age, education, income, and health status (P < .05). The items had good data quality fit statistics and good range of difficulty. The construct unidimensionality was confirmed by good model fits for Rasch model and principal component analysis of residuals found no meaning structure. The questionnaire showed acceptable psychometrics. Patient activation was moderate and needs to be improved.