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Complementary or Alternative Medicine as Possible Determinant of Decreased Persistence to Aromatase Inhibitor Therapy among Older Women with Non-Metastatic Breast Cancer  [PDF]
Laetitia Huiart, Anne-Deborah Bouhnik, Dominique Rey, Frédérique Rousseau, Frédérique Retornaz, Mégane Meresse, Marc Karim Bendiane, Patrice Viens, Roch Giorgi
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0081677
Abstract: Purpose Aromatase inhibitor therapy (AI) significantly improves survival in breast cancer patients. Little is known about adherence and persistence to aromatase inhibitors and about the causes of treatment discontinuation among older women. Methods We constituted a cohort of women over 65 receiving a first AI therapy for breast cancer between 2006 and 2008, and followed them until June 2011. Women were selected in the population-based French National Health Insurance databases, and data was collected on the basis of pharmacy refills, medical records and face-to-face interviews. Non-persistence to treatment was defined as the first treatment discontinuation lasting more than 3 consecutive months. Time to treatment discontinuation was studied using survival analysis techniques. Results Overall among the 382 selected women, non-persistence to treatment went from 8.7% (95%CI: 6.2–12.1) at 1 year, to 15.6% (95%CI: 12.2–19.8) at 2 years, 20.8% (95%CI: 16.7–25.6) at 3 years, and 24.7% (95%CI: 19.5–31.0) at 4 years. In the multivariate analysis on a sub-sample of 233 women with available data, women using complementary or alternative medicine (CAM) (HR = 3.2; 95%CI: 1.5–6.9) or suffering from comorbidities (HR = 2.2; 95%CI: 1.0–4.8) were more likely to discontinue their treatment, whereas women with polypharmacy (HR = 0.4; 95%CI: 0.2–0.91) were less likely to discontinue. In addition, 13% of the women with positive hormonal receptor status did not fill any prescription for anti-hormonal therapy. Conclusion AI therapy is discontinued prematurely in a substantial portion of older patients. Some patients may use CAM not as a complementary treatment, but as an alternative to conventional medicine. Improving patient-physician communication on the use of CAM may improve hormonal therapy adherence.
Complementary and Alternative Medicine and Dermatology  [PDF]
Bilal Do?an,?zlem Karabudak Abuaf,Ercan Karabacak
Turkderm , 2012,
Abstract: Alternative medicine is defined as the methods used independently or instead of conventional medicine, but the complementary medicine is mainly used to describe methods used in conjunction with or to comlement the conventional medical therapies.It is known by many of dermatologists that a lot of patients with dermatological problems try to use complementary and alternative medical methods because of having no cure with the conventional medical treatments. Complementary and alternative medical condition in our country was analysed and the recipe suggestions were discussed in this review.
Complementary and alternative medicine in cancer patients
Jens Büntzel,Ralph Mücke,Frank Bruns,Oliver Micke
European Journal of Oncology Pharmacy , 2008,
Abstract: One thousand and thirteen cancer patients were interviewed in five German cancer centres, 30% reported a subjective improvement in quality of life due to the use of complementary and alternative medicine (CAM). The high rate of CAM use and possible interactions with basic anticancer-therapies, e.g. radiotherapy, are reasons to extend CAM anamnesis.
Complementary and Alternative Exercises for Management of Osteoarthritis  [PDF]
Ming-Chien Chyu,Vera von Bergen,Jean-Michel Brismée,Yan Zhang,James K. Yeh,Chwan-Li Shen
Arthritis , 2011, DOI: 10.1155/2011/364319
Abstract: Osteoarthritis (OA) is a chronic condition characterized by degeneration of cartilage and its underlying bone within a joint. With no cure currently available, the goals of treating OA are to alleviate pain, maintain, or improve joint mobility, increase the muscle strength of the joints, and minimize the disabling effects of the disease. Recent research has suggested that complementary and alternative medicine (CAM) exercises may improve OA symptoms. This paper covers CAM mind-body exercises—Tai Chi, qigong, and yoga—for OA management and evaluates their benefits in pain reduction, muscle strength, physical function, stiffness, balance, fear of falling, self-efficacy, quality of life, and psychological outcomes in patients with OA, based on randomized controlled trials published. Findings from the literature suggest that CAM exercises demonstrate considerable promise in the management of OA. Future studies require rigorous randomized controlled trials with larger sample sizes.
Informed Consent in Complementary and Alternative Medicine
Opher Caspi,Tamar Shalom,Joshua Holexa
Evidence-Based Complementary and Alternative Medicine , 2011, DOI: 10.1093/ecam/nep032
Abstract: The objective of this study was to examine complementary and alternative medicine (CAM) practitioners’ (i) attitudes toward informed consent and (ii) to assess whether standards of practice exist with respect to informed consent, and what these standards look like. The design and setting of the study constituted face-to-face qualitative interviews with 28 non-MD, community-based providers representing 11 different CAM therapeutic modalities. It was found that there is great deal of variability with respect to the informed consent process in CAM across providers and modalities. No unique profession-based patterns were identified. The content analysis yielded five major categories related to (i) general attitude towards the informed consent process, (ii) type and amount of information exchange during that process, (iii) disclosure of risks, (iv) discussions of alternatives, and (v) potential benefits. There is a widespread lack of standards with respect to the practice of informed consent across a broad range of CAM modalities. Addressing this problem requires concerted and systematic educational, ethical and judicial remedial actions. Informed consent, which is often viewed as a pervasive obligation is medicine, must be reshaped to have therapeutic value. Acknowledging current conceptions and misconception surrounding the practice of informed consent may help to bring about this change. More translational research is needed to guide this process.
Complementary and alternative health care in Israel
Judith T Shuval, Emma Averbuch
Israel Journal of Health Policy Research , 2012, DOI: 10.1186/2045-4015-1-7
Abstract: Despite the vast achievements and dramatic successes of conventional bio-medicine, remarkable numbers of people in Western societies seek complementary or alternative health care (CAM). In most cases they do not abandon conventional medicine but turn to CAM as an additional mode of care [1-4].The National Institutes of Health in the United States have provided scientific evidence for the effectiveness of some forms of alternative care, but many of the widely used methods have not passed rigorous tests for efficacy or have never been scientifically scrutinized http://nccam.nih.gov webcite. The lack of scientific evidence hardly troubles users of alternative medicine: what counts for them is the fact that in many cases it works! - they have little interest in how or why. Failures are largely ignored while success is celebrated. It would seem that these social processes in the field of health care are not ephemeral but are likely to continue in one form or another. Indeed it seems fruitful to view CAM as an important component of the overall health care system. For this reason it is our hope that the Israel findings reported here will be useful to health policy planners in other countries as well.The present paper draws on over ten years of research on CAM in Israel that included observation, survey research, and more than one hundred in-depth interviews with a variety of CAM practitioners - many with bio-medical credentials - and with policy makers in the bio-medical system. The overall goal of that research was to explore the multiplicity of empirical types of coexistence between alternative and bio-medicine that have emerged in Israel. These are seen in a variety of forms that reflect cultural, political, and social forces in the society. We sought to understand the dilemmas and quandaries that arise due to the perspectives of the principal actors who adhere to different beliefs and ideologies regarding the causes of health problems and appropriate therapeutic proce
Complementary and Alternative Exercises for Management of Osteoarthritis  [PDF]
Ming-Chien Chyu,Vera von Bergen,Jean-Michel Brismée,Yan Zhang,James K. Yeh,Chwan-Li Shen
Arthritis , 2011, DOI: 10.1155/2011/364319
Abstract: Osteoarthritis (OA) is a chronic condition characterized by degeneration of cartilage and its underlying bone within a joint. With no cure currently available, the goals of treating OA are to alleviate pain, maintain, or improve joint mobility, increase the muscle strength of the joints, and minimize the disabling effects of the disease. Recent research has suggested that complementary and alternative medicine (CAM) exercises may improve OA symptoms. This paper covers CAM mind-body exercises—Tai Chi, qigong, and yoga—for OA management and evaluates their benefits in pain reduction, muscle strength, physical function, stiffness, balance, fear of falling, self-efficacy, quality of life, and psychological outcomes in patients with OA, based on randomized controlled trials published. Findings from the literature suggest that CAM exercises demonstrate considerable promise in the management of OA. Future studies require rigorous randomized controlled trials with larger sample sizes. 1. Introduction Osteoarthritis (OA), the most common joint disorder, is a major cause of disability in the aging population with its prevalence increasing and consequences significantly impacting society [1]. As the population ages worldwide, OA has become a serious health threat to many countries [2]. It is estimated that almost 18% of women and 10% of men 60 years of age and older have symptomatic OA [3]. Eighty percent of those with OA report limitations in movement, while 25% report inability to perform major daily activities of life [3]. The economic costs associated with OA sequelae have increased tremendously in the past decade and are predicted to continue to grow [4]. Pain, muscle weakness, and physical dysfunction form a vicious cycle in the knee OA, with muscle weakness being associated with pain and physical dysfunction [5]. Individuals with OA can experience difficulty in walking, balance deficit, and muscle weakness, thus increasing the risk of falling by threefold [6] and consequently, fall-related fractures [7]. Well-established modifiable risk factors of OA include overweight, injury, occupation, structural malalignment, and muscle weakness, while nonmodifiable risk factors include older age, female gender, race, and genetic predisposition [2]. There is no cure for OA, as it is very difficult to restore the cartilage [8]. The goals of treatment are to alleviate pain, maintain, or improve joint mobility, increase the muscle strength of the joints, and minimize the disabling effects of the disease [9–13]. Nonpharmacological intervention such as exercise has been
A Complementary Alternative Medicine Questionnaire for Young Adults
Christine Patterson and Heather Arthur
Integrative Medicine Insights , 2012,
Abstract: Limited information exists on how adolescents decide to use complementary/alternative medicine (CAM). There are also no instruments specific to CAM, for the young adult population, which makes it difficult to explore knowledge in this area. The purpose of this study was to develop and examine the psychometric properties of the CAM Questionnaire for Young Adults which measures young adults’ attitudes about CAM. Participants for this cross-sectional survey were selected from enrolled undergraduate students at an urban university. Factor analysis identified three subscales: 1) positive beliefs about CAM; 2) environmental influence; and 3) psychological comfort. The scale has good internal consistency (Cronbach’s alpha = 0.79) and shows beginning demonstration of validity. Its use in this sample revealed that young adults who are female and have used CAM in the past for preventing or treating illness have the most positive attitude towards CAM and the greatest likelihood for continued use. The implication that prevention may play a role in young adults’ attitudes about CAM is a potential focus for future research.
A Complementary Alternative Medicine Questionnaire for Young Adults
Christine Patterson,Heather Arthur
Integrative Medicine Insights , 2009,
Abstract: Limited information exists on how adolescents decide to use complementary/alternative medicine (CAM). There are also no instruments specific to CAM, for the young adult population, which makes it difficult to explore knowledge in this area. The purpose of this study was to develop and examine the psychometric properties of the CAM Questionnaire for Young Adults which measures young adults’ attitudes about CAM. Participants for this cross-sectional survey were selected from enrolled undergraduate students at an urban university. Factor analysis identified three subscales: 1) positive beliefs about CAM; 2) environmental influence; and 3) psychological comfort. The scale has good internal consistency (Cronbach’s alpha = 0.79) and shows beginning demonstration of validity. Its use in this sample revealed that young adults who are female and have used CAM in the past for preventing or treating illness have the most positive attitude towards CAM and the greatest likelihood for continued use. The implication that prevention may play a role in young adults’ attitudes about CAM is a potential focus for future research.
Complementary/Alternative Medicine Use in Primary Care
Alis Ozcakir,Serpil Aydin
Research Journal of Medical Sciences , 2012,
Abstract: The question is why are people using complementary/alternative therapies more and more today and where do we stand on the use of such therapies as a primary care provider. We need to determine the answers to such questions as: Do we need more education about complementary/alternative therapies? Do we just say "no" to complementary/alternative medicine? What about our patients who are using all of these therapies? What will be our approaches? Being a touchstone and gatekeeper in the health care system, primary care physicians should be made aware of the growing use of complementary medicine and they need to be knowledgeable about the use of complementary/alternative modalities.
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