thesis statement for alternative medicine

Complementary and Alternative Medicine Essay

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Introduction

Cam definition, methods, and specifics of safe use, ethics and informed consent, sample informed consent form.

Alternative medicine is the area of knowledge, skills, and techniques based on centuries-old theory. The use of alternative medicine methods depends on many factors – historical, ethnic, cultural, economic, etc. However, many researchers believe that the main principles of the CAM are “aligned with the goals of contemporary medical education and serve a critical function in the development of effective, humanistic physicians” (Chow et al., 2016, p. 16). Therefore, it is vital to examine the methods, principles, and peculiarities of using CAM in a safe manner and for the benefit of a patient.

Complementary and alternative medicine has been defined in multiple ways by different medical institutions. A certain number of researchers argue that “complementary therapies can be combined with conventional medical treatment while alternative therapy is to be used instead of conventional therapy” (Khan et al., 2016, p. 1). However, most agree that CAM is a set of practices and approaches to be used in a health care system that is not considered conventional.

Users of CAM are often people who turn to holistic practitioners in the hope of getting a cure or relief from symptoms due to unmet medical requirements or a delay in obtaining medical treatment. Debates about the usefulness of CAM are ongoing for a long time. Some concerns also include the possible harmful side effects, delaying the required surgery, chemotherapy, or other traditional treatments (Simon, 2019). The most common misconception about holistic healthcare providers is that they believe and see alternative medicine as the only correct treatment option. Health care practitioners need to have information and knowledge to discuss CAM practices with their patients by communicating the possibilities of alternative treatment, thus exploring all the options of serving their patients’ best interests. As with any procedure, it is important to discuss its safety before using it. Natural products, herbal medicines, sold as dietary supplements, are readily sold to the consumers. However, it should be stressed that their use needs to be consulted with a health care practitioner.

Acupuncture, massage, chiropractic are among the holistic treatments used along with the traditional ones. Recent research on Infant Colic showed that the use of probiotics and acupuncture might alleviate symptoms of the condition along with the use of conventional treatments (Perry et al., 2019). CAM therapies such as aromatherapy and reflexology are also popular with asthma and allergy patients.

CAM ethical assumptions to be made include a doctor’s commitment to the patient’s welfare, respect for the choices of a patient, ability to consider various forms of treatment. One of the ethical issues a health care practitioner encounters is the disclosure of medical conditions transparently and responsibly. A trust-based relation should be established for practical patient/professional cooperation when patients are enabled to discuss any issues with openness and honesty and expect the same in return.

The primary purpose of informed consent is to protect the patient by providing all the information about the use, benefits, risks, and potential outcomes of treatment. A patient must be of legal age, mentally healthy, and in a clear mind to sign the consent form. During the process of signing the consent form, a health professional must be responsible for covering all the aspects and ensuring understanding.

Procedure: Extraction of teeth

I understand that if this tooth is not removed, my condition may worsen, resulting in complications including but not limited to:

• Loss of additional teeth

Possible complications that have been explained to me include dry socket, infection, swelling, bruising.

I had the opportunity to discuss this surgery with the doctor and fully consent to the surgery as described.

• Patient, Parent, or Guardian

Chow, G., Liou, K. T., & Heffron, R. C. (2016). Making whole: Applying the principles of integrative medicine in medical education . Rhode Island Medical Journal 99 (3), 16-19.

Khan, M. U., Jamshed, S. Q., Ahmad, A., Bidin, M. A., Siddiqui, M. J., & Al-Shami, A. K. (2016). Use of complementary and alternative medicine among osteoarthritic patients: a review . Journal of Clinical and Diagnostic Research 10 (2), 1-6.

Perry, R., Leach, V., Penfold, C., & Davies, P. (2019). An overview of systematic reviews of complementary and alternative therapies for infantile colic . Systematic Reviews 8 (271).

Simon, S. (2019). The truth about alternative medical treatments . American Cancer Society .

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1. IvyPanda . "Complementary and Alternative Medicine." September 6, 2022. https://ivypanda.com/essays/complementary-and-alternative-medicine-essay-examples/.

Bibliography

IvyPanda . "Complementary and Alternative Medicine." September 6, 2022. https://ivypanda.com/essays/complementary-and-alternative-medicine-essay-examples/.

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Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis

Phanupong phutrakool.

1 School of Global Health and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Patumwan, Bangkok, 10330 Thailand

Krit Pongpirul

2 Department of International Health and Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA

3 Bumrungrad International Hospital, Bangkok, Thailand

Associated Data

All data generated or analyzed during this study are included in this published article.

Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists.

We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines.

Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42–62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37–54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods.

Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice.

Systematic review registration

PROSPERO CRD42019125628

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13643-021-01882-4.

Medical specialist is a healthcare professional who has undertaken specialized medical studies to diagnose, treat and prevent illness, disease, injury, and other physical and mental impairments in humans, using specialized testing, diagnostic, medical, surgical, physical, and psychiatric techniques, through application of the principles and procedures of modern medicine [ 1 ]. The specialized and general medical care have dominated as ‘conventional’ medical care in several countries, including Thailand.

Complementary and Alternative Medicine (CAM) is defined as medicine or treatment which is not considered as conventional (standard) medicine. The National Center for Complementary and Integrative Health (NCCIH) categorized most types of complementary medicines under two categories: (1) natural products and (2) mind-body practices [ 2 ]. Natural products include herbs, vitamins, minerals, and probiotics whereas mind-body practices include yoga, chiropractic, massage, acupuncture, yoga, meditation, and massage therapy. Types of CAM may vary across studies, but they overlap in most senses.

CAM is used by people throughout the world. A study showed that the prevalence estimate of CAM usage from 32 countries from all regions of the world to be 26.4%, ranging from 25.9 to 26.9%. For example, in 2013, the prevalence use of CAM in Australia, the USA, UK, and China were 34.7%, 21.0%, 23.6%, and 53.3%, respectively. The prevalence estimate of CAM satisfaction was as high as 71.9%, ranging from 71.0 to 72.7% [ 3 ].

Although patients are highly satisfied with CAM treatment, professional health care providers who are medical doctors do not offer CAM because it is not part of the standard conventional medical care. Although the majority of physicians who have used CAM were pleased with the results [ 4 – 8 ] and were more likely to recommend it to patients, friends, and family [ 9 , 10 ] as a non-toxic treatment option; less than one third of the medical doctors were very comfortable in answering questions about CAM [ 9 , 11 – 13 ] so patients who do not have the option to use CAM instead of standard medical care might be lost to follow-up. Some doctors are still skeptical of CAM because of a lack of specific knowledge and qualification as well as a lack of evidence from high-quality experimental studies on the efficacy of the CAM treatments [ 4 , 12 , 14 , 15 ]. In the field of oncology, for example, the 5-year survival rate of breast cancer patients who refused standard treatment was 43.2%, compared with 81.9% of those who underwent the standard treatment [ 16 ]. When CAM was used, the 5-year survival rate was significantly worse. The 5-year survival rate of cancer patients who used CAM versus those who used standard treatment were stratified by cancer type were as follows: [ 17 ] for breast cancer 58.1% vs 86.6% ( p value < 0.01; HR = 5.68), lung cancer 19.9% vs 41.3% ( p value < 0.01; HR = 2.17), and colorectal cancer 32.7% vs 79.4% ( p value < 0.01; HR = 4.57). On the contrary, the 28-day mortality of patient with sepsis and acute gastrointestinal injury who received CAM bundle with conventional therapy was statistically significantly lower than those who received only conventional therapy (21.2% vs 32.5%, p value = 0.038) [ 18 ]. These differential clinical benefits of CAM across various medical specialties could be partly explained by how CAM is perceived by the medical specialists in conventional medicine dominated contexts.

Several studies have surveyed the acceptance and use of CAM from laypersons [ 19 – 22 ] to healthcare professional perspectives [ 23 – 29 ]. Nonetheless, these surveys did not cover all medical specialists so the findings could not reflect the comparative acceptance and use of CAM across medical specialties. Also, previous studies could not determine whether the acceptance and use of CAM by medical specialists differ across contexts (i.e., regions and economic levels of the country) and study designs (i.e., survey and sampling methods). A better understanding of how various medical specialists perceive of CAM is strategically essential for harmonizing CAM into conventional medicine practices. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists.

Materials and methods

Protocol and registration.

This systematic review has been registered in PROSPERO (CRD42019125628) and the protocol can be accessed at http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42019125628 .

Literature search

This systematic review was conducted and reported according to the PRISMA statement as well as the Synthesis Without Meta-analysis (SWiM) guidelines [ 30 ]. A systematic literature search was performed by two independent authors (PP and KP) using PubMed and Scopus databases. The search was limited to observational studies of human subjects and the English language. The medical specialist’s perspective related to CAM studies were focused. The search strategy was based on various combinations of words and focused on two main concepts: acceptance and usage of CAM. The last search was conducted on March 1, 2019.

For the PubMed database, the following combinations were applied: ("Traditional Medicine"[All Fields] OR "Alternative Medicine"[All Fields] OR "Complementary Medicine"[All Fields] OR "Acupuncture Therapy"[All Fields] OR "Holistic Health"[All Fields] OR "Homeopathy"[All Fields] OR "Spiritual Therapies"[All Fields] OR "Faith Healing"[All Fields] OR "Yoga"[All Fields] OR "Witchcraft"[All Fields] OR "Shamanism"[All Fields] OR "Meditation"[All Fields] OR "Aromatherapy"[All Fields] OR "Medical Herbalism"[All Fields] OR "Mind-Body Therapies"[All Fields] OR "Laughter Therapy"[All Fields] OR "Hypnosis"[All Fields] OR "Tai Ji"[All Fields] OR "Tai Chi"[All Fields] OR "Relaxation Therapy"[All Fields] OR "Mental Healing"[All Fields] OR "Meditation"[All Fields]) AND ("Health care provider"[All Fields] OR "Health care providers"[All Fields] OR "Health personnel"[All Fields]) AND ("2002/01/01"[PDAT]: "2017/12/31"[PDAT]) AND "humans"[MeSH Terms].

For the Scopus database, the following combinations were applied: (ALL("Traditional Medicine") OR ALL("Alternative Medicine") OR ALL("Complementary Medicine") OR ALL("Acupuncture Therapy") OR ALL("Holistic Health") OR ALL("Homeopathy") OR ALL("Spiritual Therapies") OR ALL("Faith Healing") OR ALL("Yoga") OR ALL("Witchcraft") OR ALL("Shamanism") OR ALL("Meditation") OR ALL("Aromatherapy") OR ALL("Medical Herbalism") OR ALL("Mind-Body Therapies") OR ALL("Laughter Therapy") OR ALL("Hypnosis") OR ALL("Tai Ji") OR ALL("Tai Chi") OR ALL("Relaxation Therapy") OR ALL("Mental Healing") OR ALL("Meditation")) AND (ALL("Health care provider") OR ALL("Health care providers") OR ALL("Health personnel")) AND PUBYEAR AFT 2001 AND PUBYEAR BEF 2018 AND DOCTYPE(ar) AND INDEXTERMS("Humans")

Selection of studies

The titles and abstracts of the primary studies identified in the electronic search were screened by the same two authors. Duplicated studies were excluded. For the meta-analysis, the following inclusion criteria were set: (1) medical specialist’s perspective, (2) prevalence of acceptance or usage of CAM, (3) observational study design, and (4) published between 2002 to 2017. The following exclusion criterion was set: (1) Not relevant to the practice. We contacted the authors for studies that had incomplete and unclear information. If the authors did not respond within 14 days, we proceeded to analyze the data we had. Any disagreement was resolved through discussion and the final determination was made by the first author (PP).

Data extraction and management

Two authors worked independently to review and extract the following variables: (1) general information, including the name of the studies, authors, and publication year, (2) characteristics of the studies, including the design of the studies, sampling method, country, and setting, (3) characteristics of the participants, including sample size, response, and type of specialty, and (4) outcomes, including the prevalence of acceptance, and usage of CAM. All relevant text, tables, and figures were examined for data extraction. Discrepancies between the two reviewers were resolved by the first author (PP).

Study quality/risk of bias

We used the tool developed by Hoy et al. [ 31 ] to evaluate the study quality/risk of bias of the studies included in the analysis. The tool has 11 items: (1) national representativeness, (2) target population representativeness, (3) random selection or census undertaken, (4) minimal non-response bias, (5) data collection direct from the subject, (6) definition of the case used, (7) valid and reliable instrument, (8) the same mode of data collection for all subjects, (9) length of shortest prevalence period, (10) appropriate numerator and denominator used, and (11) summary assessment. Items 1 to 4 assessed the external validity, items 5 to 10 assessed the internal validity, and items 11 evaluated the overall study quality/risk of bias. Each item was assigned a score of 1 (high quality/low risk) or 0 (low quality/high risk), and the scores were summed to generate an overall quality score that ranged from 0 to 10. According to the overall score, we classified the studies as having a high quality/low risk of bias (>6), moderate quality/risk of bias (4 to 6), and low quality/high risk of bias (<4). Two authors (PP and KP) independently assessed the study quality/risk of bias and any disagreement was resolved by discussion and consensus.

Conflict of interest

We assessed the conflict of interest of the authors’ declarations in the studies.

Statistical analysis

Unadjusted prevalence estimates of acceptance and usage of CAM were calculated based on the information of crude numerators and denominators provided by the studies and medical specialty [ 32 ]. Pooled prevalence was estimated from the prevalence as reported by the eligible studies. For each study and specialty, forest plots were generated displaying the prevalence with a 95% CI. The overall random-effects pooled estimate with its 95% CI were reported. To examine the magnitude of the variation between the studies, we quantified the heterogeneity by using I 2 and its 95% CI.

To assess the level of heterogeneity as defined in Chapter 9 of the Cochrane Handbook for Systematic Reviews of Interventions, the following I 2 cut-offs for 0 to 40% represented that the heterogeneity may not be important, 30 to 60% may represent moderate heterogeneity, 50 to 90% may represent substantial heterogeneity, and 75 to 100% represented that there was a considerable heterogeneity. For the X 2 test, statistical heterogeneity of the included trials was assessed with a p value of less than 0.05 (statistically significant). The random-effects meta-analysis by DerSimonian and Laird method was used, and statistical heterogeneity was encountered. The meta-analysis was performed using Stata/MP software version 15 (StataCorp 2017, College Station, TX).

Additional analysis

Meta-regression was performed to investigate the pooled prevalence differences between various regions (African region, region of the Americas, Eastern Mediterranean region, European region, Southeast Asia region, Western Pacific region, and mixed region) [ 33 ], economic levels of the country (low-income, lower-middle-income, upper-middle-income, high-income, and mixed-income) [ 34 ], and the sampling method (random and convenience sampling) for each study.

Selection of the studies

The literature search yielded 5628 articles. After 794 duplicates were removed, 4831 titles and abstracts were screened, and 4719 irrelevant articles were removed. Of 115 articles selected for full-text screening, 62 were excluded for the following reasons: two were not relevant to this study’s objective, 17 had the wrong target population, 22 did not have the study design required for this review, two study was not published in English, 19 did not have full-text available, and 28 did not provide the prevalence. Finally, a total of 25 articles, published between 2002 and 2017, fulfilled the selection criteria and were included in this meta-analysis (Fig. ​ (Fig.1 1 ).

Characteristics of the studies

All included studies were cross-sectional. The publication years ranged from 2002 to 2017 in various countries: European region ( n = 11, 44%), region of the Americas ( n = 10, 40%), Western Pacific region ( n = 3, 12%), and mixed region ( n = 1, 4%). Twenty-three studies (88%) were from high-income countries, 2 (8%) from upper-middle income countries, and 1 (4%) was from mixed-economic level country. The included studies indicated which type of collection method was used: online survey ( n = 8, 32%), postal survey ( n = 8, 32%), online and postal survey ( n = 3, 12%), online and phone survey ( n = 1, 4%), and the collection method was not reported ( n = 5, 20%). The studies included a total of 7320 participants who were categorized as medical specialty ( n = 5445, 74%), and non-medical specialty ( n = 1875, 26%) (Table ​ (Table1 1 ).

Characteristics of the included studies

The included studies had the following medical specialties: internal medicine (11 studies, n = 2253), pediatrics (6 studies, n = 2,130), obstetrics and gynecology (6 studies, n = 707), anesthesiology (4 studies, n = 342), surgery (3 studies, n = 564), family medicine (3 studies, n = 296), physical medicine and rehabilitation (3 studies, n = 104), psychiatry and neurology (2 studies, n = 22), otolaryngology (1 study, n = 49), and neurological surgery (1 study, n = 24) (Table ​ (Table2 2 )

The number of medical specialists according to the American Board of Medical Specialties

Based on the specialty

Prevalence of cam acceptance.

The overall random-effect pooled prevalence of CAM acceptance in medical specialty was 52% (95% CI, 42–62%). The prevalence of CAM acceptance in Family Medicine was 67% (95% CI, 60–73%), Psychiatry and Neurology was 64% (95% CI, 35–85%), Neurological Surgery was 63% (95% CI, 43–79%), Obstetrics and Gynecology was 62% (95% CI, 36–82%), Pediatrics was 60% (95% CI, 41–77%), Anesthesiology was 52% (95% CI, 45–58%), Physical Medicine and Rehabilitation was 51% (95% CI, 42–61%), Internal Medicine was 41% (95% CI, 39–43%), and Surgery was 26% (95% CI, 22–30%). The overall heterogeneity was significant ( I 2 = 94.99%, p value < 0.001) (Fig. ​ (Fig.2 2 ).

Forest plot of CAM acceptance by specialty

Prevalence of CAM usage

The overall random-effect pooled prevalence of CAM usage in medical specialty was 45% (95% CI, 37–54%). The prevalence of CAM usage in Obstetrics and Gynecology was 68% (95% CI, 63–73%), Family Medicine was 63% (95% CI, 58–68%), Psychiatry and Neurology was 55% (95% CI, 35–73%), Pediatrics was 44% (95% CI, 42–46%), Otolaryngology was 43% (95% CI, 30–57%), Anesthesiology was 42% (95% CI, 37–47%), Internal Medicine was 38% (95% CI, 36–41%), Physical Medicine and Rehabilitation was 32% (95% CI, 24–41%), and Surgery was 25% (95% CI, 22–29%). The overall heterogeneity was significant ( I 2 = 94.90%, p value < 0.001) (Fig. ​ (Fig.3 3 ).

Forest plot of CAM usage by specialty

Based on the studies

The overall random-effect pooled prevalence of CAM acceptance was 54% (95% CI, 36–73%) (Fig. ​ (Fig.4a). 4 a). Twelve studies provided CAM acceptance: five studies in the European region, five studies in the region of the Americas, and two studies in the Western Pacific region. The pooled prevalence of the European region, region of the Americas, and Western Pacific region that accepted CAM were 60% (95% CI, 36–83%), 54% (95% CI, 39–68%), and 20% (95% CI, 17–22%), respectively (Fig. ​ (Fig.4b). 4 b). All 12 studies were done in high-income economic countries (Fig. ​ (Fig.4c). 4 c). Based on the sampling method, the pooled prevalence of random sampling method, and non-random sampling method were 54% (95% CI, 30–77%), and 55% (95% CI, 44–67%), respectively (Fig. ​ (Fig.4d). 4 d). The overall heterogeneity was significant ( I 2 = 99.14%, p value < 0.001) as was the between-group heterogeneity ( p value < 0.001). Meta-regression showed that there were no significant differences in the pooled prevalence of CAM acceptance by region, economic levels of the country, and the sampling method (Table ​ (Table3 3 ).

Forest plot of CAM acceptance

Subgroup analysis

Abbreviations : CI confidence interval

The overall random-effect pooled prevalence of CAM usage was 52% (95% CI, 42–62%) (Fig. ​ (Fig.5a). 5 a). Twenty-one studies provided CAM usage information: nine studies in the European region, eight studies in the region of the Americas, three studies in the Western Pacific region, and one study in the mixed region. The pooled prevalence of European region, region of the Americas, Western Pacific region, and mixed region that used CAM were 54% (95% CI, 37–71%), 59% (95% CI, 46–73%), 37% (95% CI, 18–56%), and 18% (95% CI, 11–27%), respectively (Fig ​ (Fig5b). 5 b). All 18 studies were conducted in high-income economic countries, two studies were conducted in upper-middle-income economic countries, and one study was conducted in a mixed-income economic country. The pooled prevalence of high-income economic countries, upper-middle-income economic, and mixed-income economic countries that used CAM was 52% (95% CI, 41–62%), 74% (95% CI, 67–80%), and 18% (95% CI, 11–27%), respectively (Fig. ​ (Fig.5c). 5 c). Based on the sampling method, the pooled prevalence of the random sampling method, and non-random sampling method were 51% (95% CI, 39–64%), and 54% (95% CI, 38–70%), respectively (Fig. ​ (Fig.5d). 5 d). The overall heterogeneity was significant ( I 2 = 98.29%, p value < 0.001) as was between-group heterogeneity ( p value < 0.001). Meta-regression showed that there were no significant differences in the pooled prevalence of CAM usage by region, economic levels of the country, and the sampling method (Table ​ (Table3 3 ).

Forest plot of CAM usage

Assessment of study quality/risk of bias/conflict of interest

A total of 24 (96%) studies were categorized as high quality/low risk of bias, whereas one (4%) was categorized as moderate quality/moderate risk of bias. No study met the criteria of low quality/high risk of bias (Fig ​ (Fig6). 6 ). Only five studies (20%) declared that there were conflicts of interest.

Study quality/risk of bias of the included studies

This study is the first of its kind to compare the acceptance and use of CAM across various medical specialties in different contexts. As nearly three-quarters of the specialties accepted CAM more than 50% whereas nearly a third were using CAM more than 50%.

The synthesis of all prevalence estimates of acceptance and usage was 52% and 45%, respectively. The highest prevalence of acceptance was in Family Medicine, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The highest prevalence of usage was in Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. These findings were useful in terms of improving care plan, decision-making processes, and communication in terms of CAM between the doctors and the patients.

All of the medical specialties mentioned above had a higher prevalence of acceptance than the prevalence of CAM use, except for Obstetrics and Gynecology because the gynecologic oncologists have used CAM to treat a large number of breast cancer patients [ 14 ]. There was a small difference in the prevalence (<5%) between the acceptance and the usage in Family Medicine (4%), Obstetrics and Gynecology (4%), Internal Medicine (3%), and Surgery (1%).

A highest difference of prevalence of CAM acceptance and usage was in the field of Physical Medicine and Rehabilitation (19%). This difference may be due to the reduction in the use of acupuncture in the academic hospitals [ 7 ] as well as personal use. Nearly two thirds of the rehabilitation physicians advised against the use of CAM as a therapeutic option [ 41 ]. The lowest prevalence of acceptance and usage of CAM was observed in Surgery. This relatively low prevalence compared to other medical specialties may be due to the belief that CAM products were ineffective. Many surgeons lacked information regarding CAM usage.

The acceptance of CAM was neutral in European region and region of the Americas. The World Health Organization reported that the prevalence of CAM usage in the European region, region of the Americas, and Western Pacific region in 2018 was 89%, 80%, and 95%, respectively [ 33 ], while this review found that the corresponding prevalence was 54%, 59%, and 37%, respectively. The lower prevalence may be from the dominating studies that were conducted before 2010 whereas CAM has used more often after 2010.

The variation of prevalence of CAM used was investigated in relation to the economic level of the countries. There was a higher prevalence of CAM use in the upper-middle-income economies than the high-income economies which may be due to cultural, historical influences, and implementation of CAM in the national health system as seen in Brazil [ 39 ] and Mexico [ 49 ].

Our study has some limitations that should be considered when interpreting the findings. Only two databases—PubMed and Scopus—were included so this review might have missed some relevant studies that were indexed elsewhere. Nonetheless, both databases were considered efficiently sufficient and most relevant to our research question within a specific domain [ 53 ]. While Web of Science and Scopus share several common features, Scopus is a relatively smaller database but covers more modern studies than Web of Science. The included studies did not cover some medical specialties that might have different acceptance and usage of CAM. Therefore, the prevalence of acceptance and usage of CAM in these populations need additional surveys. The prevalence of acceptance in some specialties like Neurological Surgery, Obstetrics and Gynecology, Otolaryngology, Pediatrics, and Psychiatry and Neurology was reported by a single study, thus limiting the generality of such findings. High heterogeneity of acceptance and usage of CAM between medical specialty referred to the variation in professional characteristic and practice, measurement methods, and study questionnaire. Most of the studies were from high-income economic countries. There were no studies from low-middle and low-income economic countries which is of concern. We found that no studies compared the relevant demographic characteristics between the responders and non-responders that would increase non-response bias when estimating the prevalence of CAM use. Although most of the studies demonstrated low risk of bias, over 88% of the studies did not use a validated instrument. Finally, the conflict of interest was not declared in more than 80% of the studies which may result in unintentional bias in the collection, analysis, and interpretation of the data. This can consequently lead to claims that the CAM used was beneficial because the researcher and/or entity may have a financial or management interest in the CAM used.

Conclusions

Acceptance and use of CAM varied across medical specialties. Based on available survey data, CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice.

Acknowledgements

We thank Dr. Kulthanit Wanaratna and Dr. Monthaka Teerachaisakul of the Department of Thai Traditional and Alternative Medicine, Ministry of Public Health for their administrative supports.

Authors’ contributions

Phutrakool P conceptualized and designed the study, collected the data, analyzed and interpreted the data, drafted the article, and finalized the manuscript for submission. Pongpirul K conceptualized and designed the study, collected the data, analyzed and interpreted the data, drafted the article, and finalized the manuscript for submission.

This study received financial support from the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University (Grant Number RA62/059), and Department of Thai Traditional and Alternative Medicine, Ministry of Public Health. The sponsors have no involvement in the systematic search, abstract screening, data extraction, or manuscript preparation. Phutrakool P received the 90th anniversary of Chulalongkorn University Fund (Ratchadaphiseksomphot Endowment Fund).

Availability of data and materials

Declarations.

Not applicable.

The authors declare that they have no competing interests.

Supported by Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University (Grant Number RA62/059), and Department of Thai Traditional and Alternative Medicine, Ministry of Public Health. The sponsors have no involvement in the systematic search, abstract screening, data extraction, or manuscript preparation. PRISMA 2009 Checklist statement: Uploaded

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Alternative medicine is the term given for medicinal products or services that are not a part of a standard medical care. It means nonstandard treatments that can be used along with the standard treatment. Some examples of alternative medicine are herbal medicines, acupuncture, chiropractic medicine, energy therapies, magnetic field therapy, hypnosis, Reiki, Ayurveda, Chinese Medicine, Traditional Medicine, and healing touch therapies (National Institute of Health, n.d.). These have been around for many years, but in literature, there is a support as well as controversy surrounding it. In some cases, there has been considerable research done while in some other cases, there has been no research at all (National Institute of Health, n.d.). When used along with standard care, researchers claim that alternative therapies have the potential to transform the physical, emotional, and spiritual lives of people living with chronic illnesses (National Cancer Institute, 2011). Most of the therapies cannot be substitutes for mainstream standard medical care, but when used along with standard care, they reduce stress, anxiety, pain, and other physical and emotional symptoms; and improve the health related quality of life (National Cancer Institute, 2011). Let us see briefly what each type of alternative medicine therapy is all about and we will also read about some research that has been done till date to test the safety and efficacy of some of the alternative medicine treatment approaches on some medical conditions of which some are common illnesses like low back pain or headaches, while some are deadly diseases like cancer and HIV/AIDS. Acupuncture is a traditional Chinese medicine that makes use of thin needles to stimulate various points around the body with an aim to restore energy. It helps ease certain chronic pain conditions like headache, low back pain, and osteoarthritis. In chiropractic medicine, the spine is manipulated to better align the body (Martin, 2011). It helps provide relief in low back pain, shoulders, and neck. Energy therapies make use of magnets and healing touch to improve health. Reiki accesses the body’s natural energy to heal the body. The Reiki practitioner hovers his hand on the patient’s body to bring about a state of calmness. Herbal medicine is medicine extracted from plants. Ayurveda, Chinese medicine, and traditional medicine all offer herbal remedies (Martin, 2011). In an observational study by Jones and colleagues, patients in fatiguing illness take more help of alternative therapies than those who have non-fatiguing illnesses. The alternative medicine therapies commonly used by them are chiropractic and massage therapies and mind-body therapies. It was also seen that those who have a poor physical and mental health appear to use them more often (Jones, 2007). In recent years, there have been many systematic reviews of trials, reviews of reviews, and meta-analyses published on the relative efficacy of different alternative medicine approaches to fibromyalgia, a condition in which the pharmacological efficacy (standard medical care) is limited. Therefore, patients often seek treatment from alternative medicine providers. Surveys have shown that 60% - 90% of patients in USA report using alternative therapies for fibromyalgia (Bennet, 2007). A recent survey in 29 centers of integrative medicine showed the most promise, most success with conditions like chronic pain, gastrointestinal disorders, depression/anxiety, cancer, and stress. The centers also treated patients with fatigue, sleep problems, and anxiety/depression (Horrigan, 2012). Through yoga and meditation, a somatically focused technique was found to be helpful for depressive symptoms (Baranowsky, 2009). A systematic review by Langhorst confirmed that beneficial effects for the condition of fibromyalgia syndrome were found in hydrotherapy and massage. Homeopathy and acupuncture too were found to have promise, but need further research (Langhorst, 2012). Chinese techniques that incorporated body movements with breathing and attention training improved symptoms of fibromyalgia. Yoga had a significant effect on pain, fatigue, depression, and quality of life. Certain Chinese techniques were effective for sleep. The review also showed traditional Chinese medicine to be an emerging approach to the management of the symptoms of fibromyalgia syndrome (Langhorst, 2012). Another deadly disease, cancer, has rising incidence in both developed and developing nations. According to National Cancer Institute, cancer patients take the help of alternative medicine to help them cope with the side effects of cancer treatments, such as nausea, pain, and fatigue. Alternative medicines help them comfort themselves and ease the worries of cancer treatment and related stress. Importantly, patients feel that they are doing something more to help with their own care (National Cancer Institute, n.d.). Alternative medicines are widely used by 50% - 90% of patients with chronic painful, debilitating, or fatal conditions, such as HIV/AIDS and cancer (Richardson and Straus, 2002). Importantly, there is little correlation between the use of alternative medicines and a scientific evidence that they are safe or effective. The only evidence is of their safety and efficacy is embodied in folklore. Herbals like comfrey and kava have been associated with liver failure, aristolochia with genitourinary cancer (De Smet, 2002), and ephedra with heart attacks and strokes (Shekelle, 2003). A lot of data also suggests that patients discuss the use of their supplements with knowledgeable practitioners before initiating any treatment. Several randomized control trials have been conducted on the safety and efficacy of the alternative medicine treatment approaches and many have positive reviews (Debas and others, n.d.). Treating drug-resistant malaria with Artemisia annua, preventing urinary tract infections with cranberries, lowering blood pressure with garlic, relieving osteoarthritis with Glucosamine, improving liver function with milk thistle, treating mild depression with St. John’s wort, relieving symptoms of benign prostatic hyperplasia (BPH) with saw palmetto and relieving arthritis pain with acupuncture all these trials have had positive study outcome. Decreasing anxiety with meditation, preventing migraine with biofeedback, and treating lower back pain with chiropractic therapy have also shown to have positive study outcomes (Debas and others, n.d.). Alternative medicines can provide a rationale for conserving species, but a concern could be overharvesting of endangered species. According to WHO, 85% of the world’s population (principally those in developing countries) depends on plants for medicine, and 25% of prescription drugs have an active ingredient derived from a flowering plant (Debas and others, n.d.)

Below, we will discuss a few of the alternative therapy approaches in detail that have really been promising.

Artemisinin is an herbal extract that has been used in China for centuries to treat fever. The active ingredient was discovered in 1970s, and some western pharmaceutical companies have developed several derivatives of the herbal extract as treatments against resistant Plasmodium malaria (Li, 2000). Another such drug, dihydroartemisinin-piperaquine, is effective against drug resistant Plasmodium falciparum malaria. Another derivative of artemisinin known as artesunate, has shown to increase parasite clearance and reduce the gametocyte count when added to existing drugs to combat malaria (Adjuik and others 2004). Rigorous clinical trials have demonstrated positive efficacy in two areas, managing postoperative nausea and emesis (Shen, 2000) and amelioration of the pain of chronic osteoarthritis (Ezzo, 2001). Chiropractic medicine uses spinal manipulation to treat an array of conditions thought to arise because of abnormal alignment of or stresses on vertebrae, most often in patients with musculoskeletal complaints (Debas and others, n.d.). Even though conventional medicine professionals ostracized practitioners of chiropractic medicine in earlier times, it has gradually evolved into a viable healing discipline that is increasingly accepted by the conventional medicine community. Secondly, the evolution of chiropractic can be compared with that of osteopathy. Osteopathy was developed in the USA in parallel with chiropractic, but the field elected to accommodate rather than reject allopathic techniques (Debas and others, n.d.). David Spiegel at Stanford University, while working on group support for breast cancer patients, observed that appropriate psychotherapy (both group and individual) not only reduced depression and anxiety and improved coping skills, but also saved money by reducing the number of office visits, diagnostic tests, medical procedures, and hospital admittances (Spiegel, 1994). In spite of some promising data, the alternative approach presents major challenges and often poses difficulties for opportunities on research. Alternative medicine practitioners need to understand the strengths, limitations, and contributions of their particular approach towards individual and public heath, so that they can work together to ensure the best possible care for everyone.

Complementary and Alternative Medicine. N.d. Medline Plus. National Institute of Health. Retrieved from: http://www.nlm.nih.gov/medlineplus/complementaryandalternativemedicine.html; Accessed: 15th March 2013. The Medline Plus, created by the National Institute of Health provides trusted health information and assists its readers in locating authorative health information. Do Complementary Therapies Work? – Ask the expert about herbs, acupuncture, and other complementary therapies. (2011) National Cancer Institute. Retrieved from: https://researchtoreality.cancer.gov/node/522 Accessed: 15th March 2013 Researchtoreality.cancer.gov was developed by the National Cancer Institute, which among other many functions, also provides trusted information on health. Martin, L. (2011) Complementary and Alternative Medicine (CAM). WebMD. Retrieved from: http://www.webmd.com/balance/what-is-alternative-medicine?page=2; Accessed: 15th March 2013. WebMD is the Health on the Net Code certified website. A HON Code means the website can be trusted for its information. The complementary and alternative medicine overview mentions most of the alternative medicine practices around the world with a brief summary of what every therapy is and how does it benefit patients. Jones, J. F., Maloney, E., Roumiana, B., Ann-Britt, J., William, R. (2007) Complementary and alternative medical therapy utilization by people with chrobnic fatiguing illnesses in the United States. BMC Complmentary and Alternative Medicine 7, 12. Retrieved from: http://stacks.cdc.gov/view/cdc/3467/ The information is provided by authors James Jones and colleagues on the CDC website, the main aim of CDC being saving lives and protecting people. The abstract provides information on the utilisation of alternative treatment approaches by patients with fatiguing illnesses and also by those suffering with non-fatiguing illnesses. It concludes with an aim to state the requirement of development of intervention strategies for alternative medicine practices. Greene, A. M., Walsh, E. G., Sirois, F. M., McCaffrey, A. (2009) Perceived Benefits of Complementary and Alternative Medicine: A Whole Systems Research Perspective. The Open Complementary Medical Journal. 1, 35 - 45. Retrieved from: http://www.benthamscience.com/open/toaltmedj/articles/V001/35TOALTMEDJ.pdf The study examined the benefits of alternative medicine therapies from a patients’ perspective. The findings have provided insights and directions for its use. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. (2007) An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord, 8:27. An internet survey by National Fibromyalgia Association provided information on many factors many factors of fibromyalgia like symptoms, aggravating factors, medications used, and the use of alternative therapies for assisting in treating fibromyalgia or stleast controlling the symptoms of fibromyalgia. Horrigan B, Lewis S, Abrams D, Pechura C. (2012) Integrative Medicine in America. Minneapolis, Minn: The Bravewell Collaborative. Retrieved from: http://www.bravewell.org/current_projects/mapping_field. The content provides current data on the patient populations and health conditions most commonly treated with integrative strategies. Baranowsky J, Klose P, Musial F, Häuser W, Dobos G, Langhorst J. (2009) Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatol Int, 30, 1-21. The systematic review provides a summary of randomized control trials on alternative medicine as defined by NIH. Langhorst J, Klose P, Dobos G, Bernardy K, Häuser W. (2012) Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Rheumatol Int. [Epub ahead of print] This systematic review and meta analysis collected data from quality randomized trials that compared a few alternative therapy approaches. The review shows yoga and some Chinese techniques to have a significant effect on quality of life. The review is also in favour of hydrotherapy and massage for fibromyalgia. Reasons People with Cancer Choose CAM. n.d. National Cancer Institute. http://www.cancer.gov/cancertopics/cam/thinking-about-CAM/page2 The national cancer institute, along with other aims, also aims to provide trusted health information to its readers. Richardson, M. A., and S. E. Straus. (2002). “Complementary and Alternative Medicine: Opportunities and Challenges for Cancer Management and Research.” Seminars in Oncology 29, 531–45. This is a work by the US government. The report summarizes the challenges facing the alternative medicine researchers, the most fruitful areas for exploration, and existing information resources. De Smet, P. A. (2002). “Herbal Remedies.” New England Journal of Medicine, 347, 2046–56. De Smet’s review summarizes the safety and efficacy of herbal medicines, focusing mainly on four herbs – Ginkgo biloba, hawthorn, saw palmetto, and St. John's wort. These herbs have been evaluated in a sufficient number of randomized, controlled trials. Shekelle, P. G., M. L. Hardy, S. Morton, M. Maglione,W. A. Mojica, M. J. Suttorp, and others. (2003). “Efficacy and Safety of Ephedra and Ephedrine for Weight Loss and Athletic Performance: A Meta- Analysis.” Journal of the American Medical Association, 289, 1537–45. The meta analysis has reviewed the efficacy and safety of ephedra and ephedrine in weight loss and enhanced athletic performance. Debas, H. T., Laxminarayan, R., Straus, S. E. Complementary and Alternative Medicine. Disease Control Priorities in Developing Countries. Retrieved from: http://files.dcp2.org/pdf/DCP/DCP69.pdf; Accessed: 15th March, 2013. This chapter on alternative and complementary medicine by Debas and colleagues is part of a book that considers the formidable challenges to advancing human health. The chapter reviews certain alternative medicine practices to understand their current and potential place in the overall practice of medicine. Li, Y., Y.M. Zhu, H. J. Jiang, J. P. Pan, G. S.Wu, J.M.Wu, and others. (2000). “Synthesis of Antimalarial Activity of Artemisinin Derivatives Containing an Amino Group.” Journal of Medical Chemistry 43 (8): 1635–40. The study is a preclinical trial on water-soluble artemisinin derivative to determine their efficacies. Adjuik, M., A. Babiker, P. Garner, P. Olliaro,W. Taylor, and N.White. (2004). “Artesunate Combinations for Treatment of Malaria: Meta-Analysis.” Lancet, 363 (9402): 9–17. The study assessed the evidence that addition of artemisinin derivatives to existing drug regimens could reduce treatment failure. The interpretation was there was a reduction in treatment failure when artesunate was added to the regimen. Shen, J., N. Wenger, J. Glaspy, R. D. Hays, P. S. Albert, C. Choi, and P. G. Shekelle. (2000). “Electroacupuncture for Control of Myeloablative Chemotherapy-Induced Emesis: A Randomized Controlled Trial.” Journal of the American Medical Association, 284: 2755–61. The RCT was performed on cancer patients undergoing chemotherapy. The study compared the efficacy of electropuncture vs. minimal needling and mock electrical stimulation or antiemetic drugs alone in controlling episodes of nausea and vomiting among patients undergoing chemotherapy regimen, to show that adjunct electroacupuncture was more effective in controlling emesis. Ezzo, J., V. Hadhazi, H. Birch, L. Lao, G. Kaplan, and M. Hochberg. (2001). “Acupuncture for Osteoarthritis of the Knee: A Systematic Review.” Arthritis and Rheumatism, 44 (4): 819–825. The study is a systematic review evaluating trials of acupuncture for osteoarthritis of knee. It assessed the methodologic quality of trials and determined if low quality trials were associated with positive outcomes. Spiegel, D. (1994). “Health Caring, Psychosocial Support for Patients with Cancer.” Cancer 74 (4): 1453–56. Spiegel, in this paper, has reviewed four issues regarding psychosocial treatments and concludes that appropriate and timely psychotherapeutic interventions are cost beneficial by reducing unnecessary office visits, diagnostic tests, medical procedures, and hospital admissions.

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• Complementary and alternative medicine in HIV care: frequency of consumption, risks and interactions with antiretroviral therapy
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• Elena Colominas-González 1 , 2 ,
• Marta De Antonio 1 ,
• Montserrat Masip 3 ,
• Maria Teresa Martin Conde 4 ,
• Glòria Cardona 5 ,
• http://orcid.org/0000-0002-4647-1823 Daniel Fresán Restituto 6 ,
• Dolors Comas 7 ,
• Maria Angeles Roch 8 ,
• Belen López 9 ,
• Francisco Ignacio Torres-Bondia 10 ,
• http://orcid.org/0000-0003-3615-5082 Alexandra Retamero 11 ,
• Hernando Knobel 12 ,
• Sonia Luque 1 , 13 , 14
• 1 Pharmacy Department , Hospital del Mar , Barcelona , Spain
• 2 Medicine Department , Universitat Pompeu Fabra , Barcelona , Spain
• 3 Pharmacy Department , Hospital de la Santa Creu i Sant Pau , Barcelona , Spain
• 4 Pharmacy Department , Hospital Clinic de Barcelona , Barcelona , Spain
• 5 Pharmacy Department , Hospital Germans Trias i Pujol , Badalona , Spain
• 6 Pharmacy Department , Hospital García Orcoyen , Estella , Spain
• 7 Pharmacy Department , Hospital Bellvitge Barcelona , Barcelona , Spain
• 8 Pharmacy Department , Hospital Joan XXIII , Tarragona , Spain
• 9 Pharmacy Department , Hospital Parc Tauli , Sabadell , Spain
• 10 Pharmacy Department , Hospital Universitario Santa Maria , Lleida , Spain
• 11 Pharmacy Department , Hospital d'Igualada , Igualada , Spain
• 12 Infectious Diseases Department , Hospital del Mar , Barcelona , Spain
• 13 Infectious Pathology and Antimicrobials Research Group (IPAR) , Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) , Barcelona , Spain
• 14 CIBER of Infectious Diseases (CIBERINFEC CB21/13/0002) , Institute of Health Carlos III , Madrid , Spain
• Correspondence to Dr Sonia Luque, Pharmacy Department, Hospital del Mar, Barcelona, Spain; sluque{at}psmar.cat

Objectives People living with HIV (PLWH) are common users of complementary and alternative medicine (CAM). The main objective of this study was to study the frequency and patterns of CAM natural products use in a large cohort of PLWH and to identify potential drug–drug interactions (DDIs) and the impact on their antiretroviral treatment (ART) adherence and efficacy.

Methods This was a cross-sectional multicenter survey including 420 PLWH from different Spanish hospitals. Participants completed a face-to-face questionnaire on CAM consumption and different sociodemographic and clinical data were collected. DDIs between CAM and ART were identified and classified according to the Liverpool University Database and patient factors related to CAM consumption were assessed.

Results 420 participants were included (82.6% male, mean age 47 years); 209 patients (49.8%) were taking at least one CAM. The most consumed CAM were green, black and red tea (n=146, 25.4%), ginger (n=26, 4.5%), fish oil (n=25, 4.4%) and cannabis (n=24, 4.2%). An ART based on integrase inhibitors was the only factor independently associated with CAM consumption (OR 1.54, 95% CI 1.04 to 2.26). 50 potential CAM–ART interactions in 43 (20.6%) patients taking CAM were identified, being clinically significant in 80% of the cases. CAM products most frequently involved with a potential significant DDI were supplements containing divalent cations (n=11) and garlic (n=7). No differences in ART efficacy and adherence were observed between patients with and without CAM consumption.

Conclusions Almost 50% of patients were taking at least one CAM product and its use was associated with an integrase inhibitor based ART. One out of every six patients was at risk of presenting with an interaction between a CAM and their ART, confirming the need to review continuously the use of CAM as part of the medication review process.

• COMPLEMENTARY THERAPIES
• DRUG INCOMPATIBILITY
• CLINICAL MEDICINE
• PHARMACY SERVICE, HOSPITAL

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Data are available upon reasonable request.

https://doi.org/10.1136/ejhpharm-2024-004118

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WHAT IS ALREADY KNOWN ON THIS TOPIC

People living with HIV are common users of complementary and alternative medicine (CAM) products.

WHAT THIS STUDY ADDS

Almost 50% of patients were taking at least one CAM product and its use was associated with an integrase inhibitor based antiretroviral therapy (ART).

One out of every six patients was at risk of presenting with an interaction between a CAM product and their ART, but this did not have an impact on ART adherence or efficacy.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

Pharmacists have an important role in the continuous revision of the use of CAM as part of the antiretroviral medication review process. Not only concomitant medications, but also CAM ought to be assessed in order to detect potential interactions with ART.

Introduction

Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard medicine. It is often classified into two subgroups: natural products, including herbs, vitamins, minerals, and probiotics; or mind and body practices. 1 CAM use is frequent among patients living with HIV (PLWH) 2 3 and its prevalence of use ranges between 16–90%, depending on the population included and the CAM definition used. 2–6 The use of CAM natural products, including herbal medicine, vitamins, minerals and food supplements, has considerably increased throughout the world for the treatment of many different health problems. 5–7 Within PLWH, the main reasons for consuming these products as a self-medication are to boost the immune system to fight the HIV, to relieve the adverse effects of antiretroviral treatment (ART) or to delay disease progression. 5 8

In addition, the high consumption frequency may be explained by the widespread belief among the population that herbal products, especially those from a natural origin, are not harmful to health. 7 However, some products are not exempt from risks and adverse events can occur, including drug interactions with ART, and impact on the adherence of ART. 4 6

The identification of PLWH at higher risk for CAM consumption may be useful to identify potential related drug problems. Previous studies have associated self-medication with different individual factors, the most common being female gender, a high educational background and income, the presence of adverse effects to prescribed treatments, mental problems, and pain. 9 10 CAM consumption may also be different between patients from different regions of the world with specific beliefs and cultures, which suggests the need to know the most common products consumed in each country. 11 One important limitation is the fact that the real frequency of consumption is usually underestimated in these studies because patients do not accept that they self-medicate and they do not report this information to their physicians, if they are not specifically asked about it. 4

To date, only a few studies have explored the use of medical plants in the general population 12 and PLWH 13 in Spain. The study performed by Moltó et al included a high number of PLWH, but it was carried out in 2012. The introduction of integrase inhibitors as a first line combination in international guidelines is a new scenario in which the pattern of use of these products and the risk of potential interactions may be very different.

The main objective of this study was to explore the frequency and patterns of use of CAM natural products in a large cohort of PLWH from different Spanish hospitals. Secondary objectives were to identify potential drug–drug interactions (DDIs) and the impact of their consumption on ART adherence and efficacy.

Study design and participants

We performed a descriptive cross-sectional multicenter study including PLWH taking ART from nine Spanish referral hospitals. In Spain, ART is dispensed at hospital-based ambulatory-care Pharmacies (HACPh). 14 We recruited patients attending the HACPh for ART refill in a 6-month period of inclusion (from June to November 2018).

Inclusion criteria were: PLWH taking ART for at least 6 months, able to read and understand the Spanish language, and signed informed consent.

Survey and clinical data collection

Patients accepting to participate were interviewed at the HACPh visit using a structured face-to-face questionnaire to identify CAM consumption. Only the so-called complementary and alternative self-medication natural products were considered (herbal medicine (ie, phytotherapy), vitamins, minerals and food supplements). 6 Concomitant drugs and foods known to interact, such as grapefruit, were not included in the analysis.

The questionnaire (see online supplemental appendix 1 ) was created in Spanish for this study and refined by drug interaction expert pharmacists for clarity and relevance. Participants could report CAM consumption using a list of the most common CAM products or adding additional ones in an open filed option. For each product the following information was collected: frequency of consumption, pharmaceutical form, who recommended its consumption, place of purchase, and reason for its consumption. Additionally, patients’ beliefs about CAM safety were captured by asking two questions: ‘Do you believe CAM products are safe?’ and ‘Do you think that the consumption of CAM can affect the efficacy of your medication?’

Supplemental material

The following sociodemographic and clinical data were also collected from the electronic medical records in all patients: age, gender, country of origin, ethnicity, educational level, current ART, other concomitant drugs, alcohol, smoking or substance abuse, and virological and immunological current status (CD4 lymphocyte count, HIV viral load from the time closest to the survey completion). ART adherence was assessed by patients’ self-report. Patients were considered as adherent if the possession medication ratio was ≥90%. Clinical efficacy to ART was considered when the patients had an undetectable viral load and a CD4 count ≥500 cells/mm 3 .

Potential CAM–ART interactions

Potential interactions between CAM products and ART were screened for each patient according to the University of Liverpool Database. 15

CAM products were categorised according to the suspected severity of interactions with ART as: interaction not expected (‘green category’), potential weak interaction (‘yellow category’), possible interaction but manageable by dose adjustments and/or closer monitoring (‘orange category’), not recommended or contraindicated for co-administration (‘red category’). 15 If information about the CAM was not found in the Liverpool database, the CAM was classified as ‘No information found’.

Statistical analysis

Descriptive statistics of demographic and clinical variables include absolute and relative frequencies for categorical variables, and means and SD for continuous quantitative variables. The comparison of continuous variables between CAM users and non-users was performed by using the Student t-test for those with a normal distribution, and using the non-parametric Mann-Whitney U test when normality could not be assumed. For dichotomous variables, the χ 2 and Fisher exact tests were applied.

Logistic regression was used to explore various risk factors associated with the primary endpoint of the study, CAM consumption. Univariate analyses were performed separately for each of the risk factor variables to ascertain the odds ratio (OR) and 95% confidence interval (95% CI). Covariates influencing the outcome of the univariate analysis (p<0.10) were included in the regression analysis. Multivariate analysis was performed using a backward stepwise logistic regression model to determine the independent predictors of CAM use; for all analyses, a two-sided p value <0.05 was considered statistically significant. The SPSS (Statistical Package for the Social Sciences) version 20.0 statistical package was used throughout.

Description of the participants

During the study period, 420 patients agreed to participate in the study: 347 (82.6%) were male with a mean (SD) age of 47 (10.4) years. Characteristics of all included patients are detailed in table 1 . Over two thirds of participants were Spanish (68.8%), but patients from 38 different nationalities were included. The level of education was high in the entire cohort, as 261 (62.1%) patients had at least secondary studies.

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Patient baseline characteristics according to CAM consumption

A low proportion of patients had hepatitis B virus/hepatitis C virus (HBV/HCV) co-infection and only 17 (4.0%) had liver cirrhosis. The most common comorbidity in this cohort were the psychiatric disorders (16.2%). More than 50% of patients were on integrase inhibitors and the level of adherence to ART was higher than 80%. Clinical efficacy (CD4 count ≥500 cells/mm 3 and undetectable viral load) was achieved in 244 (58.1%) patients.

CAM use and factors associated with consumption

Two-hundred and nine patients (49.8%) reported to be taking at least one CAM. Of these patients, 176 (84.2%) were taking herbal medicines, representing 41.9% of all interviewed patients.

A total number of 574 CAM products were reported, with a mean (SD) number of CAMs consumed per patient of 2.74 (0.16). Thirty-four (16.3%) patients were taking five or more products. Patients’ baseline characteristics comparing patients with and without CAM use in the univariate analysis are described in table 1 . No differences were found in any of the sociodemographic characteristics between CAM consumers and non-consumers. Most comorbidities were similar between groups; we found a tendency to a lower CAM use within diabetic patients (4.8% vs 8.5%), but this did not reach statistical significance (p=0.124).

Regarding ART, a higher proportion of CAM users (61.2%) were treated with an integrase inhibitor based ART compared with the non-users (50.7%, p=0.030). In the multivariate analysis, being treated with an integrase inhibitor based ART was the only factor independently associated with CAM consumption (OR 1.54, 95% CI 1.04 to 2.26). Nevertheless, no differences in CD4 counts (p=0.598), the proportion of patients with an undetectable HIV viral load (p=0.865) or ART adherence were observed between patients with and without CAM use (p=0.972).

A high diversity of CAMs was reported with 86 different products: 71 herbal medicines and 15 non-herbal food supplements. The most consumed CAMs in our cohort were green, black and red tea that accounted for 146 (25.4%) of the reported products, ginger (n=26, 4.5%), fish oil (n=25, 4.4%) and cannabis (n=24, 4.2%). The top 20 most consumed CAMs, their main forms, frequency of consumption, person who recommended the CAM use and providers are described in the online supplemental tab le .

The most frequent CAM forms were infusions (n=270, 47.0%), which commonly included different type of teas (n=142), horsetail (n=16), ginger (n=14), yohimbus (n=12), boldus (n=9) or thymus (n=7). The second most consumed form of products were tablets or capsules (n=181, 31.6%), mainly fish oil (n=24), ginseng (n=10), magnesium (n=14), multivitamins (n=9) and artichoke (n=9). The remaining products were consumed as powder (n=60, 10.5%) or liquid (n=19, 3.3%) and cannabis was consumed mainly by inhalation (n=16, 2.8%).

CAM frequency of use was daily in 164 (28.6%) cases, weekly in 138 (24.0%) and monthly or with a lower frequency in the other cases (n=270, 47.2%).

A total number of 419 (73.0%) CAM products were consumed as self-medication, and naturopaths were the most frequent prescribers. Only about 1% of CAMs were recommended by doctors or pharmacists. CAMs were commonly purchased in herbal remedy shops or supermarkets.

Reasons for consuming CAM and patients’ safety beliefs

The ‘improvement of well-being’ was the main reason described by CAM consumers for using these products in 26.4% of patients. Other reasons included obtaining HIV specific benefits (11.4%), alleviation of ART side effects (8.1%), liver protection (6.9%) or lowering cholesterol blood levels (6.4%). The specific reasons for consuming CAM and the most used CAM products in each category are described in table 2 .

Reasons for CAM consumption reported by patients and most frequent products consumed for each reason

When asked about the safety of CAM products, 286 (68.1%) patients believed that CAM products were safe, 80 (19.0%) believed that CAM products were not safe, and 54 (12.9%) did not know; 245 (58.3%) patients said that they did not think the consumption of CAM could affect the rest of their medication, 141 (33.6%) patients said that CAM products could affect their other medication, and 34 (8.1) did not know.

According to the University of Liverpool Interactions Database, 15 we identified 50 potential CAM–ART interactions in 43 (20.6%) patients taking CAM. Most of the interactions (n=40; 80%) were classified as clinically significant (‘orange colour’ category) in 34 (79.1%) patients and 10 (20%) were classified as potential weak interaction (‘yellow colour’ category) in 10 patients (23.3%). No contraindicated (‘red colour’ category) CAM–ART interactions were detected. CAM products most frequently involved with a potential significant interaction with the ART were supplements (those containing divalent cations, including multivitamins) (n=11) and garlic (n=7). Potential CAM–ART interactions and severity, number of patients affected and the interaction mechanisms are described in table 3 .

CAM products involved in clinically significant potential interactions (n=40) (‘orange colour’ in Liverpool database) with the ART

In the consulted University of Liverpool Interactions Database, information about potential CAM–ART drug interactions was missing for 68 (79.1%) CAM products. Information about at least one of the consumed CAM products was lacking in 164 patients, representing 78.5% of those patients taking CAM products (n=209). Green, black and red tea (n=146), horsetail (n=21), ginseng (n=19), artichoke (n=14), boldus (n=13), and dandelion (n=10) were the most prevalent CAM products without information about potential interactions.

To our knowledge, this is the first multicenter study exploring the frequency and patterns of CAM use in PLWH taking ART from different Spanish hospitals. Our results show a high frequency of CAM use, with almost 50% of patients consuming at least one product at the time of the interview. We did not find differences in any of the demographic, social or clinical variables compared between consumers and non-consumers except for the antiretroviral regimen. Patients taking integrase inhibitors had a 50% higher risk of CAM consumption, a fact probably related to the low interaction risk of this ART regimens.

Green, black and red tea, fish oil and ginger were the most consumed products. CAMs were consumed in infusions in almost half of patients taking any CAM. Reasons for consuming were to promote health or improve quality of life in a quarter of patients, while other reasons were less frequently described.

Previous studies evaluating CAM use in PLWH showed heterogeneous data due to a wide range of prevalence of consumption and a frequency of use higher and lower than the one reported in this study (50%). However, direct comparisons between studies are difficult because of methodological differences such as different CAM definitions or the time period considered for CAM consumption. 2–4 11 16 The study by Moltó et al included a Spanish cohort of 1000 PLWH and observed that 58% and a third of patients had used CAM and herbal remedies within the previous year, respectively. 13 This slightly higher frequency may be explained by the fact that they included complementary treatments such as homeopathy or acupuncture that were excluded in our study. The use of herbal medicines was more frequent in our cohort, which could be related to the global increase in the consumption of these products during the last decades. 17 18

Considering the patients’ characteristics, the only factor associated with CAM use was the class of ART. More patients in the CAM consumers group were receiving an integrase inhibitor, a fact probably related to low potential risk of interactions of this family. 19 In contrast, other studies have found an association between CAM consumption and a higher degree of education or ethnicity. 13 17

Different types of tea were the most consumed CAM, accounting for the 25% of the total 572 reported CAM products. Tea is one of the most popular beverages worldwide and it can be consumed as green, black or oolong (red) tea depending on the different degrees of fermentation of the leaves of Camellia sinensis . 20 The other most consumed CAMs were fish oil (omega-3), ginger, cannabis, horsetail, curcuma or aloe vera. Some of these products, mainly garlic, ginseng, echinacea, boldus or cannabis, have also been reported as the most consumed products in previous experiences. 5 13 21

Half of the CAM products were taken as infusions followed by tablets or capsules. This information may be important because the risk of interactions or toxicity is different. For example, drinking green tea has not been associated with liver injury or serum aminotransferase elevations, but green tea extract has been raised as a well-established potential cause of hepatotoxicity. 22

Most CAM products were administered as self-medication, which highlights the need for an ongoing medication review in these patients by asking them directly to report all products taken, including CAM. It has been described that between 50–80% of PLWH do not report their self-medication to their physicians, which may increase the risk of adverse effects or DDIs. 4 6

An important finding of this study is that 16% of patients taking CAMs were at risk of presenting a clinically significant interaction with their ART. Nevertheless, ART efficacy and adherence do not seem to be influenced by CAM consumption because high efficacy rates were observed between both groups. All detected interactions were classified as low/moderate severity. However, some patients were taking products with a high risk of severe interaction such as St John’s wort, some forms of garlic, or red rice yeast. These products may significantly interact with some ART and a concomitant administration should be avoided or, if necessary, given with caution. 6 15 As an example, one patient in our cohort was taking red yeast rice which contains monacolin K, a structural analogue of lovastatin; thus, its administration is not recommended in patients taking HIV protease inhibitors or elvitegravir/cobicistat due to the increase in the risk of myopathy. 15 23 However, ART of this patient comprised etravirine and abacavir/lamivudine, so no interaction was present.

Regarding patients’ beliefs, most of them consider CAM products to be safe and only a third were aware of the possibility of a potential interaction between CAM products and their pharmacological treatment. These results reflect the need to provide adequate information to patients including safety issues and potential drug interactions related to CAM consumption.

Our study has some limitations. It is focused on the prevalence of CAM consumption in patients receiving ART that were already being followed by a multidisciplinary team, which could have influenced the low prevalence of CAM–ART interactions and absence of contraindicated interactions. Besides, unlike other studies, 3 4 13 21 we considered both herbal medicine and food supplements as CAMs and other therapies, such as homeopathy, acupuncture, prayer or meditation, were not included, which makes it difficult to compare results between studies.

In conclusion, a high proportion of patients of our cohort were taking at least one CAM product, herbal medicines being the most common. CAM use was more frequent in patients receiving integrase inhibitors. One out of every six patients was at risk of presenting with an interaction between a CAM and the ART. These findings confirm the need to continuously review the use of CAM as part of the medication review process. All drugs, herbal medicine and food supplements should be identified, documented in the electronic medical records, and both potential adverse effects and CAM–drug interactions ruled out to optimise ART.

Ethics statements

Patient consent for publication.

Consent obtained directly from patient(s)

Ethics approval

This study involves human participants and was approved by the Ethics Committee Hospital del Mar (2017/7731/I). Participants gave informed consent to participate in the study before taking part.

• ↵ Collection development guidelines of the National Library of Medicine . Complementary and Alternative Medicine , 2018 . Available : https://www.ncbi.nlm.nih.gov/books/NBK518811
• Josephs JS ,
• Fleishman JA ,
• Gaist P , et al
• Arnsten JH ,
• Klein RS , et al
• Montaner JSG , et al
• Leguelinel-Blache G ,
• Lavigne J-P , et al
• Sparber A ,
• Wootton JC ,
• Bauer L , et al
• Agnoletto V ,
• Chiaffarino F ,
• Nasta P , et al
• Dobalian A ,
• Myers CD , et al
• Sánchez M ,
• González-Burgos E ,
• Iglesias I , et al
• Miranda C ,
• Malo S , et al
• Margusino-Framiñán L ,
• Cid-Silva P ,
• Martínez-Roca C , et al
• University of Liverpool
• Ladenheim D ,
• Werneke U , et al
• Rashrash M ,
• Schommer JC ,
• Strassl RP ,
• Friehs H , et al
• Scarsi KK ,
• Havens JP ,
• Podany AT , et al
• Kamboh AA , et al
• Standish LJ ,
• Greene KB ,
• Bain S , et al
• ↵ Livertox . Green Tea ; 2020 . Available : https://www.ncbi.nlm.nih.gov/books/NBK547925/
• Farkouh A ,
• Baumgärtel C

Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1
• Data supplement 2

EAHP Statement 4: Clinical Pharmacy Services.

Contributors SL, EC-G, MDA and HK conceived the idea of the project and designed the study. SL and MDA supervised the development of the project. EC-G, MDA, MM, MTMC, GC, DC, MAR, BL, FIT-B, AR and SL recruited patients for the study. SL and EC-G performed the statistical analysis of the results. DFR supervised the findings of this work. SL is guarantor.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests EC-G has received fees from Gilead, Abbvie y Amgen as a speaker. MDA has received fees from VIIV and MDS as a speaker. MM has received compensation for presentations from Janssen-Cilag and Merck Sharp & Dohme, research funding from Gilead Sciences as well as support for attending meetings and/or travel from Janssen-Cilag, ViiV Healthcare and Gilead Sciences. GC has served as a speaker or has received advisory fees from AbbVie, Biogen, Jansen-Cilag, MSD, Pfizer and UCB. SL has received fees from Pfizer, Shionogi, Angelini and Advanz Pharma as a speaker and participant in advisory board meetings. Other authors declare no conflicts of interest

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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Band 7+: Currently there is a trend towards the use of alternative forms of medicine. However, at best these methods are ineffective , and at worst they may be dangerous. To what extend do you agree with statement ?

The growing popularity of using different forms of medicine for treating ailments has become a topic of discussion. Experts argued that this new trend of drugs may not cure disease or might be detrimental to human life. I strongly concur with this view, and my reasoning is outlined below.

One of the most compelling arguments in favor of this stance is that there is a lack of required research on this kind of treatment. For instance, in the rural part of India, some ayurvedic doctors use medicinal leaves such as tulsi or neem to cure skin diseases. Research has shown that the collaboration of these two leaves exhales a gas that is harmful for the liver, and the constant exposure might damage the organ permanently. Thus, people should be careful with the side effects of these traditional aids, as they can be dangerous.

Another argument in support of my view is that it takes a long time for healing, yet there is no certainty that the illness will be healed, such as homeopathy. In this case, the process of treatment sometimes takes six months to recover from sickness. However, after a year, an individual can start seeing the symptoms again. According to the research done by American scientist’s, homeopathic medicines only suppress the symptoms of illness for a short period of time, and then the problem resurfaces. Therefore, this alternative form of curing diseases has proved ineffective many times.

In conclusion, one should not run behind the trend of using other means of medical treatment blindly. These remedies are not fully researched, resulting in life-threatening side effects. Moreover, there is always a chance of a recurrence of sickness, as the problem is not well cured by these kinds of medicines.

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