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      Complementary medicine use among Moroccan patients with cancer: A descriptive study

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          Abstract

          Background

          Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. As cancer incidence rates and survival time increase, use of CAM will likely increase. However, little is known about the use of CAM in cancer patients, specifically in emerging countries.

          Methods

          We conducted a study in the medical oncology department at the University Hospital of Fez on the use of complementary medicine among cancer patient. The aims of this study were to estimate and describe the reasons of use of complementary medicine (CM) in patients with a cancer treated in a Moroccan oncology department. A specially designed questionnaire was completed for patient during treatment or follow-up in the oncology department after formal consent was obtained. It was a descriptive study among 100 patients over a period of 6 months between September 2008 and February 2009.

          Results

          A total of 100 patients participated in the study, 46 of them were identified as users of complementary medicine. The most substances used were plants 24%, pure honey 13% and water of Zem Zem (holy water from Mecca) 11%. Concerning techniques, religious practices 37%, special diets 22% and recourse to traditional healers 11% were most commonly used. No specific user profile was observed depending of different sociodemograhics and clinical parameters. The majority of the users of complementary medicine were not revealing their habits to their oncologist because the question was not raised in consultation.

          Conclusion

          It seems that medical doctors should ask patients about their use of complementary medicine when they obtain medical history and they need to know more about complementary medicine to offer better consultation. Complementary medicine must benefit, as well as conventional medicine, from scientific studies to evaluate potential benefits, toxicity and interactions with the conventional treatment to enable the oncologist better inform his patients.

          Most cited references9

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          Use of complementary and alternative medicine in cancer patients: a European survey.

          The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients across a number of European countries. A descriptive survey design was developed. Fourteen countries participated in the study and data was collected through a descriptive questionnaire from 956 patients. Data suggest that CAM is popular among cancer patients with 35.9% using some form of CAM (range among countries 14.8% to 73.1%). A heterogeneous group of 58 therapies were identified as being used. Herbal medicines and remedies were the most commonly used CAM therapies, together with homeopathy, vitamins/minerals, medicinal teas, spiritual therapies and relaxation techniques. Herbal medicine use tripled from use before diagnosis to use since diagnosis with cancer. Multivariate analysis suggested that the profile of the CAM user was that of younger people, female and with higher educational level. The source of information was mainly from friends/family and the media, while physicians and nurses played a small part in providing CAM-related information. The majority used CAM to increase the body's ability to fight cancer or improve physical and emotional well-being, and many seemed to have benefited from using CAM (even though the benefits were not necessarily related to the initial reason for using CAM). Some 4.4% of patients, however, reported side-effects, mostly transient. It is imperative that health professionals explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
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            Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology.

            Oncologists are aware that their patients use complementary/alternative medicine (CAM). As cancer incidence rates and survival time increase, use of CAM will likely increase. This study assessed the prevalence and predictors of CAM use in a comprehensive cancer center. Subjects were English-speaking cancer patients at least 18 years of age, attending one of eight outpatient clinics at The University of Texas M.D. Anderson Cancer Center, Houston, TX, between December 1997 and June 1998. After giving written informed consent, participants completed a self-administered questionnaire. Differences between CAM users and nonusers were assessed by chi(2) and univariate logistic regression analysis. A multivariate logistic regression model identified the simultaneous impact of demographic, clinical, and treatment variables on CAM use; P values were two-sided. Of the 453 participants (response rate, 51.4%), 99.3% had heard of CAM. Of those, 83.3% had used at least one CAM approach. Use was greatest for spiritual practices (80.5%), vitamins and herbs (62.6%), and movement and physical therapies (59.2%) and predicted (P <.001) by sex (female), younger age, indigent pay status, and surgery. After excluding spiritual practices and psychotherapy, 95.8% of participants were aware of CAM and 68.7% of those had used CAM. Use was predicted (P <.0001) by sex (female), education, and chemotherapy. In most categories, CAM use was common among outpatients. Given the number of patients combining vitamins and herbs with conventional treatments, the oncology community must improve patient-provider communication, offer reliable information to patients, and initiate research to determine possible drug-herb-vitamin interactions.
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              Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions.

              To determine the prevalence of use of complementary/alternative medicine (CAM) by breast cancer survivors in Ontario, Canada, and to compare the characteristics of CAM users and CAM nonusers. A questionnaire was mailed to a random sample of Ontario women diagnosed with breast cancer in 1994 or 1995. The response rate was 76.3%. Overall, 66.7% of the respondents reported using CAM, most often in an attempt to boost the immune system. CAM practitioners (most commonly chiropractors, herbalists, acupuncturists, traditional Chinese medicine practitioners, and/or naturopathic practitioners) were visited by 39.4% of the respondents. In addition, 62.0% reported use of CAM products (most frequently vitamins/minerals, herbal medicines, green tea, special foods, and essiac). Almost one half of the respondents informed their physicians of their use of CAM. Multiple logistic regression analysis determined that support group attendance was the only factor significantly associated with CAM use. CAM use is common among Canadian breast cancer survivors, many of whom are discussing CAM therapy options with their physicians. Knowledge of CAM therapies is necessary for physicians and other health care practitioners to help patients make informed choices. CAM use may play a role in the positive benefits associated with support group attendance.
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                Author and article information

                Journal
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                11 November 2011
                2011
                : 10
                : 36
                Affiliations
                [1 ]Medical Oncology Unit, Hassan II University Hospital, Fez, Morocco
                [2 ]Department of Epidemiology, Hassan II University Hospital, Fez, Morocco
                Author notes
                [& ]Corresponding author: Sami Aziz Brahmi, Medical Oncology Unit, Hassan II University Hospital, Fez, Morocco
                Article
                PAMJ-10-36
                3240925
                22187618
                fe2a949f-eadf-46b9-97a0-fa4fd7d01c69
                © Sami Aziz Brahmi et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 July 2011
                : 22 October 2011
                Categories
                Research

                Medicine
                complementary medicine,cancer,alternative medicine,morocco
                Medicine
                complementary medicine, cancer, alternative medicine, morocco

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