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      Complementary and Alternative Medicine Use and Its Association with Emotional Status and Quality of Life in Patients with a Solid Tumor: A Cross-Sectional Study

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          Abstract

          Objectives: Complementary and alternative medicine (CAM) has been used widely in various populations for various purposes, including emotional support and improvement of quality of life (QOL). However, CAM use and purposes for using CAM are less clear among Korean patients with a solid tumor. The purpose of this study was to determine the prevalence and type of CAM use, and the association between CAM use and anxiety, depression, and QOL in patients with a solid tumor.

          Design: A cross-sectional survey.

          Setting: A cancer center in Korea.

          Subjects: Two hundred and sixteen patients diagnosed with a solid tumor.

          Outcome measures: Standard questionnaires on CAM use, Hospital Anxiety and Depression Scale, and European Organization for Research and Treatment of Cancer QLQ-C30.

          Results: One hundred thirty one patients (60.6%) reported using CAM. CAM users, compared with non-CAM users, were significantly younger (57.8 vs. 60.9 years, p = 0.05), had higher level of education ( p = 0.008), had higher income ( p = 0.008), were less likely to seek physician consultation on CAM use ( p = 0.002), and had a more advanced stage of tumor ( p = 0.003) with more distant metastasis ( p = 0.001). The most commonly used CAM was herbal medicine ( n = 89, 67.9%). CAM users had significantly lower anxiety ( t = 5.21, p < 0.001) and depression ( t = 4.90, p < 0.001) than non-CAM users. When the effects of CAM use were tested on anxiety, depression, and QOL, controlling for covariates, CAM use was significantly associated with 8.7% and 8.8% of variance in decreasing anxiety and depression, but there was no unique association of CAM use with variance in QOL.

          Conclusions: CAM use is prevalent and younger age, higher education levels, higher income, less physician consultation, and higher cancer stage are significant correlates to CAM use. Controlling for covariates (e.g., gender, BMI), CAM use is significantly associated with lower anxiety and depression compared with those of non-CAM users.

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          Unconventional medicine in the United States. Prevalence, costs, and patterns of use.

          D M Eisenberg, R C Kessler, C. Foster … (1993)
          Many people use unconventional therapies for health problems, but the extent of this use and the costs are not known. We conducted a national survey to determine the prevalence, costs, and patterns of use of unconventional therapies, such as acupuncture and chiropractic. We limited the therapies studied to 16 commonly used interventions neither taught widely in U.S. medical schools nor generally available in U.S. hospitals. We completed telephone interviews with 1539 adults (response rate, 67 percent) in a national sample of adults 18 years of age or older in 1990. We asked respondents to report any serious or bothersome medical conditions and details of their use of conventional medical services; we then inquired about their use of unconventional therapy. One in three respondents (34 percent) reported using at least one unconventional therapy in the past year, and a third of these saw providers for unconventional therapy. The latter group had made an average of 19 visits to such providers during the preceding year, with an average charge per visit of $27.60. The frequency of use of unconventional therapy varied somewhat among socio-demographic groups, with the highest use reported by nonblack persons from 25 to 49 years of age who had relatively more education and higher incomes. The majority used unconventional therapy for chronic, as opposed to life-threatening, medical conditions. Among those who used unconventional therapy for serious medical conditions, the vast majority (83 percent) also sought treatment for the same condition from a medical doctor; however, 72 percent of the respondents who used unconventional therapy did not inform their medical doctor that they had done so. Extrapolation to the U.S. population suggests that in 1990 Americans made an estimated 425 million visits to providers of unconventional therapy. This number exceeds the number of visits to all U.S. primary care physicians (388 million). Expenditures associated with use of unconventional therapy in 1990 amounted to approximately $13.7 billion, three quarters of which ($10.3 billion) was paid out of pocket. This figure is comparable to the $12.8 billion spent out of pocket annually for all hospitalizations in the United States. The frequency of use of unconventional therapy in the United States is far higher than previously reported. Medical doctors should ask about their patients' use of unconventional therapy whenever they obtain a medical history.
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            Complementary and alternative medicine use among adults: United States, 2002

            Patricia Barnes, Eve Powell-Griner, Kim McFann … (2004)
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              The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis.

              Robert Zachariae, Jacob Piet, Hanne Würtzen (2012)
              The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and survivors. Electronic databases were searched, and researchers were contacted for further relevant studies. Twenty-two independent studies with a total of 1,403 participants were included. Studies were coded for quality (range: 0-4), and overall effect size analyses were performed separately for nonrandomized studies (K = 13, n = 448) and randomized controlled trials (RCTs; K = 9, n = 955). Effect sizes were combined using the random-effects model. In the aggregated sample of nonrandomized studies (average quality score: 0.5), MBT was associated with significantly reduced symptoms of anxiety and depression from pre- to posttreatment corresponding to moderate effect sizes (Hedges\'s g) of 0.60 and 0.42, respectively. The pooled controlled effect sizes (Hedges\'s g) of RCTs (average quality score: 2.9) were 0.37 for anxiety symptoms (p < .001) and 0.44 for symptoms of depression (p < .001). These effect sizes appeared robust. Furthermore, in RCTs, MBT significantly improved mindfulness skills (Hedges\'s g = 0.39). While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression.
              Article 0 comments Cited 141 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Altern Complement Med
                Journal ID (iso-abbrev): J Altern Complement Med
                Journal ID (publisher-id): acm
                Title: Journal of Alternative and Complementary Medicine
                Publisher: Mary Ann Liebert, Inc. (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
                ISSN (Print): 1075-5535
                ISSN (Electronic): 1557-7708
                Publication date (Print): 01 May 2017
                Publication date (Electronic): 01 May 2017
                Publication date PMC-release: 01 May 2017
                Volume: 23
                Issue: 5
                Pages: 362-369
                Affiliations
                [ 1 ]School of Nursing, The University of Texas Health Science Center at Houston , Houston, TX.
                [ 2 ]School of Medicine, Pusan National University, and Biomedical Research Institute, Pusan National University Hospital , Busan, South Korea.
                Author notes
                [†]

                Deceased.

                Address correspondence to: Dong Uk Kim, PhD, MD, Department of Internal Medicine, Pusan National University Hospital 1-10 Ami-dong, Seo-gu, Busan 602-739, South Korea

                E-mail: amlm374@ 123456yahoo.co.kr
                Article
                Publisher ID: 10.1089/acm.2016.0289
                DOI: 10.1089/acm.2016.0289
                PMC ID: 5446597
                PubMed ID: 28453297
                SO-VID: 0c8af962-8871-492d-a8b5-09fd028c0f47
                Copyright © © Aelee Jang et al. 2017; Published by Mary Ann Liebert, Inc.
                License:

                This article is available under the Creative Commons License CC-BY-NC http://creativecommons.org/licenses/by-nc/4.0. This license permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited. Permission only needs to be obtained for commercial use and can be done via RightsLink.

                History
                Page count
                Tables: 5, References: 56, Pages: 8
                Categories
                Subject: Original Articles

                Keywords: complementary and alternative medicine,cancer,herbal medicine,anxiety,depression,quality of life
                Data availability:
                Keywords: complementary and alternative medicine, cancer, herbal medicine, anxiety, depression, quality of life

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