Abstract
Background: Use of complementary and alternative medicine (CAM) is increasingly prevalent among patients with inflammatory bowel disease (IBD). We sought to characterize the practices and attitudes of IBD physician providers toward CAM.
Methods: A web-based survey was sent to non-trainee physician members of the American Gastroenterological Association with an interest in IBD. The survey included multiple-choice and Likert scale questions which queried physician perceptions of CAM and their willingness to discuss CAM with patients.
Results: The vast majority of respondents (80%) considered themselves IBD subspecialists with 75% holding academic appointments. Nearly a third reported initiating conversations on CAM in the majority of their patient interactions, while 90% perceived that a majority of their patients were reluctant to bring up the topic of CAM. Nearly three quarters (72%) of respondents felt comfortable discussing CAM, while those that did not most frequently cited lack of knowledge as the reason. More than half (55%) stated they had no systematic approach to discussing CAM. Most gastroenterologists (65%) reported no formal training in CAM. Most gastroenterologists had recommended use of probiotics, and nearly half had recommended acupuncture. A vast majority believed that there was adjunctive role for CAM in treatment of IBD.
Conclusions: Academic IBD specialists were receptive to the use of CAM, and most felt that it had a role in the treatment of IBD, without necessarily compromising conventional therapy. Formal educational initiatives and societal recommendations on the use of CAM may facilitate a more systematic approach to its use in daily practice.
Acknowledgments
This study was supported by an operating grant from the Canadian Institutes of Health Research (CIHR) and the Canadian Association of Gastroenterology (CAG). G.C.N. is a recipient of New Investigator Awards by CIHR, CAG, and the Canadian Crohn’s and Colitis Foundation of Canada.
Author contributions: Z.G. developed and implemented the study survey and drafted the manuscript. G.C.N. conceived and supervised the study, obtained funding, and contributed to major revisions of the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. HeuschkelR, AfzalN, WuerthA, ZurakowskiD, LeichtnerA, KemperK, et al. Complementary medicine use in children and young adults with inflammatory bowel disease. Am J Gastroenterol2002;97:382–8.10.1111/j.1572-0241.2002.05474.xSuche in Google Scholar
2. EisenbergDM, DavisRB, EttnerSL, AppelS, WilkeyS, Van RompayM, et al. Trends in alternative medicine use in the united states, 1990-1997: results of a follow-up national survey. J Am Med Assoc1998;280:1569–75.10.1001/jama.280.18.1569Suche in Google Scholar
3. KesslerRC, DavisRB, FosterDF, Van RompayMI, WaltersEE, WilkeySA, et al. Long-term trends in the use of complementary and alternative medical therapies in the united states. Ann Intern Med2001;135:262–8.10.7326/0003-4819-135-4-200108210-00011Suche in Google Scholar
4. LimdiJK, ButcherRO. Complementary and alternative medicine use in inflammatory bowel disease. Inflamm Bowel Dis2011;17:E86–8.10.1002/ibd.21748Suche in Google Scholar
5. JoosS, RosemannT, SzecsenyiJ, HahnEG, WillichSN, BrinkhausB. Use of complementary and alternative medicine in Germany – a survey of patients with inflammatory bowel disease. BMC Complement Altern Med2006;6:19.10.1186/1472-6882-6-19Suche in Google Scholar
6. HilsdenR. Complementary and alternative medicine use by Canadian patients with inflammatory bowel disease: results from a national survey. Am J Gastroenterol2003;98:1563–8.10.1111/j.1572-0241.2003.07519.xSuche in Google Scholar
7. WeizmanAV, AhnE, ThanabalanR, LeungW, CroitoruK, SilverbergMS, et al. Characterisation of complementary and alternative medicine use and its impact on medication adherence in inflammatory bowel disease. Aliment Pharmacol Ther2011;35:342–9.10.1111/j.1365-2036.2011.04956.xSuche in Google Scholar
8. GanguliSC, CawdronR, IrvineEJ. Alternative medicine use by Canadian ambulatory gastroenterology patients: secular trend or epidemic?Am J Gastroenterol2004;99:319–26.10.1111/j.1572-0241.2004.04046.xSuche in Google Scholar
9. LangmeadL, RamptonD. Review article: complementary and alternative therapies for inflammatory bowel disease. Aliment Pharmacol Ther2006;23:341–9.10.1111/j.1365-2036.2006.02761.xSuche in Google Scholar
10. MoserG, TillingerW, SachsG, Maier-DobersbergerT, WyattJ, VogelsangH, et al. Relationship between the use of unconventional therapies and disease-related concerns: a study of patients with inflammatory bowel disease. J Psychosom Res1996;40:503–9.10.1016/0022-3999(95)00581-1Suche in Google Scholar
11. KelwalaS. Why patients use alternative medicine. J Am Med Assoc1998;280:1660–1.10.1001/jama.280.19.1659-aSuche in Google Scholar
12. HilsdenRJ, VerhoefMJ. Complementary and alternative medicine: evaluating its effectiveness in inflammatory bowel disease. Inflamm Bowel Dis1998;4:318–23.10.1097/00054725-199811000-00010Suche in Google Scholar
13. BarnesJ. Pharmacovigilance of herbal medicines. Drug Saf2003;26:829–51.10.2165/00002018-200326120-00001Suche in Google Scholar
14. NiggemannB, GrüberC. Side-effects of complementary and alternative medicine. Allergy2003;58:707–16.10.1034/j.1398-9995.2003.00219.xSuche in Google Scholar
15. WetzelMS, KaptchukTJ, HaramatiA, EisenbergDM. Complementary and alternative medical therapies: implications for medical education. Ann Intern Med2003;138:191–6.10.7326/0003-4819-138-3-200302040-00011Suche in Google Scholar
16. HilsdenRJ, VerhoefMJ, RasmussenH, PorcinoA, DeBruynJC. Use of complementary and alternative medicine by patients with inflammatory bowel disease. Inflamm Bowel Dis2011;17:655–62.10.1002/ibd.21360Suche in Google Scholar
17. EisenbergDM, KesslerRC, FosterC, NorlockFE, CalkinsDR, DelbancoTL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med1993;328:246–52.10.1056/NEJM199301283280406Suche in Google Scholar
18. TasakiK, MaskarinecG, ShumayDM, TatsumuraY, KakaiH. Communication between physicians and cancer patients about complementary and alternative medicine: exploring patients’ perspectives. Psychooncology2002;11:212–20.10.1002/pon.552Suche in Google Scholar
19. KoretzRL, RotblattM. Complementary and alternative medicine in gastroenterology: the good, the bad, and the ugly. Clin Gastroenterol Hepatol2004;2:957–67.10.1016/S1542-3565(04)00461-6Suche in Google Scholar
20. GolnikAE, IrelandM. Complementary therapy medicine for children with autism: a physician survey. J Autism Dev Disord2009;39:996–1005.10.1007/s10803-009-0714-7Suche in Google Scholar PubMed
21. O’BeirneM, VerhoefM, PaluckE, HerbertC. Complementary therapy use by cancer patients. Physicians’ perceptions, attitudes, and ideas. Can Fam Physician2004;50:882–8.Suche in Google Scholar
22. ShanahanF. Probiotics and inflammatory bowel disease: is there a scientific rationale?Inflamm Bowel Dis2000;6:107–15.10.1097/00054725-200005000-00007Suche in Google Scholar PubMed
23. KruisW. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut2004;53:1617–23.10.1136/gut.2003.037747Suche in Google Scholar PubMed PubMed Central
24. DurberJ, OtleyA. Complementary and alternative medicine in inflammatory bowel disease: keeping an open mind. Expert Rev Clin Immunol2005;1:277–92.10.1586/1744666X.1.2.277Suche in Google Scholar PubMed
25. ErnstE, ShermanKJ. Is acupuncture a risk factor for hepatitis? Systematic review of epidemiological studies. J Gastroenterol Hepatol2003;18:1231–6.10.1046/j.1440-1746.2003.03135.xSuche in Google Scholar PubMed
26. MahaN, ShawA. Academic doctors’ views of complementary and alternative medicine (CAM) and its role within the NHS: an exploratory qualitative study. BMC Complement Altern Med2007;7:17.10.1186/1472-6882-7-17Suche in Google Scholar PubMed PubMed Central
©2014 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Review
- Phytodentistry: use of medicinal plants
- Preclinical Studies
- The effect of hydroalcoholic extract of Cannabis Sativa on appetite hormone in rat
- Hypolipidaemic and haematological evaluation of the hydromethanolic extract of Ficus glumosa stem bark in alloxan-induced diabetic rats
- A study to investigate the biological activity of proteoglycan mixture extract from Convolvulus arvensis
- Some biochemical and haematological changes in rats pretreated with aqueous stem bark extract of Lophira lanceolata and intoxicated with paracetamol (acetaminophen)
- Clinical Studies
- Tai Chi and meditation-plus-exercise benefit neural substrates of executive function: a cross-sectional, controlled study
- A preliminary comparison of primary care use by refugees before and after acupuncture
- Practices and attitudes toward complementary and alternative medicine in inflammatory bowel disease: a survey of gastroenterologists
Artikel in diesem Heft
- Frontmatter
- Review
- Phytodentistry: use of medicinal plants
- Preclinical Studies
- The effect of hydroalcoholic extract of Cannabis Sativa on appetite hormone in rat
- Hypolipidaemic and haematological evaluation of the hydromethanolic extract of Ficus glumosa stem bark in alloxan-induced diabetic rats
- A study to investigate the biological activity of proteoglycan mixture extract from Convolvulus arvensis
- Some biochemical and haematological changes in rats pretreated with aqueous stem bark extract of Lophira lanceolata and intoxicated with paracetamol (acetaminophen)
- Clinical Studies
- Tai Chi and meditation-plus-exercise benefit neural substrates of executive function: a cross-sectional, controlled study
- A preliminary comparison of primary care use by refugees before and after acupuncture
- Practices and attitudes toward complementary and alternative medicine in inflammatory bowel disease: a survey of gastroenterologists