Disclosure and adverse effects of complementary and alternative medicine used by hospitalized patients in the North East of England

Objectives: This study aimed to investigate the prevalence, disclosure and adverse effects of complementary and alternative medicine (CAM) use in hospitalised patients, and to explore the associations between patients’ perceived side-effects and relevant factors. Methods: Patients who were admitted to a district general hospital and met the eligibility criteria were interviewed using a semi-structured questionnaire. Their medications and pertinent details were verified from the medical notes. All quantitative and qualitative data were collated and analysed. A chi-squared test was performed to test the associations of the perceived CAM side-effects with the significance level determined at a=0.05. Results: A total of 240 in-patients completed the study. They were mostly white British (98.8%). The prevalence of CAM use within two years was 74.6% and one month 37.9%. Only 19 of 91 patients (20.9%) using CAM within one month disclosed their current CAM applications. Nearly half of patients (45.8%) who used CAM within two years experienced various CAM side-effects that tended to resolve after discontinuation. Slightly more than half (57.6%) perceived CAM side-effects and their perceptions were significantly associated with gender (P=0.048) and consideration for future CAM use (P=0.033). Potential interactions between herbal remedies/dietary supplements and prescribed drugs, such as garlic with lisinopril or aspirin, were assessed in 82 patients (45.8%). Conclusion: Most in-patients used CAM and experienced some adverse effects. The disclosure of CAM use and its adverse outcomes should be encouraged by healthcare professionals

Use of Alternative medicine by Consumers in Health Shops in the Community and In-Patients in Secondary Healthcare Settings in the North East of England

The term “Alternative Medicine” refers to a diverse group of health-related therapies and disciplines, some of which have existed for thousands of years, which fall outside the domain of mainstream medical care. Although, their use was gaining widespread popularity and there was some research evidence relating to their use in some populations, there were still knowledge gaps. This seemed to be particularly the case for consumers in health shops and patients in secondary healthcare. Therefore the aim of this research programme was to investigate the use of alternative medicine with reference to the pattern of use, attitudes and incidence of adverse outcomes of alternative medicine in these two population settings. The study, limited to the North East of England for practical reasons, was conducted in 14 health shops and comprised primarily of interviews with 130 adult consumers and a self-administered questionnaire survey of 24 health shop staff. The investigation in the secondary care setting included face-to-face interviews with 240 in-patients across five specialty wards of admission in a district general hospital using a semi-structured questionnaire with a review of the patients’ medical notes. In general, the results showed a similar pattern of use of alternative medicine, attitudes and identified possible adverse outcomes of alternative medicine in the two population settings. Amongst the wealth of detailed useful information uncovered, principal findings included establishing that the most common use of alternative medicine was by white females with specific, defined conditions. The users’ background, education and age influenced their use of the products and their perceptions of their effectiveness and safety. The prevalence of use was identified among in-patients in the past, prior to and during admission in hospital. Less than a quarter of the in-patients using alternative medicine at the time of admission in hospital had reported the use to a healthcare professional. Quantitative data showed statistical significance between perceived effectiveness and patients’ past alternative medicine use, consideration of future use, age and gender. Perceived side-effects were not associated with past use, but rather with gender and future use. Taken together these findings significantly closed the knowledge gap on use of alternative medicine in the community and patients in secondary care. As such they will be of benefit to healthcare practitioners, insightful to professionals and a source of primary research evidence when formulating policy. While some further studies might be useful to confirm the generality of some of the findings and to maintain currency as populations and attitudes change, the finding of under-reporting of alternative medicine use is important and has obvious general relevance in the context of patient safety. Improved patient / consumer education on alternative medicine and reporting systems to healthcare professionals would be beneficial