Rural Australian community pharmacists' views on complementary and alternative medicine: a pilot study

<p>Abstract</p> <p>Background</p> <p>Complementary and alternative medicines (CAMs) are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS) in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study.</p> <p>Methods</p> <p>A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics.</p> <p>Results</p> <p>Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books.</p> <p>Conclusions</p> <p>Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to address the gaps in attitudes, knowledge and to improve effectiveness of information seeking behaviour.</p

Acupuncture in migraine prophylaxis in Czech patients: an open-label randomized controlled trial

Frantisek Musil,1 Jitka Pokladnikova,1,2 Zbysek Pavelek,3 Bo Wang,4 Xin Guan,4 Martin Valis3 1Czech-Chinese Center for Traditional Chinese Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; 2Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic; 3Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; 4Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People&rsquo;s Republic of China Background: Adjuvant acupuncture for the symptomatic treatment of migraine reduces the frequency of headaches and may be at least similarly effective to treatment with prophylactic drugs.Methods: This article describes an open-label randomized controlled clinical trial with two groups: the intervention group (n=42) and the waiting-list control group (n=44). This study occurred at the Czech-Chinese Center for Traditional Chinese Medicine at the University Hospital Hradec Kralove between October 2015 and April 2017.Results: After 12&nbsp;weeks of acupuncture, the number of migraine days was reduced by 5.5 and 2.0&nbsp;days in the acupuncture and the waiting-list control groups, respectively, with a statistically significant inter-group difference of 2.0 migraine days (95% CI: -4 to -1). A significantly greater reduction in the number of migraine days per 4&nbsp;weeks was reached at the end of the 6-month follow-up period in the acupuncture vs. control groups (&Delta; -4.0; 95% CI: -6 to -2). A statistically significant difference was observed in the number of responders to treatment (response defined as at least a 50% reduction in average monthly migraine day frequency) in the acupuncture vs waiting-list control groups (50% vs 27%; p&lt;0.05) at the end of the intervention. A significantly greater percentage of responders to treatment was noted in the intervention vs control groups at the 6-month follow-up (81% vs 36%; p&lt;0.001).Conclusion: Acupuncture can reduce symptoms and medication use, both short term and long term, as an adjuvant treatment in migraine prophylaxis in Czech patients. Keywords: acupuncture, effectiveness, migraine, prophylaxis, Traditional Chinese medicine, treatmen

Economic analysis of acupuncture for migraine prophylaxis

Jitka Pokladnikova,1,2 Petra Maresova,3 Josef Dolejs,3 A-La Park,4 Bo Wang,5 Xin Guan,5&nbsp;Frantisek Musil1 1Czech-Chinese Centre for Traditional Chinese Medicine, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic; 2Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic; 3Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic; 4Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London, UK; 5Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China Background: Acupuncture has become a viable option for migraine prophylaxis in Europe; however, despite its wide use, more data on the short- and long-term cost-effectiveness are needed when considering the perspectives of a paying third-party, the patient, and of society in general. The aim was to evaluate the cost and effectiveness of adjuvant acupuncture to pharmacologic treatment vs pharmacologic treatment alone in migraine patients after a 3-month acupuncture course and a 6-month follow-up from all perspectives.Methods: The study involved an open-label randomized clinical trial of patients receiving acupuncture (n=42), and a waiting list control group (n=44). The number of migraine days during the last 28 days, as well as direct and indirect costs were considered. The trial was registered under DRKS00009803.Results: The total cost per patient reached &euro;696 vs &euro;285 after 3 months of acupuncture and &euro;66 vs &euro;132 in the acupuncture and control groups after a 6-month follow-up, respectively (P=0.071). The trends observed in effectiveness and costs from all perspectives are discussed.Conclusion: The inclusion of acupuncture in health care results beneficial mainly for its observed trend in reduced losses of productivity and income, with the latter often exceeding the costs of acupuncture treatment. As such, acupuncture may be recommended as an adjuvant treatment in migraine prophylaxis to standard pharmacotherapy. Keywords: acupuncture, cost, effectiveness, migraine, prophylaxis, Traditional Chinese Medicin

Knowledge, attitude, influences and use of complementary and alternative medicine (CAM) among chiropractic and nursing students

Background: Complementary and alternative medicine (CAM) is becoming more widely used in the community however there are differences in knowledge and attitudes among and within the various health professions. Chiropractic and nursing students represent a future generation of two health profession groups who may have differing views on CAM. The objectives of this study were to investigate the knowledge, attitudes and beliefs of nursing and chiropractic students about CAM. To investigate the factors that influence their attitudes and beliefs and their likelihood of recommending CAM; and to compare the findings between nursing and chiropractic students to determine similarities and differences. Methods: A modified and pre-tested survey including a previously validated 10-item CAM Health Belief Questionnaire (CHBQ) was administered to nursing and chiropractic students at Murdoch University. Student's demographics were collected as well as other information regarding knowledge, attitudes, influences and use of CAM. Results: Three hundred twenty-one nursing and 227 chiropractic students responded with a 91% response rate. The CHBQ overall mean scores for nursing and chiropractic students were 47.6 and 47.4 out of possible 70 respectively, confirming positive attitudes toward C AM in both groups. Nursing and chiropractic students also demonstrated similar knowledge levels. Factors that were most influential in shaping both chiropractic and nursing students' attitudes and beliefs towards CAM were personal experience and the influence of external peers. Nursing students would not dissuade future patients from CAM, however chiropractic students were more likely to recommend CAM to their future patients. Conclusions: Nursing and chiropractic students demonstrate relatively positive attitudes and beliefs towards CAM despite, their limited knowledge concerning CAM modalities generally. © 2017 The Author(s)

Understanding, perceptions and self-use of complementary and alternative medicine (CAM) among Malaysian pharmacy students

Background: In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia.Methods: This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSSversion 18.Results: Overall, the students tend to disagree that complementary therapies (CM) are a threat to public health (mean score = 3.6) and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7). More than half (57.8%) of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9%) was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM) (21%). Most of the students (74.8%) believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8%) and music therapy (53.8%) to be effective. Majority of them (69.3%) asserted that CAM knowledge is necessary to be a well-rounded professional.Conclusions: This study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit