The use of complementary and alternative medicine by adults with allergies: a Czech national representative survey

Background: The prevalence rates of the use of Complementary and Alternative Medicine (CAM) in allergy patients range from 42% in the United States up to 50% in Europe. In the Czech Republic, no such data exists. Our aim was to examine patterns in CAM use in populations with self-reported allergies in the Czech Republic. Methods: A cross-sectional survey was conducted. A sample of citizens aged 15 years and older, sex, age, and region-stratified, was randomly selected from the 2014 voter registration lists (n = 8,395,132). Respondents with self-reported allergies were further analyzed. Results: Overall, 93% of the respondents with self-reported allergies reported the use of 1 or more CAM modalities during the past 30 days. Herbal teas, relaxation techniques, a detoxifying diet, dietary supplements (excluding vitamins and minerals), and reflexology were used in respondents with allergies. Females, under age 30, with higher education, higher income, and self-reported poor health, were significantly associated with the use of CAM among respondents with allergies. Conclusions: The prevalence of CAM use among people with self-reported allergies in the Czech Republic is higher compared to other countries, with determinants of CAM varying across specific CAM categories. More attention to existing use is needed to promote the healthy adoption of CAM by raising awareness of its safe and effective use, both for CAM users as well as for health care providers

Economic analysis of acupuncture for migraine prophylaxis

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 €696 vs €285 after 3 months of acupuncture and €66 vs €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

Comparison of attitudes, beliefs, and resource-seeking behavior for CAM among first- and third-year Czech pharmacy students.

To assess and compare first- and third-year Czech pharmacy students' attitudes toward CAM, CAM use, CAM evidence, recommending CAM to patients, and including CAM in the pharmacy curricula.The CAM Health Belief Questionnaire (CHBQ) was translated from English to Czech and administered to 250 first-year and 187 third-year students.The students' mean CHBQ score was 48.5, affirming positive attitudes toward CAM. Vitamins, herbs, massage, and relaxation were the most commonly used therapies among students. Czech students reported significantly low use of evidence-based resources on CAM. Ninety percent of the pharmacy students surveyed would recommend CAM and 89% believed pharmacists should be knowledgeable of CAM. Ninety-one percent of first-year vs 78% of third-year students supported CAM education (p = 0.01).Czech students have positive attitudes about CAM, but are less likely to access evidence-based information. They agree pharmacists should be educated about CAM

Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase(®)

INTRODUCTION Herbal medicines are used worldwide and with an increasing popularity in Western countries. Although often perceived as 'naturally safe', herbals may cause severe adverse drug reactions (ADRs), with immediate allergic reactions being particularly life threatening. OBJECTIVES The aim of this study was to analyse immediate allergy-like ADRs to herbals documented in VigiBase(®), the WHO international pharmacovigilance database. METHODS The documentation of all suspected ADRs in association with herbal exposure reported to VigiBase(®) from 1969 to August 2014 was retrieved. Among all reports in which WHO-ART reaction terms were indicative of acute allergic reactions, those classified as 'suspect' with a documented causality assessment and latency time of ≤1 day were selected. For the most frequent specific herbal-ADR combinations, the information component (IC) as a measure of disproportionality based on Bayesian statistics was calculated. RESULTS We identified 757 reports out of 1039 ADRs. Products with mixed herbals (36.0 %) as well as those administered orally (63.2 %) were predominant. The most frequent reactions were urticaria and rash (49.2 %). Anaphylactic reactions accounted for 9.5 %. Disproportionally frequent reporting of mouth edema (IC = 1.81) and anaphylactic reactions (IC = 1.24) to Phleum pretense were noted. CONCLUSION Our findings indicate that herbal medicines for oral use carry a risk of causing immediate allergy-like ADRs. Studies using the Vigibase(®) database can identify specific combinations of particular herbs and adverse reactions. Healthcare professionals and patients should be aware of these risks and report any serious adverse experiences

Effect of expectation on short- and long-term treatment response to Acupuncture in migraine patients

Introduction: There are relatively few studies addressing the relationship between the patient's expectation and the short and long-term response to treatment with acupuncture. The aim of this study was to assess the association between pre- and post-treatment expectation of acupuncture and post-treatment and post-follow-up patient outcomes. Methods: This was an open-label, randomized controlled clinical trial conducted at the Czech-Chinese Centre for Traditional Chinese Medicine at the University Hospital Hradec Kralove between October 2015 and April 2017. Non-specific factors were examined in the intervention arm using regression analysis. Results: Post-treatment positive expectation concerning the success of the treatment, as well as the affective status of the patient, is one of the most significant nonspecific factors contributing to an increased post-treatment effectiveness of acupuncture; however, this positive expectation decreased with time. On the other hand, the post-follow-up effect of acupuncture was significantly improved by the patients’ positive perception of the TCM practitioner. Conclusions: Correct calibration of a patient's expectation, good mental status, and patients' perceptions of an acupuncturist's skills reduced the number of migraine days in patients treated with acupuncture. Understanding non-specific treatment effects can potentially help clinicians to integrate them in to practice and thus optimise treatment effectiveness. Future research is needed to clarify whether interventions targeting modifiable non-specific factors prior to and during acupuncture treatment can result in better patient outcomes and future cost-savings.</p