BackgroundCancer is a major disease worldwide, and many patients use complementary and alternative treatments. The purpose of this study was to identify the herbal remedies and functional foods used as complementary medicine by prostate, breast and colorectal cancer patients at speciality care facilities in Trinidad. We also sought to determine how patients rated the efficacy of these modalities compared with conventional treatment.MethodsA descriptive, cross-sectional survey was conducted using an interviewer-administered pilot-tested de novo questionnaire during the period June to August 2012 at two speciality treatment centres on the island. Data was analysed using χ2 analyses.ResultsAmong the 150 patients who reported use of herbal remedies/functional foods, soursop (Annona muricata L.) was the most popular; with 80.7 % using the leaves, bark, fruit and seeds on a regular basis. Other common herbal remedies/functional foods included wheatgrass (Triticum aestivum L.), saffron (Crocus sativus L.) and Aloe vera (L.) Burm. f. The most commonly used functional foods were beetroot (Beta vulgaris L.), carrots (Daucus carata L.) and papaya (Carica papaya L.) used by 43.3 % of patients; and these were mostly blended as a mixture. Herbal remedies and functional foods were used on a daily basis and patients believed that this modality was equally (32.0 %) or more efficacious (14.7 %) than conventional treatment.ConclusionsThis survey identified the most common herbal remedies and functional foods used among prostate, breast and colorectal cancer patients in Trinidad. Although functional foods rarely pose a problem, herbs may interact with conventional chemotherapy and physicians need to inform patients regarding probable herb-drug interactions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1380-x) contains supplementary material, which is available to authorized users.

Objectives This novel, pilot study aimed to assess the estimated prevalence of high on-treatment platelet reactivity (HPR) in Trinidad and Tobago.MethodsPatients (n=40) who were awaiting elective percutaneous coronary intervention on maintenance dual antiplatelet therapy (DAPT) with aspirin 81 mg daily and clopidogrel 75 mg or loaded at least 48 hours prior were recruited. Platelet reactivity with the VerifyNow P2Y12 assay (Accriva Diagnostics, San Diego, California, USA) was assessed prior to cardiac catheterisation.Results60.7% (17/28) of the South Asian (Indo-Trinidadians) patients had HPR, whereas 14.3% (1/7) of Africans and 40% (2/5) of mixed ethnicity had HPR. There was a significant association between HPR (P2Y12 reaction units >208) and ethnicity with South Asians (Indo-Trinidadians) (OR 5.4; 95% CI 1.18 to 24.66, p=0.029).ConclusionsThis pilot study serves to introduce the preliminary observation that the estimated prevalence of HPR is considerably higher within the heterogeneous population in Trinidad at 50% as compared with predominantly Caucasian studies. Furthermore, the HPR is significantly higher in South Asians (Indo-Trinidadians) (>60% of patients) which has severe clinical repercussions considering the cardiovascular disease pandemic. Clopidogrel may not be a satisfactory or optimal antiplatelet agent in this subgroup, and therefore, another more potent antiplatelet such as ticagrelor should be used instead. Further large-scale studies are imperative to confirm these findings. (Funded by the University of the West Indies, St. Augustine; POINT ClinicalTrials.gov number, NCT03667066.)

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Background: This study aims to quantitatively estimate the level of cardiovascular medication adherence in Trinidad’s public health sector and to determine any correlating factors. The study was of a descriptive, cross-sectional design which was performed at a cardiology outpatient clinic located at a northern-central public health care tertiary hospital in Trinidad during the period November 2016 to June 2017. Methods: 595 persons in total were asked to participate, of whom, 535 agreed. Patients that were younger under the age of 18 years and those that declined participation were excluded from the study. Primary endpoints were the percentages of low, medium and high cardiovascular medication adherence. Secondary endpoints were the comorbidity prevalence rates and prevalence of cardiovascular medications prescribed to patients. Results: In total, 595 individuals were asked to participate in the study; of whom, 535 agreed with a resultant 90% response rate. The mean age of the sample population was 63.5 years. Approximately half of the respondents were females and over 75% had only primary and secondary level of education combined as well as a monthly income of <$5,000 Trinidad and Tobago dollars (TTD). Almost 75% of study participants had low and medium adherence levels, and conversely a little more than one-quarter had high adherence levels. There were no significant associations between adherence and any other demographic factor, however there was near-significance with respect to adherence and level of education (p= 0.061). Conclusions: Patients generally displayed a limited level of cardiovascular medication adherence which is likely to translate into a higher rate of cardiovascular events with their potentially devastating sequalae. This study underscores the imperative need of implementing comprehensive interventions to accentuate cardiovascular medication adherence in Trinidad and Tobago. Further comparable studies with reference national data are required to validate these findings.

The aim of this study was to describe the level and perception of control in severe asthma in Trinidad after the introduction of revised guidelines for asthma management. Adult asthmatics (N = 329) at Trinidad's chest clinics were cross-sectionally examined for guideline-defined disease control. Patients' mean (SD) age was 54.36 (14.9) years, with body mass index = 28.54 (7.4) kg/meter(2), and females were proportionally more (246, 74.74%). Measured (45.29%) and perceived (18.96%) uncontrolled disease were poorly concordant (κ statistic = 0.197). Co-morbidity (≥2 conditions) correlated with uncontrolled disease in 55.80% of patients (Spearman correlation p = 0.03). Absolute peak expiratory flow was higher (p < 0.001) in controlled and/or partially controlled disease than in uncontrolled asthma. Routine work limitation, night-time disturbances, work absenteeism, exacerbations, rescue inhalation and perceived control correlated with uncontrolled asthma (p < 0.001). Few patients self-monitored lung function (9.73%) or kept an asthma diary (6.69%), but 65.1% believed they had to live with their symptoms. The asthma burden was at least one hospitalization (53.80%) and emergency department visit (66.36%) in the past year, cough (74.49%), dyspnoea (84.50%), wheezing (80.55%) and chest tightness (66.87%). After the revised guidelines, uncontrolled asthma and related morbidity remain suboptimal, with disagreeing actual and perceived control. Efforts to transform guidelines into patient care with realistic interpretation of control are recommended.