Knowledge, attitudes, and practices among health care providers regarding complementary and alternative medicine in Trinidad and Tobago

Abstract

BackgroundHealth care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use. We explored the knowledge, attitudes, and practices of health care providers regarding CAM.MethodsThis cross-sectional study was conducted between March 1 and July 31, 2015 among health care providers working mainly in the public sector in Trinidad and Tobago. A 34-item questionnaire was distributed and used for data collection. Questionnaire data were analysed using inferential and binary logistic regression models.ResultsResponse rate was 60.3% (362/600). Responders were 172 nurses, 77 doctors, 30 pharmacists, and 83 other health care providers of unnamed categories (mainly nursing assistants). Responders were predominantly female (69.1%), Indo-Trinidadian (55.8%), Christian (47.5%), self-claimed “very religious” (48.3%), and had <5 years of working experience (40.6%). The prevalence of CAM use was 92.4% for nurses, 64.9% for doctors, 83.3% for pharmacists, and 77.1% for other health care providers. The majority (50–75%) reported fair knowledge of herbal, spiritual, alternative, and physical types of CAM, but had no knowledge of energy therapy and therapeutic methods. Sex, ethnicity, and type of health care provider were associated with both personal use and recommendation for the use of CAM. Predictors of CAM use were sex, religion, and type of health care provider; predictors of recommendation for the use of CAM were sex and type of health care provider. About half of health care providers (51.4%) and doctors (52%) were likely to ask their patients about CAM and <15% were likely to refer patients to a CAM practitioner. However, health care providers expressed interest in being educated on the subject. Doctors (51.9%) and pharmacists (63.3%) said that combination therapy is superior to conventional medicine alone. Less than 10% said conventional medicine should be used alone.ConclusionKnowledge about CAM is low among health care providers. The majority engages in using CAM but is reluctant to recommend it. Predictors of CAM use were sex, religion, and profession; predictors of recommendation for the use of CAM were sex and profession. Health care providers feel the future lies in integrative medicine.

Prevalence and Predictors of Complementary and Alternative Medicine (CAM) Use Among Health Workers in Nigeria

“…This to our views is not surprising as the use of acupuncture, chiropractic, spinal manipulation, smart phones and computers among others is not common in Nigeria. The odds of a female using whole-body treatment was thrice that of male (AOR: 3.186, 95% CI: 1.816 -5.620) and this agrees with a study on use of CAM among health workers in Trinidad and Tobago (Bahall & Legall, 2017). Whereas, those between ages 31 -60 were 83% less likely to use whole-body compared to those who were 61 years and above.…”

“…The prevalence of use of manipulative and body-based therapy was 61.4% (207) and from the study, the odds of a health worker of Idoma extraction using a manipulative and body-based therapy was thrice that of a Tiv health worker (AOR: 3.00, 95% CI: 1.318 -6.829). This is not surprising as ethnicity is associated with use of CAM among health workers (Bahall & Legall, 2017). The odds of a CHEW using manipulative and body-based therapies was 10 times that of a Pharmacist while the odds of a Medical Doctor and Nurse were five and four times respectively compared to a Pharmacist.…”

Health‐care providers’ perspectives on traditional and complementary alternative medicine of childhood cancer in Kenya

“…In a previous study at MTRH, most parents confirmed that they had been informed by HCP that most children with cancer will die even after receiving chemotherapy . Doctors, on the other hand, are more optimistic, their attitudes being molded during prolonged evidence‐based medical training . The differences in health beliefs among HCP themselves may serve to retard the parents’ commitment to conventional chemotherapy and lead to treatment abandonment, further escalating the poor outcomes …”

“…21 Doctors, on the other hand, are more optimistic, their attitudes being molded during prolonged evidencebased medical training. [31][32][33] The differences in health beliefs among HCP themselves may serve to retard the parents' commitment to conventional chemotherapy and lead to treatment abandonment, further escalating the poor outcomes. 16,19 Apart from self-prayer, the most commonly used traditional medicine by HCP was herbal medicines, suggesting that lack of access to and affordability of conventional health care are not necessarily the only factors fueling the popularity of TCAM in low-income countries.…”

“…The level of knowledge on TCAM was generally low among all HCP, corroborating studies reporting that physicians are inadequately trained on TCAM. 25,32,42 In Kenya, only biomedicine is formally regulated and is dominant within the national health system. 6…”