Patient activation, self-efficacy and usage of complementary and alternative medicine in cancer patients

Hübner, Jutta; Welter, S.; Ciarlo, Gianluca; Käsmann, Lukas; Ahmadi, Emadaldin; Keinki, Christian

doi:10.1007/s12032-022-01796-8

Cited by 9 publications

(3 citation statements)

References 20 publications

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“…Moreover, the signi cance of patient-physician trust in medication adherence has been welldocumented. Establishing trust fosters a therapeutic relationship characterized by effective communication and the addressing of patient concerns, leading to improved compliance [38][39][40]. Notably, trust in the physician has been identi ed as the strongest predictor of adherence to conventional therapy.…”

Section: Discussionmentioning

confidence: 99%

Association Between Traditional Chinese Medicine and Medication Adherence in Hypertensive Patients in Mainland China: A Real-World Population-Based Cohort Study

Zhou,

Shang,

Bao

et al. 2023

Preprint

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Background: Hypertension and associated CVD are the major public health challenges in China. Medication adherence is the cornerstone for achieving hypertension control and reduce the risk of CVD and mortality. Considering that more and more people have turned on complementary and alternative medicine(CAM) , combined with pharmacotherapy for treating hypertension, including Traditional Chinese Medicine(TCM).However, the relationship between medication adherence and TCM usage remains unknown. This study aimed to assess the association between non-pharmacological therapies of TCM and adherence to anti-hypertensive medication in mainland China. Methods: Data was extracted from the electronic health records of a Chinese medical hospital. A retrospective cohort study was conducted on hypertension patients enrolled between January 2016 and April 2021. Propensity score matching (PSM) was employed, resulting in 1179 patients in the TCM user group and 257 patients in the no TCM user group. Medication possession ratios (MPR) were used to measure medication adherence in the presence or absence of TCM. Generalized estimating equations (GEE) were applied to identify factors associated with adherence, including TCM exposure, age and sex. Results: Medication compliance in the real world was generally low, at approximately 10%. The percentage of TCM exposure among differed significantly between the two groups throughout the follow-up period. The proportions of optimal adherence (MPR≥ 80) and continuous treatment rate showed no significant difference. GEE regression results indicated that TCM visits could improve medication adherence to anti-hypertensive drugs. Subgroup analysis revealed that TCM use had a positive impact on optimal adherence for male patients and patients aged 60 years and above (p<0.05). Conversely, there was no association between TCM use and MPR in female patients. Conclusions: Notably, medication compliance was higher among TCM users compared to no TCM users. TCM exposure appeared to have a positive effect on medication adherence in hypertensive patients, suggesting its potential as a complementary approach to conventional Western drug therapy. This study provides important insights for integrating Chinese and Western medicine to enhance adherence to anti-hypertensive medications.

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Section: Discussionmentioning

confidence: 99%

Association Between Traditional Chinese Medicine and Medication Adherence in Hypertensive Patients in Mainland China: A Real-World Population-Based Cohort Study

Zhou,

Shang,

Bao

et al. 2023

Preprint

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“…Since 2011, we conducted several studies in diverse groups of cancer patients in different settings to learn more on CAM usage. In 12 of these studies, we also had a section asking for assumed causes of cancer (lay etiological concepts) (Huebner et al 2016 , 2014a , b , c ; Loquai et al 2017 ; Bauer et al 2018 ; Dufter et al 2021 ; Paul et al 2013 ; Firkins et al 2018 ; Hübner et al 2022 ; Ebel et al 2015 ; Kleine Wortmann et al 2016 ; Halwas et al 2017 ; Eisfeld et al 2020 ; Welter et al 2021 ; Hoppe et al 2023 ; Ciarlo et al 2021 ). So far, in these smaller studies, we did not find any associations.…”

Section: Introductionmentioning

confidence: 99%

Lay etiology concepts of cancer patients do not correlate with their usage of complementary and/or alternative medicine

Huebner

Muecke²,

Micke³

et al. 2023

J Cancer Res Clin Oncol

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Background The usage of complementary and alternative medicine (CAM) is widespread among cancer patients. While reasons for and aims of using CAM have been evaluated in many studies, less is known about whether patients’ concepts of how and why cancer develops has an influence on the choice of the CAM method. Methods We pooled the data from all studies of our working group containing questions on lay etiological concepts and CAM usage and reanalyzed them with respect to the associations between these parameters. Results The pooled dataset from 12 studies included 4792 patients. A third (1645 patients) reported using CAM. Most often used were supplements (55.9%), relaxation techniques (43.6%), and homeopathy (37.9%). Regarding perceived causes, patients most often marked stress (35.4%) followed by genes (31.9%). While all lay etiological beliefs were highly significantly associated with usage of CAM in general, there was no association between single lay etiological concepts and types of CAM used. Yet, in a network analysis, we found two associations: one comprising trauma, mistletoe, genes, and nutritional supplements, the other yoga, vitamin C, nutritional supplements, and TCM herbs. In the correlation heatmap, one cluster comprises etiological concepts of personality, immune system and trauma, and two clusters of CAM methods emerged: one comprising praying, yoga, meditation, and relaxation procedures, the other nutritional supplements, selenium, vitamins A and C. Conclusion While physicians are trained to derive treatment strategies from etiological concepts, lay people choosing CAM do not follow these rules, which may point to other needs of patients addressed by CAM.

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“…While the rate of cancer patients using complementary and alternative medicine increases, data are growing that CAM usage may go along with risks of side efects and interactions [10][11][12][13]. Counseling patients on CAM with the aim to reduce these risks and at the same time to increase self-efcacy and patient empowerment is a difcult task for physicians due to lack of knowledge on the topic and high expectations of patients on the efects of CAM [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Patients’ Reasons to Consider and Their Attitudes toward Complementary and Alternative Medicine

Matjuschenko,

Keinki,

Huebner

2023

European Journal of Cancer Care

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Purpose. In recent years, decision-making between conventional medicine, complementary medicine (CM), and alternative medicine (AM) has been studied. The purpose of this study is to take a closer look at patients’ thoughts regarding AM and CM and, if possible, to identify differences. Patients and Methods. Ten cancer patients were recruited to participate in a guided semistructured interview. Recruitment was via verbal request during counseling sessions for complementary healing methods. The main recruiting criterion was their interest in or use of AM or CM. In the following face-to-face interviews, demographic data, previous experience with alternative medicine and conventional medicine, doctor-patient communication, role of the family, and sources of information were determined. The interviews were conducted in a semistructured manner using a guide and were recorded anonymously. The recordings were subsequently transcribed. Results. The number of patients was 10, of which eight were female and seven could show higher educational status. In most of the cases, poor communication was mentioned, both in past situations and at the time of diagnosis. Patients described a lack of emotion in the communication of their diagnosis and paternalistic discussions. They complained that they did not receive an overview of the therapy and that they were hardly involved in the decision-making process. Especially, the demanding content as well as the scarcity of conversation time played an important role for the doctor-patient relationship and the resulting trust toward the doctor. A fundamentally dismissive attitude toward CM, AM, and CAM procedures led to a more fragile trust base. Most frequently used sources were the Internet, support organizations, and books. Conclusion. The first point of contact for cancer patients is usually the conventional physician. Commonly, he is one of the most important sources. If the patient is satisfied with the atmosphere of the conversation and the information regarding CAM received, he will probably follow the doctor’s recommendations. Only in the case of dissatisfaction do patients seek advice from alternative medicine. Good training of conventional physicians in communication and complementary therapy options could, therefore, be of great importance.

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Patient activation, self-efficacy and usage of complementary and alternative medicine in cancer patients

Cited by 9 publications

References 20 publications

Association Between Traditional Chinese Medicine and Medication Adherence in Hypertensive Patients in Mainland China: A Real-World Population-Based Cohort Study

Association Between Traditional Chinese Medicine and Medication Adherence in Hypertensive Patients in Mainland China: A Real-World Population-Based Cohort Study

Lay etiology concepts of cancer patients do not correlate with their usage of complementary and/or alternative medicine

Patients’ Reasons to Consider and Their Attitudes toward Complementary and Alternative Medicine

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