BACKGROUND: The use of complementary and alternative medicine (CAM) is common among individuals with underlying chronic illnesses. OBJECTIVE: This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease (CKD). SEARCH STRATEGY: PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024. INCLUSION CRITERIA: Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy. DATA EXTRACTION AND ANALYSIS: Two independent reviewers performed the literature screening. The data were extracted from the included studies by one reviewer and cross-checked by another. Discrepancies were resolved by discussion and consensus among two reviewers. Primary information included prevalence of CAM use, types of CAM used, reasons for CAM use, factors associated with CAM use, and disclosure to healthcare providers. Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model. RESULTS: Forty-one studies were included in this systematic review and meta-analysis. The pooled prevalence of CAM use was 43% (95% confidence interval: 34%, 51%), I² = 99.46%. The reasons for CAM use included treatment of underlying comorbidities, complications or symptoms, maintenance of general health, and treatment of CKD. Nutritional approaches were the most common CAM modality, with 412 different herbal and dietary supplements reported; psychological and physical approaches included massage therapy, relaxation techniques, and mind-body practices; and other complementary health approaches such as homeopathy, traditional Chinese medicine, and Ayurvedic medicine were also frequently reported. Factors associated with CAM use included sociodemographic characteristics such as older age, female gender, or higher income; disease or therapy factors such as not having diabetes, relying on hemodialysis, or poor adherence to medication; and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM. About 66% (61%, 72%) of CAM users did not disclose the use of CAM to their healthcare providers. CONCLUSION CAM use is prevalent among individuals with CKD, and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm. Please cite this article as: Chin JW, Abdullah R, Tan BWW, Wong KW, Khor BH. Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: A systematic review and meta-analysis. J Integr Med. 2025; 23(4): 370-381.
Adult ; Humans ; Complementary Therapies/statistics & numerical data* ; Prevalence ; Renal Insufficiency, Chronic/therapy*

OBJECTIVETo conduct a study on attitudes, knowledge, and use of complementary and alternative medicine (CAM) therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies.

METHODSThe questionnaire used was based on previously validated CAM Health Belief Questionnaire (CHBQ), formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010-July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals (50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses). Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude.

RESULTSStudents of dentistry (54.65±6.07) were better informed on CAM therapies than medicine students (50.26±7.92). Pharmacy students (51.16±7.10) accepted low-scientific CAM. Pharmacists scored better than university professors (55.12±6.55 vs. 50.29±9.50). Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy.

CONCLUSIONThese pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.

Attitude of Health Personnel ; Complementary Therapies ; utilization ; Cross-Sectional Studies ; Delivery of Health Care ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Serbia ; Students ; Surveys and Questionnaires

The United States National Cancer Institute (NCI) supports complementary and alternative medicine (CAM) research which includes different methods and practices (such as nutrition therapies) and other medical systems (such as Chinese medicine). In recent years, NCI has spent around $120 million each year on various CAM-related research projects on cancer prevention, treatment, symptom/side effect management and epidemiology. The categories of CAM research involved include nutritional therapeutics, pharmacological and biological treatments, mind-body interventions, manipulative and body based methods, alternative medical systems, exercise therapies, spiritual therapies and energy therapies on a range of types of cancer. The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) supports various intramural and extramural cancer CAM research projects. Examples of these cancer CAM projects are presented and discussed. In addition, OCCAM also supports international research projects.
Complementary Therapies ; statistics & numerical data ; trends ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; International Cooperation ; National Cancer Institute (U.S.) ; statistics & numerical data ; trends ; Neoplasms ; epidemiology ; therapy ; Research Support as Topic ; statistics & numerical data ; trends ; United States

OBJECTIVETo survey the use, capability and satisfaction of complementary and alternative medicine (CAM) in comparison with conventional medicine in Iran.

METHODSIn this national survey, a cross-sectional study was designed, 5,000 people were surveyed to identify predictors of Iranian traditional medicine (ITM) use compared with conventional medicine. Data were collected through a questionnaire that covered three different predictor categories: demographic information, patient's viewpoint, and patients' experiences.

RESULTSMost of the participants preferred government owned hospitals rather than other places. Praying for one's own health was the most frequent and favorable ITM domain (P=0.017) based on patients' interests, both in low- (P=0.08) and high-level (P=0.011) educated subjects. Among the participants, 97.8% had previous conventional medicine history due to their chronic diseases

CONCLUSIONSIranian patients resort to ITM as a choice at the late stage of the disease. Current deficiency in integration of CAM and conventional medicine is in contrast to the increasing demand on patients' side. Health care organizers should be facilitating the CAM services by tuition of CAM practitioners and supporting eligible CAM centers for diagnosis and treatment of patients.

Adolescent ; Adult ; Aged ; Complementary Therapies ; statistics & numerical data ; utilization ; Cross-Sectional Studies ; Demography ; Female ; Health Care Surveys ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Humans ; Iran ; epidemiology ; Male ; Middle Aged ; Surveys and Questionnaires ; Young Adult

PURPOSE: The purpose of this study was to analyze the reason to select complementary and alternative therapy for terminally ill cancer patients. METHODS: The data were collected from 21 terminal cancer patients and families through the in-depth interview. Data analysis were performed by the Colaizzi's phenomenological method (1976). RESULTS: The reason to select complementary and alternative therapy for terminal cancer patients and families was then categorized with 4 elements; Awareness of limitations in contemporary medical treatments, Belief in effectiveness of the CAM, Satisfaction with emotional needs of family members, and Disbelief due to negative attitudes of physicians. The result indicated the following 9 themes expectation for a complete cure, uncertainty in hospital treatments, complementary method for management of side effect of chemotherapy, alleviation of symptoms and life-sustaining, fear for side effects of cancer treatments, belief in earned information, referrals by other, responsibility of family, and dissatisfaction with negatine attitudes of physicians. CONCLUSION: Physicians should provide a sufficient explanation and try to effectively communicate with clients about hospice and palliative service and the CAM. We strongly realized that concerns about patients' best care and satisfactions with family's needs should be understood.
Complementary Therapies ; Hospices ; Humans ; Qualitative Research ; Referral and Consultation ; Statistics as Topic ; Terminally Ill ; Uncertainty

The purpose of this survey was to obtain information on the prevalence, costs, and patterns of use of complementary and alternative medicine (CAM) in a general population in the Republic of Korea. In 2006, we conducted nationwide and population- weighted personal interviews with 6,021 adults ranging from 30 to 69 yr of age; the final sample consisted of 3,000 people with a 49.8% response rate. In addition to their general socio-demographics, the respondents were asked about their use of CAM during the previous 12-month period, costs, sources of information, and reasons for use. The prevalence of use overall was 74.8%, while biologically based CAM therapies were the most likely type of use (65.4%). The median annual out-of-pocket expenditures for CAM therapies was about US$203. The primary reason for using CAM was for disease prevention and health promotion (78.8%). The main source of advice about CAM therapies use was most likely to be from family and friends (66.9%). Our study suggests that CAM use has been and continues to be very popular in South Korea. Conventional western medical doctors and governments should obtain more evidence and become more interested in CAM therapies.
Adult ; Aged ; *Complementary Therapies/economics/statistics & numerical data ; Demography ; Family ; Female ; Friends ; Health Promotion ; Humans ; Interviews as Topic ; Korea ; Male ; Middle Aged ; Population Groups

PURPOSE: This study was done to describe the research trend of Complementary and Alternative Medicine(CAM) in Korea and internationally. METHOD: A Systematic review of CAM related literature published from 2000 to 2005 was done. A comprehensive search by using 34 CAM modalities as search terms to identify all articles dealing with CAM was undertaken from 4 databases: PubMed, RICHIS, KoreaMed, and Riss4U. A Total of 588 abstracts and 223 original articles were reviewed by two independent reviewers using systematic analysis guidelines. Data regarding the types of study design, characteristics of subjects and researchers, and classification of CAM modalities was recorded. The outcome measures of CAM were identified. RESULTS: CAM research has been rapidly increasing worldwide in the last decade. In Korea, nursing(53.5%) followed by medicine(42.7%) occupied the majority of CAM research in comparison to medicine(42.9%) and disciplines in CAM(25.0%), like homeopathy, internationally. Prevailing research designs in Korea were experimental and quasi-experimental, however, randomized clinical trials were found. Internationally, survey research was dominant, with the exception of randomized clinical trials that were mostly an experimental design. CONCLUSION: The findings suggest that a robust research design in CAM research is needed to accumulate strong scientific evidence and to adopt nursing interventions from CAM modalities.
Biomedical Research/statistics & numerical data/*trends ; Complementary Therapies/statistics & numerical data/*trends ; Humans ; MEDLINE ; Models, Nursing ; PubMed ; Research Design