Factors contributing to the use of complementary and alternative medicine in rural older women with chronic pain in South Korea

Traditional and complementary medicine for promoting healthy ageing in WHO Western Pacific Region: Policy implications from utilization patterns and current evidence

BACKGROUND

With increasing burden of chronic non-communicable diseases (NCD), ageing becomes a global public health concern, and the World Health Organization Western Pacific Region has no exception. To address the NCD challenge, priority should be given to promote healthy ageing across the life-course. As traditional and complementary medicine (T&CM) is popular within the Region, it is of policy interest to explore possibilities of applying T&CM for promoting healthy ageing.

METHODS

We first summarized sources of clinical evidence supporting the use of T&CM. We then searched publications through MEDLINE from its inception to April 2020 to identify studies focusing on the perception of T&CM among older people. Finally, taking current evidence base and patient choice into account, we generated policy recommendations for of integrating T&CM into health systems.

RESULT

Experiences from countries with different income levels suggested that promoting evidence-based T&CM as self-care modalities would be the most efficient way of maximizing impact among the older population, especially via a train the trainer approach. Meanwhile, popularity of natural products in the Region mandates policy makers to implement appropriate regulation and quality assurance, and to establish pharmacovigilance to detect potential harm. The role of pharmacists in advising patients on self-medication using natural products needs to be strengthened.

CONCLUSION

Policy-makers will benefit from continued global dialogue and sharing of experience in T&CM policy development and implementation. Harmonizing regulatory frameworks for natural products at regional and global levels, including mutual recognition of regulatory approval, to improve standards and protect patients could be a priority.

Ethnopharmacological analysis of medicinal plants and animals used in the treatment and management of pain in Mauritius

ETHNOPHARMACOLOGICAL RELEVANCE

Pain is a multi-faceted and multi-factorial condition which is challenging to manage and treat. Conventional therapies such as analgesics, Non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids amongst others have been successful to some extent in its management and treatment. Nonetheless, such therapies tend to be accompanied by undesirable effects and have a limited therapeutic range. Consequently, there is a pressing need to probe for novel analgesic and anti-nociceptive drugs from traditional medicines (TM). This study was designed to record, document and analyze herbal and animal-based therapies used for the management and treatment of pain in the tropical of Mauritius.

MATERIALS AND METHODS

Data was collected via face-to-face interviews with TM users (n=332) and practitioners (n=20). Seven quantitative ethnopharmacological indexes, namely family use value (FUV), use value (UV), informant agreement ratio (IAR), relative frequency of citation (RFC), fidelity level (FL), relative importance (RI) and ethnobotanicity index (EI) were calculated.

RESULTS

A total of 79 plant species distributed within 40 families and 20 polyherbal preparations was recorded. Interestingly, 6 indigenous/endemic plants have been reported for the first time to be in common use for pain management and treatment in Mauritius. The most significant biologically important plant family was Xanthorrhoeaceae with highest FUV. The species which ranked highest according to its UV was Morinda citrifolia L. Morinda citrifolia L. and Ricinus communis L. also scored the highest RFC. The IAR values for the disease categories were high (0.95-0.97). Based on EI, plants species which are known to be useful in TM accounted for 11.5% of the total flora in Mauritius. Coix lacryma-jobi L. (FL=100%) had highest FL for lower back ache. Morinda citrifolia L. scored highest on most of the quantitative indices calculated including RI, which is endorsed by extensive documentation on its versatility and particularly its anti-nociceptive properties. Seven animal species were recorded to be in common use.

CONCLUSION

The present ethnopharmacological study revealed a panoply of TM to be in common use for pain management and treatment in Mauritius. This study has documented for the first time medicinal plants and animal species with potential analgesic and/or anti-nociceptive properties. This study has therefore provided important baseline primary data for the discovery of new lead molecules for drug development geared towards pain management and treatment.