The use of complementary and alternative medicine among hypertensive and type 2 diabetic patients in Western Jamaica: A mixed methods study

A mosaic of medicine: Acquainting pharmacy education with the rich tapestry of African-descent immigrant cultures

There is an increasing number of African-descent immigrants to the United States, often from the Caribbean, South America, and Africa. These immigrants tend to have different healthcare needs than native-born Black Americans because they come from diverse backgrounds with unique cultural health practices and beliefs. While these immigrants may be healthier when they initially present to the United States, research has found that this health advantage is not long-lasting. Acculturation, cultural beliefs, systemic, and social factors have been closely linked to the health and well-being of Black immigrants, especially with increased years of residency in the United States. Culturally competent care involves understanding the influence of culture, ethnicity, and social factors on health. It is crucial that student pharmacists are trained in understanding the cultural considerations of our continuously evolving and diverse patients. While pharmacy schools have begun incorporating cultural competency and implicit bias training in PharmD curricula, there is still room for improvement to bring about meaningful change in health outcomes. This review calls for an end to oversimplified views of Black immigrant health, advocates for better recognition of distinct African-descent cultures, and recommends tools and strategies to incorporate this population into multicultural pharmacy education.

The Role of Alternative Medicine in Managing Type 2 Diabetes: A Comprehensive Review

Diabetes, a chronic metabolic disorder marked by elevated blood glucose levels, is increasingly prevalent globally, significantly impacting health-related quality of life. Type 2 diabetes (T2DM), characterized by insulin resistance and inadequate insulin production, presents a substantial public health challenge, necessitating comprehensive management strategies. Conventional treatments, including lifestyle modifications and pharmacotherapy, are essential for glycemic control and preventing complications. However, adherence to these treatments is often limited, highlighting the need for alternative strategies. Complementary and alternative medicine (CAM) offers potential cost-effective and accessible approaches for managing T2DM. Key herbal remedies like cinnamon, fenugreek, and bitter melon, along with dietary supplements like chromium, magnesium, and vanadium, have shown promise in glycemic control. Mind-body therapies, including yoga, tai chi, and meditation, contribute to improved hemoglobin A1c and fasting blood glucose levels. Research supports the integration of CAM with conventional therapies, demonstrating enhanced clinical efficacy and reduced economic burden. However, challenges such as standardization, quality control, and potential risks of herbal medicines need careful consideration. Regulatory frameworks and ethical considerations are essential to ensure patient safety and informed decision-making. Patient education and effective communication between healthcare providers and patients are crucial for integrating CAM into diabetes management. Empowerment-based interventions and collaborative approaches can enhance self-management skills and clinical outcomes. Overall, integrating CAM with conventional treatments offers a holistic approach to managing T2DM, potentially improving patient outcomes and reducing healthcare costs.

Safety classification of herbal medicine use among hypertensive patients: a systematic review and meta-analysis

Background

The use of herbal medicines (HMs) for the treatment of hypertension (HTN) is increasing globally, but research on the potential adverse effects and safety of HMs in HTN patients is limited. Therefore, this systematic review and meta-analysis aim to determine the global prevalence of HM usage among HTN patients and assess the safety of identified herbs based on current scientific evidence.

Methods

The PubMed/MEDLINE, EMBASE (Ovid), and Cumulated Index to Nursing and Allied Health Literature (CINAHL) databases were searched for cross-sectional studies on the use of HM among HTN patients. Our review includes studies published in English up to the year 2023. After extracting and appraising the data from the studies, a meta-analysis was conducted using the Stata version 16.0 to estimate the pooled prevalence of HM use in patients with HTN (PROSPERO: CRD42023405537). The safety classification of the identified HM was done based on the existing scientific literature.

Results

This study analyzed 37 cross-sectional studies from 21 countries and found that 37.8% of HTN patients used HM to manage their health. The prevalence of HM use varied significantly based on publication year and geographical region. Among the 71 identified herbs, Allium sativum L., Hibiscus sabdariffa L., and Olea europaea L. were the most commonly used. However, four herbs were identified as contraindicated, 50 herbs required caution, and only 11 herbs were considered safe for use.

Conclusion

The study highlights the potential risks of toxicities and adverse effects associated with HM use in the treatment of HTN. Ensuring patient safety involves using safe HMs in appropriate doses and avoiding contraindicated HMs. Future research should focus on identifying commonly used herbs, especially in resource-limited countries with poor HTN management, and additional clinical research is required to assess the toxicity and safety of commonly used HMs.

Natural products for managing metabolic syndrome: a scoping review

Introduction

Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.

Methods

This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.

Results

We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study's outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.

Conclusion

The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.

Natural products for managing metabolic syndrome: a scoping review

Introduction

Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.

Methods

This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.

Results

We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study’s outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.

Conclusion

The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.

Barriers to accessing care for cardiometabolic disorders in Malawi: partners as a source of resilience for people living with HIV

BACKGROUND

People living with HIV (PLWH) are at increased risk of cardiometabolic disorders (CMD). Adequate access to care for both HIV and CMD is crucial to improving health outcomes; however, there is limited research that have examined couples' experiences accessing such care in resource-constrained settings. We aimed to identify barriers to accessing CMD care among PLWH in Malawi and the role of partners in mitigating these barriers.

METHODS

We conducted a qualitative investigation of barriers to CMD care among 25 couples in Malawi. Couples were eligible if at least one partner was living with HIV and had hypertension or diabetes (i.e., the index patient). Index patients were recruited from HIV care clinics in the Zomba district, and their partners were enrolled thereafter. Interviews were conducted separately with both partners to determine barriers to CMD care access and how partners were involved in care.

RESULTS

Participants framed their experiences with CMD care by making comparisons to HIV treatment, which was free and consistently available. The main barriers to accessing CMD care included shortage of medications, cost of tests and treatments, high cost of transportation to health facilities, lengthy wait times at health facilities, faulty or unavailable medical equipment and supplies, inadequate monitoring of patients' health conditions, some cultural beliefs about causes of illness, use of herbal therapies as an alternative to prescribed medicine, and inadequate knowledge about CMD treatments. Partners provided support through decision-making on accessing medical care, assisting partners in navigating the healthcare system, and providing financial assistance with transportation and treatment expenses. Partners also helped manage care for CMD, including communicating health information to their partners, providing appointment reminders, supporting medication adherence, and supporting recommended lifestyle behaviors.

CONCLUSIONS

Couples identified many barriers to CMD care access, which were perceived as greater challenges than HIV care. Partners provided critical forms of support in navigating these barriers. With the rise of CMD among PLWH, improving access to CMD care should be prioritized, using lessons learned from HIV and integrated care approaches. Partner involvement in CMD care may help mitigate most barriers to CMD care.

A descriptive survey study in endocrinology clinic: evaluation of the use of natural products

OBJECTIVE

The use of herbal products/dietary supplements (HP/DS) in endocrinal chronic diseases is growing. However, no studies have evaluated their use in patients who present to endocrinology and metabolic diseases clinics. This descriptive study aims to investigate the rate of HP/DS use and the factors affecting this in patients who presented to Karadeniz Technical University (KTU) Farabi Hospital Endocrinology and Metabolic Diseases Clinic, Türkiye between 01.11.2021 and 01.05.2022.

METHODS

Five hundred six questionnaires with acceptable data quality were included this investigation. The data were analyzed on SPSS version 23.0 software. The factors with the greatest effect on the use of HP/DS were determined using binary logistic regression analysis.

RESULTS

Analysis showed that 49.4% of the participants used HP/DS. The main factors affecting the use of herbal products were age, diagnosis of the disease, and treatment compliance problems. The most frequently used products were lemon, cinnamon, black cumin, ginger, turmeric, and dill. The participants main sources of information about HP/DS were friends/relatives, the internet/social media, and television, respectively. 74.8% of the participants using HP/DS did not inform their physcisian/pharmacist about such use, although 81.8% of these nevertheless wished to receive information from these occupational groups.

CONCLUSION

Herbal product monitoring in patients should be performed in collaboration with pharmacists, herbal product use should be investigated, and counseling services should be made available in order to maintain and promote public health.

Use of herbal medicines for the management of type 2 diabetes: A systematic review of qualitative studies

BACKGROUND

Many people with Type 2 Diabetes Mellitus (T2DM) use herbal medicines, some of which can improve glycaemic control. Providing evidence-based advice on herbal medicines could be an effective intervention to improve control of diabetes, if it is designed to address key needs and concerns of T2DM patients.

AIM

To understand the views and experiences of patients and health professionals on herbal treatments for self-management of T2DM.

METHOD

MEDLINE, EMBASE, CINAHL, SOCIOFILE and Google Scholar were searched for qualitative studies in T2DM patients about their views on herbal medicines. Included papers were analysed using thematic synthesis.

RESULTS

Thirty-one papers (about 30 studies) were included: 20 from low-and-middle income countries, 10 from high income countries, and 1 internet-based study. Almost all studies from high income countries focussed on ethnic minorities. Many people with T2DM wanted a "cure", and often took advice from friends and family, but also traditional healers and mass media. However, they were reluctant to discuss herbal medicines with health professionals, whom they perceived as "closed-minded". They based their treatment decisions on personal experience (from "trial-and-error"), availability, cost and convenience of both herbal and conventional medicines. Most health professionals were reluctant to discuss herbal medicines, or recommended against their use, because of lack of knowledge and concerns about their quality, efficacy and potential interactions.

CONCLUSION

Evidence-based information could help to overcome the current lack of communication about herbal medicines between people with T2DM and health professionals.

Psychedelic Assisted Psychotherapy preparing your target using psychohistoriography: a Jamaican perspective

The efficacy of psilocybin and other psychedelics as modes of treatment have been demonstrated through clinical trials and other studies in the management of a number of mental illnesses, including some treatment resistant cases. In Psychedelic Assisted Psychotherapy (PAP), psychedelics catalyze or enhance the experience fostered by psychotherapeutic methods. Psychohistoriographic Brief Psychotherapy, conceptualized by the late Professor Frederick Hickling in the 1970's in Kingston, Jamaica, offers a pathway for exploration in the Jamaican context. Applied to individuals, Psychohistoriographic Brief Therapy (PBT) has already shown success in patients with personality disorders in Jamaica through a process which includes documenting life experiences in a psychohistoriogram. In the De La Haye psilocybin Treatment Protocol (DPTP), micro-doses of crushed, dried psilocybin mushrooms are taken throughout an 8-week outpatient process of documenting the components of the psychohistoriogram, making use of the increased openness and empathy associated with the use of psychedelic agents. These sessions are followed by supervised in-office therapeutic/mystical doses of crushed, dried psilocybin mushrooms in the 9th week. Given the legal status and availability of psilocybin containing products in a few countries like Jamaica, there is a potential role for a regulated psychedelic industry contributing to the body of useful and rigorous clinical research which is needed in this area. Clients could benefit as we venture into this new frontier in psychiatry.

Effects of green tea polyphenol extract and epigallocatechin-3-O-gallate on diabetes mellitus and diabetic complications: Recent advances

Diabetes mellitus is one of the major non-communicable diseases accounting for millions of death annually and increasing economic burden. Hyperglycemic condition in diabetes creates oxidative stress that plays a pivotal role in developing diabetes complications affecting multiple organs such as the heart, liver, kidney, retina, and brain. Green tea from the plant Camellia sinensis is a common beverage popular in many countries for its health benefits. Green tea extract (GTE) is rich in many biologically active compounds, e.g., epigallocatechin-3-O-gallate (EGCG), which acts as a potent antioxidant. Recently, several lines of evidence have shown the promising results of GTE and EGCG for diabetes management. Here, we have critically reviewed the effects of GTE and EGCC on diabetes in animal models and clinical studies. The concerns and challenges regarding the clinical use of GTE and EGCG against diabetes are also briefly discussed. Numerous beneficial effects of green tea and its catechins, particularly EGCG, make this natural product an attractive pharmacological agent that can be further developed to treat diabetes and its complications.

Habits, Traditions, and Beliefs Associated With the Use of Complementary and Alternative Medicine Among Diabetic Patients in Al-Qassim Region, Saudi Arabia

Background Since diabetes mellitus (DM) affects every aspect of a person's being, more and more people are using complementary and alternative therapies such as ingesting ginger and cinnamon in addition to conventional medical care and lifestyle changes to manage their condition and enhance their well-being. Although this population uses complementary and alternative medicine (CAM) at a high rate, it is unclear what causes this use. Objective We aim to know the habits, traditions, and beliefs associated with the use of complementary and alternative medicine among type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients in the Al-Qassim region of Saudi Arabia. Methods This is an observational cross-sectional study conducted among diabetes patients in Al-Qassim, Saudi Arabia, in 2022. Participants were selected via a non-probability sampling technique. Patients were interviewed in the diabetic clinics using validated questionnaires. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (IBM SPSS Statistics, Armonk, NY, USA). Results A total of 444 validated responses were received in this study. The average age was 50 ± 16.9 years, and females represented the highest proportion (58.6%). Moreover, we found that most of the participants had type 2 diabetes (79.1%) and 93 (20.9%) had type 1 diabetes. Hypertension was the most reported chronic disease. Our results revealed that the prevalence of CAM usage was 29.1%. Regarding the sources of information on herbal medicines, we found that more than half of the respondents (57.4%) obtained information from friends, relatives, and neighbors. Ginger, vitamins and minerals, and cinnamon were the most frequently used herbals among our participants. Our results found that 38% of CAM users used herbal products on a regular basis. As regards the frequency of using herbal products, 29.5% of the respondents used herbal medicine weekly and 21.7% used it daily. In addition, we found that gender, marital status, and monthly income were significantly associated with the use of CAM (P value = 0.008, 0.011, and 0.011, respectively). The significantly higher CAM use was associated with females, married participants, and participants with a monthly income of 10,000-15,000 Saudi riyal (SAR). Conclusion According to our research, CAM use among diabetes patients in the Al-Qassim region was found to be relatively common. The prevalence of type 2 diabetes mellitus was higher (79.1%) in comparison to type 1 diabetes mellitus (20.9%). Also, the most commonly used herb was ginger (47.66%), followed by vitamins and minerals (44.53%), and cinnamon (42.19%). Patients with diabetes need to be informed of the significance of telling their doctors about their use of CAM.

Orally consumed ginger and human health: an umbrella review

BACKGROUND

Emerging evidence supports the health benefits of ginger for a range of conditions and symptoms; however, there is a lack of synthesis of literature to determine which health indications are supported by quality evidence.

OBJECTIVES

In this umbrella review of systematic reviews we aimed to determine the therapeutic effects and safety of any type of ginger from the Zingiber family administered in oral form compared with any comparator or baseline measures on any health and well-being outcome in humans.

METHODS

Five databases were searched from inception to April 2021. Review selection and quality were assessed in duplicate using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) checklist and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method, with results presented in narrative form.

RESULTS

Twenty-four systematic reviews were included with 3% overlap of primary studies. The strongest evidence was found for the antiemetic effects of ginger in pregnant women (effect size: large; GRADE: high), analgesic effects for osteoarthritis (effect size: small; GRADE: high), and glycemic control (effect size: none to very large; GRADE: very low to moderate). Ginger also had a statistically significant positive effect on blood pressure, weight management, dysmenorrhea, postoperative nausea, and chemotherapy-induced vomiting (effect size: moderate to large; GRADE: low to moderate) as well as blood lipid profile (effect size: small; GRADE: very low) and anti-inflammatory and antioxidant biomarkers (effect size: unclear; GRADE: very low to moderate). There was substantial heterogeneity and poor reporting of interventions; however, dosage of 0.5-3 g/d in capsule form administered for up to 3 mo was consistently reported as effective.

CONCLUSIONS

Dietary consumption of ginger appears safe and may exert beneficial effects on human health and well-being, with greatest confidence in antiemetic effects in pregnant women, analgesic effects in osteoarthritis, and glycemic control. Future randomized controlled and dose-dependent trials with adequate sample sizes and standardized ginger products are warranted to better inform and standardize routine clinical prescription.

Influence of Jamaican Cultural and Religious Beliefs on Adherence to Pharmacotherapy for Non-Communicable Diseases: A Pharmacovigilance Perspective

Worldwide, socio-cultural determinants have been shown to influence the beliefs of patients about their health and decision making for treatment. This is consistent with the evidence that cultural and religious beliefs affect illness conceptualization and behaviors of Jamaican patients living with non-communicable diseases, such as diabetes mellitus and hypertension. Despite these known socio-cultural influences, an acknowledgment of relevance of adherence to pharmacotherapy has been grossly understudied. Furthermore, while poor adherence to pharmacotherapy, especially in the management of patients living with non-communicable diseases is associated with adverse drug reactions; reporting of such information in the pharmacovigilance process is inadequate. We review previous studies on the cultural and religious beliefs within the Jamaican context that may contribute to poor adherence to pharmacotherapy, especially among those patients living with non-communicable diseases. We support the ongoing perspective that current pharmacovigilance processes need retooling with the inclusion of socio-cultural influences on adherence to pharmacotherapy.

Traditional and complementary medicine (TCM) usage and its association with Patient Assessment of Chronic Illness Care (PACIC) among individuals with metabolic syndrome in primary care

Background

Traditional and Complementary Medicine (TCM) is widely used particularly among patients with chronic diseases in primary care. However, evidence is lacking regarding TCM use among patients with Metabolic Syndrome (MetS) and its association with patients’ experience on chronic disease conventional care that they receive. Therefore, this study aims to determine the prevalence and pattern of TCM use, compare the patients’ experience of chronic disease care using the Patient Assessment of Chronic Illness Care - Malay version (PACIC-M) questionnaire between TCM users and non-users and determine the factors associated with TCM use among patients with MetS in primary care.

Methodology

A cross-sectional study was conducted at a university primary care clinic. Patients aged 18 to 80 years old with MetS were recruited. Socio-demographic characteristic, clinical characteristics and information on TCM use and its pattern were recorded in a proforma. Patient’s experience of chronic disease conventional care was measured using PACIC-M questionnaire. The comparison of PACIC-M mean score between TCM users and non-users was measured using independent t-test. The factors associated with TCM use were determined by simple logistic regression (SLogR), followed by multiple logistic regression (MLogR).

Results

Out of 394 participants, 381 (96.7%) were included in the final analysis. Of the 381 participants, 255 (66.9%) were TCM users (95% CI 62.7, 71.7). Only 36.9% of users disclosed about TCM use to their health care providers (HCP). The overall mean PACIC-M score was 2.91 (SD ± 0.04). TCM users had significantly higher mean PACIC-M score compared to non-users (2.98 ± 0.74 vs 2.75 ± 0.72, p = 0.01). The independent factors associated with TCM use were being female (Adj. OR 2.50, 95% CI 1.55, 4.06), having high education level (Adj. OR 2.16, 95% CI 1.37, 3.41) and having high overall PACIC-M mean score (Adj. OR 1.49, 95% CI 1.10, 2.03).

Conclusion

TCM use was highly prevalent in this primary care clinic. However, the disclosure rate of TCM use to HCP was low. Females, those with high education and high PACIC-M mean score were more likely to use TCM. Further research should explore the reasons for their TCM use, despite having good experience in conventional chronic disease care.

Pharmacological Study: Synergistic Antidiabetic Activity of Cinnamon Bark and Zingiber Extract in Streptozotocin-Induced Diabetic Rats

Background: Cinnamon has been widely used by Indonesian people as a complementary therapy to treat hyperglycemia such as in diabetes mellitus patients. While ginger is also used as a mixture in traditional anti hyperglycemia herb. There is not known how much antidiabetic effect of cinnamon ethanolic extract when combined with ginger, and not many studies have analyzed the correlation of lowering blood glucose levels associated with increasing of insulin of this combination.   Objectives: This study aimed to investigates antidiabetic activity of cinnamon extract, zingiber extract, and mixture on streptozotocin-induced diabetic rats.   Methods: This pharmacological study used Wistar strain male rats under hyperglycemia condition induced by streptozotocin at a dose of 45mg/kg. Sample were grouped with 6 animals in each where there was a positive and negative control group and also an intervention group given ethanol extract for 14 days.  Results: The result showed that all intervention groups experienced an increase in insulin levels and a decrease in blood glucose levels after 14 days. The One Way Anova test showed that the increase of insulin levels treated with combination of ethanolic extract cinnamon bark at the dose 150mg/200gr and ginger ethanolic extract at the dose 100mg/200gr was comparable to Glibenclamide (p=0.355), but the decrease in blood glucose levels between groups showed a difference that was not statistically significant. There was a relationship between insulin levels and blood glucose levels linearity with the equation Y (insulin level) = -5.261 + (-0.060) blood glucose level.  Conclusions: The combination of cinnamon and ginger showed beneficial synergistic anti-diabetic activity. It can increase insulin levels, making it possible to control blood sugar levels in high blood glucose conditions.

Use of Complementary and Alternative Medicine for Prostate Cancer among African Americans, African Immigrants and Caribbean Immigrants

Black men have the highest rate of prostate cancer (PCa) morbidity and mortality in the US, and often receive delayed and/or poorer-quality treatment. This inequity has led many to turn to complementary and alternative medicine/therapies (CAM). However, little is known about the use of these therapies within the Black community. The purpose of this study was to describe types of CAM therapies used, and the reasons behind their use for overall health and PCa treatment and prevention among three groups of Black males, namely African Americans, Caribbean Immigrants and African Immigrants. This study used a mixed-methods design with a quantitative phase (n = 575) followed by a qualitative phase (n = 61) with participants recruited from various parts of the country. Results revealed differences among subgroups in CAM use for overall health and PCa, as well as differences in the types of CAM therapies used and differences in the reasons behind their use. The findings of this study reveal a prevalence of CAM use for overall health and PCa within three different groups of Black men and identifies the specific CAM used. There were significant differences in the types of CAM used by each subgroup for both overall health and PCa. This study also shows that there is value in looking at Black subgroups distinctively, for their rates of CAM use and reasons for use, are distinctly different.

Experiences of Patients on Natural Herbal Treatments for Diabetes Mellitus at the Diabetes Clinic in Base Hospital - Matara, Sri Lanka

The prevalence of diabetes mellitus has become a global public health issue. Natural herbal treatments for type 2 diabetes mellitus have been widely used in traditional societies but has recently become popular among western societies as well. The aim of this study was to explore the experience of type 2 patients with diabetes mellitus who are currently on natural herbal treatment. A qualitative, phenomenological design has been used. Twelve participants from both males and females, aged between 25 and 75 years, who were on medical treatment, were selected for sampling. In-depth interviews were conducted at the diabetes clinic in a selected hospital in southern Sri Lanka. The athematic analysis was conducted, and 6 themes were derived. The majority of participants (75%) were motivated to use natural herbal treatments other than oral glycemic therapy. Experiences have been identified as the most influential factors in the use of natural herbal treatments. The need for educational interventions on natural herbal treatments and to propose the integration of herbal medicine into current medical systems is recommended.

Self-management using crude herbs and the health-related quality of life among adult patients with hypertension living in a suburban setting of Malaysia

PURPOSE

To determine the prevalence of crude herbs' use in the self-management of hypertension and the health-related quality of life (HRQOL) in patients with hypertension.

METHODS

This cross-sectional study was performed among patients with hypertension attending a government health clinic. Socio-demographic characteristics, lifestyle modifications, medical history and predictors of crude herbs users were obtained. The diversity of crude herbs used was assessed using a modified international complementary and alternative medicine questionnaire (I-CAM-Q) and the HRQOL was assessed using the SF36 instrument.

RESULTS

Out of the 294 patients recruited, 52.4% were female, 41.5% were Malay and 38.8% were within the 60 to69 age category. The prevalence of crude herbs users was 30.6% and the most common herbs used were pegaga (Centella asiatica), peria (Momordica charantia) and betik (Carica papaya). Using the regression analysis, significantly higher odds of using crude herbs are noted among Malay or Indian patients who have these characteristics: attained secondary education, experienced falls or muscle pain, and had systolic blood pressure of more than 140 mmHg. There was no significant difference in HRQOL domains between the crude herb users and non-users (p>0.05).

CONCLUSION

Besides taking allopathic medications, certain patients with hypertension use crude herbs as a form of self-management. Although patients are adamant about integrating crude herbs as a form of self-management, the effects of doing so have not been properly investigated. This implies that the healthcare staff members need to communicate with the patients regarding the use of crude herbs together with conventional drugs.