open access

Ahead of print
Research Paper
Submitted: 2022-06-12
Accepted: 2022-07-12
Published online: 2022-09-07
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Complementary and alternative medicine in multiple sclerosis: a questionnaire-based study

Aleksandra Podlecka-Piętowska1, Monika Sugalska2, Katarzyna Janiszewska1, Anna Wall-Szczech1, Agnieszka Cyganek1, Natalia Szejko13, Beata Zakrzewska-Pniewska1
DOI: 10.5603/PJNNS.a2022.0059
·
Pubmed: 36069151
Affiliations
  1. Department of Neurology, Medical University of Warsaw, Poland
  2. Department of Child Neurology, Medical University of Warsaw, Poland
  3. Department Bioethics, Medical University of Warsaw, Poland

open access

Ahead of print
Research papers
Submitted: 2022-06-12
Accepted: 2022-07-12
Published online: 2022-09-07

Abstract

Aim of the study. To assess the prevalence and characteristics of complementary and alternative medicine (CAM) use among multiple sclerosis (MS) patients in Poland.

Clinical rationale for the study. Multiple sclerosis (MS) is a chronic, progressive and disabling neurological disease with significant impact on quality of life. Although the efficacy and safety of complementary and alternative medicine (CAM) has not been scientifically confirmed, many patients use CAM as a complement or an alternative to conventional therapy.

Material and methods.
Data was collected via a self-designed survey consisting of 33 questions. The questionnaire was distributed among MS patients hospitalised during 2016 in the MS Unit at the Department of Neurology, Medical University of Warsaw, Poland. The study group consisted of 75 patients (47 females, 28 males, mean age 44.6 ± 12.5 years) with clinically defined MS.

Results.
According to the questionnaire, 48 patients (64%) had used CAM at least once. Most of the patients declared that CAM had a possible (58%) or a marked (43.7%) positive effect. 61.4% of CAM users reported reduced fatigue and 33.3% improved mood. There were significant correlations between CAM use and lower social and professional status (p < 0.04), disease progression (p < 0.03), and lack of efficacy of disease-modifying therapies (p < 0.04). There were no significant correlations between CAM usage and sex, habitation, education, marital or professional status. The most frequently used CAMs were vitamins (48%),
and polyunsaturated fatty acids (36%); psychophysical methods (44%) included manual therapies (24%) and relaxation techniques (17.3%) as well as herbal medicine (29.3%). Physicians were considered to be the most reliable authority in both conventional treatment (97.3%) and CAM (67%). Complementary and alternative medicine users significantly more often discussed this issue with their doctors (56%) compared to patients who did not use alternative medicine (p < 0.05). However, 54% of patients did not inform their physician about CAM use. Responders said that physicians did not initiate discussion about it (55.9%), but
44% of patients would like to have the possibility of talking to a doctor about CAM.

Conclusions and clinical implications.
Although CAM efficacy and safety is not confirmed, one should keep in mind that most MS patients use alternative methods, especially those individuals with a more severe phenotype. Physicians are mostly perceived as reliable authorities and therefore they should discuss this issue with patients in order to eliminate drug interactions and to improve compliance.

Abstract

Aim of the study. To assess the prevalence and characteristics of complementary and alternative medicine (CAM) use among multiple sclerosis (MS) patients in Poland.

Clinical rationale for the study. Multiple sclerosis (MS) is a chronic, progressive and disabling neurological disease with significant impact on quality of life. Although the efficacy and safety of complementary and alternative medicine (CAM) has not been scientifically confirmed, many patients use CAM as a complement or an alternative to conventional therapy.

Material and methods.
Data was collected via a self-designed survey consisting of 33 questions. The questionnaire was distributed among MS patients hospitalised during 2016 in the MS Unit at the Department of Neurology, Medical University of Warsaw, Poland. The study group consisted of 75 patients (47 females, 28 males, mean age 44.6 ± 12.5 years) with clinically defined MS.

Results.
According to the questionnaire, 48 patients (64%) had used CAM at least once. Most of the patients declared that CAM had a possible (58%) or a marked (43.7%) positive effect. 61.4% of CAM users reported reduced fatigue and 33.3% improved mood. There were significant correlations between CAM use and lower social and professional status (p < 0.04), disease progression (p < 0.03), and lack of efficacy of disease-modifying therapies (p < 0.04). There were no significant correlations between CAM usage and sex, habitation, education, marital or professional status. The most frequently used CAMs were vitamins (48%),
and polyunsaturated fatty acids (36%); psychophysical methods (44%) included manual therapies (24%) and relaxation techniques (17.3%) as well as herbal medicine (29.3%). Physicians were considered to be the most reliable authority in both conventional treatment (97.3%) and CAM (67%). Complementary and alternative medicine users significantly more often discussed this issue with their doctors (56%) compared to patients who did not use alternative medicine (p < 0.05). However, 54% of patients did not inform their physician about CAM use. Responders said that physicians did not initiate discussion about it (55.9%), but
44% of patients would like to have the possibility of talking to a doctor about CAM.

Conclusions and clinical implications.
Although CAM efficacy and safety is not confirmed, one should keep in mind that most MS patients use alternative methods, especially those individuals with a more severe phenotype. Physicians are mostly perceived as reliable authorities and therefore they should discuss this issue with patients in order to eliminate drug interactions and to improve compliance.

Get Citation

Keywords

multiple sclerosis, complementary and alternative medicine, disease-modifying therapy, efficacy, safety

About this article
Title

Complementary and alternative medicine in multiple sclerosis: a questionnaire-based study

Journal

Neurologia i Neurochirurgia Polska

Issue

Ahead of print

Article type

Research Paper

Published online

2022-09-07

Page views

153

Article views/downloads

84

DOI

10.5603/PJNNS.a2022.0059

Pubmed

36069151

Keywords

multiple sclerosis
complementary and alternative medicine
disease-modifying therapy
efficacy
safety

Authors

Aleksandra Podlecka-Piętowska
Monika Sugalska
Katarzyna Janiszewska
Anna Wall-Szczech
Agnieszka Cyganek
Natalia Szejko
Beata Zakrzewska-Pniewska

References (33)
  1. Wiendl H, Gold R, Berger T, et al. ‘Multiple Sclerosis Therapy Consensus Group’ (MSTCG). Multiple Sclerosis Therapy Consensus Group (MSTCG): position statement on disease-modifying therapies for multiple sclerosis (white paper). Ther Adv Neurol Disord. 2021; 14: 17562864211039648.
  2. Kes VB, Cesarik M, Matovina LZ, et al. The role of complementary and alternative medicine in therapy of multiple sclerosis. Acta Clin Croat. 2013; 52(4): 464–471.
  3. Clarke TC, Black LI, Stussman BJ, et al. Trends in the use of complementary health approaches among adults: United States, 2002-2012. Natl Health Stat Report. 2015(79): 1–16.
  4. Nayak S, Matheis RJ, Schoenberger NE, et al. Use of unconventional therapies by individuals with multiple sclerosis. Clin Rehabil. 2003; 17(2): 181–191.
  5. Gotta M, Mayer CA, Huebner J. Use of complementary and alternative medicine in patients with multiple sclerosis in Germany. Complement Ther Med. 2018; 36: 113–117.
  6. Namjooyan F, Ghanavati R, Majdinasab N, et al. Uses of complementary and alternative medicine in multiple sclerosis. J Tradit Complement Med. 2014; 4(3): 145–152.
  7. Skovgaard L. Use and users of complementary and alternative medicine among people with multiple sclerosis in Denmark. Dan Med J. 2016; 63(1): B5159.
  8. Leong EM, Semple SJ, Angley M, et al. Complementary and alternative medicines and dietary interventions in multiple sclerosis: what is being used in South Australia and why? Complement Ther Med. 2009; 17(4): 216–223.
  9. Team RC. R: A language and environment for statistical computing 2018.
  10. Apel-Neu A, Zettl UK. Complementary and alternative medicine in multiple sclerosis. J Neurol. 2008; 255 Suppl 6: 82–86.
  11. Olsen SA. A review of complementary and alternative medicine (CAM) by people with multiple sclerosis. Occup Ther Int. 2009; 16(1): 57–70.
  12. Hughes C, Howard IM. Spasticity management in multiple sclerosis. Phys Med Rehabil Clin N Am. 2013; 24(4): 593–604.
  13. Mews S, Zettl UK. [Use of alternative and complementary therapies in clinical practice using multiple sclerosis as an example]. Dtsch Med Wochenschr. 2012; 137(11): 547–551.
  14. Campbell E, Coulter E, Mattison P, et al. Access, delivery and perceived efficacy of physiotherapy and use of complementary and alternative therapies by people with progressive multiple sclerosis in the United Kingdom: An online survey. Mult Scler Relat Disord. 2017; 12: 64–69.
  15. Alnahdi MA, Alsulayhim AK, Bin Salem AH, et al. Patterns and outcomes of complementary and alternative medicine use among adult patients with multiple sclerosis. Cureus. 2020; 12(10): e10825.
  16. Fryze W, Mirowska-Guzel D, Wiszniewska M, et al. Alternative methods of treatment used by multiple sclerosis patients in Poland. Neurol Neurochir Pol. 2006; 40(5): 386–390.
  17. Apel A, Greim B, König N, et al. Frequency of current utilisation of complementary and alternative medicine by patients with multiple sclerosis. J Neurol. 2006; 253(10): 1331–1336.
  18. Farhoudi F, Salehi A, Vojoud M, et al. Assessment of the complementary and integrative medicine utilization among patients with multiple sclerosis using a translated and adapted version of the international questionnaire (I-CAM-QP): A cross-sectional study in Southern Iran. Complement Ther Med. 2019; 46: 47–53.
  19. Rommer PS, König N, Sühnel A, et al. Coping behavior in multiple sclerosis-complementary and alternative medicine: A cross-sectional study. CNS Neurosci Ther. 2018; 24(9): 784–789.
  20. Kochs L, Wegener S, Sühnel A, et al. The use of complementary and alternative medicine in patients with multiple sclerosis: a longitudinal study. Complement Ther Med. 2014; 22(1): 166–172.
  21. Ng JY, Kishimoto V. Multiple sclerosis clinical practice guidelines provide few complementary and alternative medicine recommendations: A systematic review. Complement Ther Med. 2021; 56: 102595.
  22. Yadav V, Bever C, Bowen J, et al. Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology. Neurology. 2014; 82(12): 1083–1092.
  23. Quandt SA, Verhoef MJ, Arcury TA, et al. Development of an international questionnaire to measure use of complementary and alternative medicine (I-CAM-Q). J Altern Complement Med. 2009; 15(4): 331–339.
  24. Re MLo, Schmidt S, Güthlin C. Translation and adaptation of an international questionnaire to measure usage of complementary and alternative medicine (I-CAM-G). BMC Complement Altern Med. 2012; 12: 259.
  25. Huang CW, Tran DN, Li TF, et al. The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q). J Chin Med Assoc. 2019; 82(8): 665–671.
  26. Lee JuAh, Sasaki Y, Arai I, et al. An assessment of the use of complementary and alternative medicine by Korean people using an adapted version of the standardized international questionnaire (I-CAM-QK): a cross-sectional study of an internet survey. BMC Complement Altern Med. 2018; 18(1): 238.
  27. Kristoffersen AE, Quandt SA, Stub T. Use of complementary and alternative medicine in Norway: a cross-sectional survey with a modified Norwegian version of the international questionnaire to measure use of complementary and alternative medicine (I-CAM-QN). BMC Complement Med Ther. 2021; 21(1): 93.
  28. Esteban S, Vázquez Peña F, Terrasa S. Translation and cross-cultural adaptation of a standardized international questionnaire on use of alternative and complementary medicine (I-CAM - Q) for Argentina. BMC Complement Altern Med. 2016; 16: 109.
  29. Druart L, Pinsault N. The I-CAM-FR: a french translation and cross-cultural adaptation of the I-CAM-Q. Medicines (Basel). 2018; 5(3).
  30. Motoo Y, Yukawa K, Arai I, et al. Use of complementary and alternative medicine in japan: a cross-sectional internet survey using the japanese version of the international complementary and alternative medicine questionnaire. JMA J. 2019; 2(1): 35–46.
  31. Silbermann E, Senders A, Wooliscroft L, et al. Cross-sectional survey of complementary and alternative medicine used in Oregon and Southwest Washington to treat multiple sclerosis: A 17-Year update. Mult Scler Relat Disord. 2020; 41: 102041.
  32. Kapica-Topczewska K, Collin F, Tarasiuk J, et al. Clinical and epidemiological characteristics of multiple sclerosis patients receiving disease-modifying treatment in Poland. Neurol Neurochir Pol. 2020; 54(2): 161–168.
  33. Stratos K, McGarragle K, Thistle J, et al. Non-compliance with disease modifying therapies in patients with Multiple Sclerosis: A qualitative analysis. Mult Scler Relat Disord. 2020; 41: 102016.

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