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在尼日利亚西南部拉各斯的一家三级医院中,镰状细胞病患者使用补充和替代医学的比例很高。

High prevalence of complementary and alternative medicine use among patients with sickle cell disease in a tertiary hospital in Lagos, South West, Nigeria.

作者信息

Busari A A, Mufutau M A

机构信息

Department of Pharmacology Therapeutics & Toxicology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.

出版信息

BMC Complement Altern Med. 2017 Jun 7;17(1):299. doi: 10.1186/s12906-017-1812-2.

Abstract

BACKGROUND

Attention and interest in the use of complementary and alternative medicine (CAM) has been reignited globally, most especially in patients with chronic diseases. Sickle cell disease (SCD) is one of such chronic diseases associated with devastating clinical and psychosocial consequences, thus leading those affected to seek alternative treatment apart from orthodox medicine. Hence, this study aimed to determine the prevalence, pattern and tolerability of the use of CAM in patients with SCD in the Lagos University Teaching Hospital (LUTH).

METHODS

This was a cross-sectional survey of 200 respondents with SCD attending the hematology clinics of the Lagos University Teaching Hospital over a period of 3 months. Data on socio-demographic characteristic, clinical profile, the types and sources of CAM used were collected using a well structured pretested questionnaire. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS®) version 17.

RESULT

Of the 200 patients who participated in the study, 113; 56.5% were males and 87; 43.5% were females. Majority of the SCD patients were 1-10 years old and their mean age was 18.8 ± 14.39 years. CAM was reportedly used by 88.5% of the respondents. Biological (herbal) products 156; 62.9% were the most commonly used CAM, followed by alternative medical systems 52; 20.9% and mind-body interventions 30; 12.1%. Relations, friends and neighbors influenced 85.2% of CAM users by recommending CAM to them. Tolerability of CAM was perceived to be excellent as only 33 (18.6%) of the respondents abandoned the use of CAM. Comparing CAM users and CAM non-users, there was no statistical significant difference in the proportion of those >18 years (45.76% vs 52.17%; p = 0.658), those who experienced two or more crises (51.41% vs 34.78%; p = 0.183), and those with stable haemoglobin concentration of >7 g/dL (15.81% vs 8.69%; p = 0.539) More patients among CAM non-users (91.30%) significantly spend over 3000 Naira (USD 15) per month on medicine than CAM users (4.51%) (p < 0.001).

CONCLUSION

CAM use is highly prevalent among adults with sickle cell diseases in Nigeria. CAM is well tolerated and relatively affordable by these patients. Clinician awareness and understanding of the factors influencing the use of CAM and the potential herbal-orthodox medicine interaction are crucial during hospital treatment of these patients.

摘要

背景

全球范围内,对补充和替代医学(CAM)使用的关注和兴趣再度燃起,尤其是在慢性病患者中。镰状细胞病(SCD)是此类慢性病之一,伴有严重的临床和心理社会后果,这使得患者除了寻求传统医学治疗外,还会寻求替代疗法。因此,本研究旨在确定拉各斯大学教学医院(LUTH)中SCD患者使用CAM的患病率、模式和耐受性。

方法

这是一项横断面调查,在3个月内对拉各斯大学教学医院血液科门诊的200名SCD受访者进行了调查。使用一份经过预测试的结构化问卷收集社会人口学特征、临床资料、所使用CAM的类型和来源等数据。使用社会科学统计软件包(SPSS®)17版对获得的数据进行分析。

结果

参与研究的200名患者中,113名(56.5%)为男性,87名(43.5%)为女性。大多数SCD患者年龄在1至10岁之间,平均年龄为18.8±14.39岁。据报道,88.5%的受访者使用过CAM。生物(草药)产品156例(62.9%)是最常用的CAM,其次是替代医学系统52例(20.9%)和身心干预30例(12.1%)。亲戚、朋友和邻居向85.2%的CAM使用者推荐CAM,从而影响了他们。CAM的耐受性被认为极佳,因为只有33名(18.6%)受访者放弃使用CAM。比较CAM使用者和非使用者,年龄>18岁者的比例(45.76%对52.17%;p=0.658)、经历过两次或更多次病情危机者的比例(51.41%对34.78%;p=0.183)以及血红蛋白浓度稳定>7g/dL者的比例(15.81%对8.69%;p=0.539)均无统计学显著差异。CAM非使用者中每月在药品上花费超过3000奈拉(15美元)的患者比例(91.30%)显著高于CAM使用者(4.51%)(p<0.001)。

结论

在尼日利亚,SCD成年患者中CAM的使用非常普遍。这些患者对CAM耐受性良好且相对负担得起。在对这些患者进行医院治疗期间,临床医生了解和认识影响CAM使用的因素以及潜在的草药与传统药物相互作用至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b32c/5463406/b686c01435f3/12906_2017_1812_Fig1_HTML.jpg

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