School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, UK.
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Eur J Clin Pharmacol. 2021 Sep;77(9):1259-1274. doi: 10.1007/s00228-021-03097-x. Epub 2021 Mar 8.
This study aimed to undertake a systematic review and meta-analysis of global prevalence and types of complementary and alternative medicine (CAM) use amongst adults with diabetes.
Nine databases, including MEDLINE and EMBASE, were searched for studies published between 2009 and 2019 which included extractable data for CAM use in adult patients with diabetes. Study characteristics, types of CAM, and overall and subgroup prevalence data in relation to CAM use were extracted. Meta-analysis of aggregate level data on prevalence and prevalence ratios (PRs) was performed using a random effects model.
From the 38 studies included in the review, a total of 37 types of CAM and 223 types of herbs were identified. Pooled prevalence of CAM use was 51%. A wide variation in prevalence rates (predictive interval 8-93%) was observed. In the context of high heterogeneity, we found no evidence that CAM use was associated with gender, chronicity or type of diabetes. Approximately one third of patients did not disclose their use of CAM to healthcare professionals (95% PrI 25%, 97%). Herbal medicines, acupuncture, homoeopathy and spiritual healing were the common CAM types reported.
A wide variation in prevalence of CAM use by patients with diabetes was identified. Healthcare professionals should be aware of their patients' use of CAM to ensure treatment optimization, avoid herb-drug interactions and promote medication adherence in diabetes. Diabetic reviews and clinical guidelines should incorporate exploration of patient use of CAM as many patients do not proactively disclose the use of CAM to their healthcare professionals.
The protocol for this study was registered with the Centre for Review and Dissemination (CRD). Protocol registration number CRD42019125036.
本研究旨在对全球成年人糖尿病患者中补充和替代医学（CAM）的使用情况进行系统回顾和荟萃分析。
检索了 MEDLINE 和 EMBASE 等 9 个数据库，以获取 2009 年至 2019 年期间发表的研究，这些研究包括可提取的成年糖尿病患者使用 CAM 的数据。提取研究特征、CAM 类型以及与 CAM 使用相关的总体和亚组患病率数据。使用随机效应模型对患病率和患病率比（PR）的汇总水平数据进行荟萃分析。
从综述中纳入的 38 项研究中，共确定了 37 种 CAM 和 223 种草药。CAM 的使用率为 51%。患病率的差异很大（预测区间为 8%-93%）。在高度异质性的情况下，我们没有发现 CAM 使用与性别、慢性或糖尿病类型有关的证据。大约三分之一的患者没有向医疗保健专业人员透露他们使用 CAM（95%PrI 25%，97%）。报告的常见 CAM 类型包括草药、针灸、顺势疗法和精神治疗。
发现糖尿病患者使用 CAM 的患病率差异很大。医疗保健专业人员应了解其患者使用 CAM 的情况，以确保治疗优化、避免药物-草药相互作用并促进糖尿病患者的药物依从性。糖尿病综述和临床指南应纳入对患者使用 CAM 的探索，因为许多患者不会主动向其医疗保健专业人员透露他们使用 CAM。
本研究的方案已在评论与传播中心（CRD）注册。方案注册号为 CRD42019125036。
