School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
J Cancer Surviv. 2022 Jun;16(3):568-581. doi: 10.1007/s11764-021-01051-5. Epub 2021 May 14.
This study explored the pattern of complementary or alternative medicine (CAM) use among Chinese survivors of childhood cancer and identified potential drug-CAM interactions and factors predicting CAM use.
This cross-sectional study recruited 393 survivors of childhood cancer (male, 57.8%; mean age, 17.7 [SD = 7.3] years; mean years post-treatment, 8.8 [SD = 5.0]) from a public hospital in Hong Kong. Participants reported CAM and over-the-counter medications that they used in the past year. Prescription drug data were extracted from pharmacy dispensing records. Potential interactions between concurrent CAM and chronic medications were identified from well-established CAM-drug/herb-drug interaction databases. A multivariate logistic regression was performed to analyze associations of socio-demographic and clinical factors with CAM use.
Half (n = 205/393, 52.2%) of the participants reported the use of CAM. The most popular CAMs were traditional Chinese medicine (n = 127/205, 62.0%) and natural products (n = 114/205, 55.3%). Among the 69 survivors (33.7%) concurrently using CAM and chronic medications, one-third (n = 21/69, 30.4%) were at risk of drug-CAM interactions that are of moderate significance. Adult survivors were more likely to use CAM than pediatric survivors (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.31-4.41). Brain tumor survivors were more likely than other solid tumor survivors to use non-oral therapies (OR, 2.70; 95% CI, 1.01-7.72).
The prevalence of CAM use among Chinese survivors of childhood cancer was high. A minority of survivors had a risk of clinically significant CAM-drug interactions. Future studies should focus on survivors' behavior and motivations for CAM use.
As the concurrent use of CAM and chronic medications might result in interactions, healthcare providers should proactively identify such interactions and develop referral pathways to promote evidence-based integrative therapies for survivors.
本研究探讨了中国儿童癌症幸存者使用补充和替代医学（CAM）的模式，并确定了潜在的药物-CAM 相互作用和预测 CAM 使用的因素。
这项横断面研究招募了来自香港一家公立医院的 393 名儿童癌症幸存者（男性占 57.8%；平均年龄为 17.7 [SD = 7.3] 岁；平均治疗后时间为 8.8 [SD = 5.0] 年）。参与者报告了他们在过去一年中使用的 CAM 和非处方药物。从药房配药记录中提取处方药物数据。从成熟的 CAM-药物/草药-药物相互作用数据库中确定了同时使用 CAM 和慢性药物的潜在相互作用。采用多变量逻辑回归分析社会人口统计学和临床因素与 CAM 使用的关联。
一半（n = 205/393，52.2%）的参与者报告使用了 CAM。最受欢迎的 CAM 是中药（n = 127/205，62.0%）和天然产品（n = 114/205，55.3%）。在 69 名同时使用 CAM 和慢性药物的幸存者中（n = 69，33.7%），有三分之一（n = 21/69，30.4%）存在中等显著的药物-CAM 相互作用风险。成年幸存者比儿科幸存者更有可能使用 CAM（优势比 [OR]，2.35；95%置信区间 [CI]，1.31-4.41）。脑肿瘤幸存者比其他实体瘤幸存者更有可能使用非口服疗法（OR，2.70；95% CI，1.01-7.72）。
中国儿童癌症幸存者使用 CAM 的比例很高。少数幸存者存在临床意义重大的 CAM-药物相互作用风险。未来的研究应关注幸存者使用 CAM 的行为和动机。
由于同时使用 CAM 和慢性药物可能会导致相互作用，医疗保健提供者应主动识别这些相互作用，并制定转诊途径，以促进为幸存者提供基于证据的综合治疗。
