Department of Neurology, Medical University of Warsaw, Poland.
Department of Child Neurology, Medical University of Warsaw, Poland.
Neurol Neurochir Pol. 2022;56(5):428-434. doi: 10.5603/PJNNS.a2022.0059. Epub 2022 Sep 7.
To assess the prevalence and characteristics of complementary and alternative medicine (CAM) use among multiple sclerosis (MS) patients in Poland.
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.
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.
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.
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.
评估波兰多发性硬化症（MS）患者中补充和替代医学（CAM）的使用情况和特点。
多发性硬化症（MS）是一种慢性、进行性和致残性神经系统疾病，对生活质量有重大影响。尽管补充和替代医学（CAM）的疗效和安全性尚未得到科学证实，但许多患者将 CAM 作为常规治疗的补充或替代。
通过一份包含 33 个问题的自我设计调查问卷收集数据。该问卷在 2016 年期间分发给波兰华沙医科大学神经病学系 MS 病房住院的 MS 患者。研究组由 75 名患者（47 名女性，28 名男性，平均年龄 44.6 ± 12.5 岁）组成，他们的 MS 均经临床诊断。
根据问卷，48 名患者（64%）至少使用过一次 CAM。大多数患者表示 CAM 具有可能（58%）或显著（43.7%）的积极作用。61.4%的 CAM 用户报告疲劳减轻，33.3%的人情绪改善。CAM 的使用与社会和职业地位较低（p < 0.04）、疾病进展（p < 0.03）以及疾病修正治疗效果不佳（p < 0.04）之间存在显著相关性。CAM 使用与性别、居住地、教育程度、婚姻或职业状况之间无显著相关性。最常使用的 CAM 是维生素（48%）和多不饱和脂肪酸（36%）；心理物理方法（44%）包括手法治疗（24%）和放松技术（17.3%）以及草药（29.3%）。医生被认为是传统治疗（97.3%）和 CAM（67%）中最可靠的权威。CAM 用户与医生讨论这个问题的频率明显高于未使用替代医学的患者（56%，p < 0.05）。然而，54%的患者没有向医生报告 CAM 的使用情况。回答者表示，医生没有主动讨论这个问题（55.9%），但 44%的患者希望有机会与医生讨论 CAM。
尽管 CAM 的疗效和安全性尚未得到证实，但应注意到大多数 MS 患者都在使用替代方法，尤其是那些症状更严重的患者。医生大多被视为可靠的权威，因此他们应该与患者讨论这个问题，以消除药物相互作用，提高依从性。
