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Open Access 01-12-2024 | Acupuncture | Research

Utilization of complementary and alternative medicine by patients undergoing maintenance hemodialysis for chronic kidney disease in Taiwan: a descriptive investigation

Authors: Ming-Yen Tsai, Chieh-Ying Chin, Wen-Chin Lee, Yu-Chuen Huang, Yu-Chen Cheng

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Despite the paucity of scientific evidence, complementary and alternative medicine (CAM) is widely used for the prevention and treatment of chronic illness, holistic care, and counteracting the adverse effects of conventional therapies. This study aims to determine the prevalence of CAM use and its associated factors among patients undergoing hemodialysis (HD) in Taiwan.

Methods

This quantitative study was conducted from August 2022 to July 2024 in the HD unit at Kaohsiung Chang Gung Memorial Hospital in Taiwan. Face-to-face questionnaire-based interviews were held with 154 of 163 eligible patients (response rate, 94.5%) at the bedside during HD. The completed questionnaires were entered into a secure computer database. Data was performed by descriptive analysis, Chi-square, and Fisher tests.

Results

More than half of the patients were CAM users (n = 86; 56%), and women was associated with significantly more usage of CAM. Fifty-six CAM users took Chinese herbal medicine (CHM), 52.3% (n = 45) used dietary supplements, and 19.8% (n = 17) used acupuncture. The benefit in the effectiveness of CAM was the main reason for use, the need of CAM to improve the well-being and HD-related complication was high. 32.7% of patients had used CAM based on recommendation from their family and friends. More than one-third (33.7%) of patients did not disclose their use of CAM to their doctors, most of them think it is unnecessary.

Conclusions

The use of CAM by patients with maintenance HD was relatively frequent. Of these, most used CHM, of which are shown to the trend into routine HD care is inevitable by high coverage and utilization in Taiwanese national health insurance system. These findings indicate that it is important for health care providers working in dialysis to assess CAM use.
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Literature
1.
2.
Wu BS, Wei CH, Yang CY, Lin MH, Hsu CC, Hsu YJ, Lin SH, Tarng DC. Mortality rate of end-stage kidney disease patients in Taiwan. J Formos Med Assoc. 2022;121 Suppl 1:S12-s19.PubMedCrossRef
3.
de Jager DJ, Grootendorst DC, Jager KJ, van Dijk PC, Tomas LM, Ansell D, Collart F, Finne P, Heaf JG, De Meester J, et al. Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA. 2009;302(16):1782–9.PubMedCrossRef
4.
Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32(5 Suppl 3):S112-119.PubMedCrossRef
5.
Filipčič T, Bogataj Š, Pajek J, Pajek M. Physical Activity and Quality of Life in Hemodialysis Patients and Healthy Controls: A Cross-Sectional Study. Int J Environ Res Public Health. 2021;18(4):1978.
6.
Hornik B, Duława J. Frailty, Quality of Life, Anxiety, and Other Factors Affecting Adherence to Physical Activity Recommendations by Hemodialysis Patients. Int J Environ Res Public Health. 2019;16(10):1827.
7.
Vondracek SF, Teitelbaum I, Kiser TH. Principles of Kidney Pharmacotherapy for the Nephrologist: Core Curriculum 2021. Am J Kidney Dis. 2021;78(3):442–58.PubMedCrossRef
8.
Hsu YT, Chen YH, Fu CM, Lee WC, Tsai MY. Juan Bi Tang, a traditional Chinese medicine, for alleviating pain related to arteriovenous fistula in maintenance hemodialysis patients: An interventional pilot study with brief review. Medicine (Baltimore). 2023;102(45):e35974.PubMedCrossRef
9.
Tsai MY, Wu CH, Huang YC, Chen SY, Ng HY, Su YJ, Chen YH. Treatment of intradialytic hypotension with an herbal acupoint therapy in hemodialysis patients: A randomized pilot study. Complement Ther Med. 2018;38:67–73.PubMedCrossRef
10.
Biçer S, Taşci S. The Effect of Body Acupressure on Blood Pressure and Fatigue Levels in Individuals Suffering From Hypotension During Hemodialysis: A Randomized Controlled Trial. Altern Ther Health Med. 2022;28(2):6–16.PubMed
11.
Duncan HJ, Pittman S, Govil A, Sorn L, Bissler G, Schultz T, Faith J, Kant S, Roy-Chaudhury P. Alternative medicine use in dialysis patients: potential for good and bad! Nephron Clin Pract. 2007;105(3):c108-113.PubMedCrossRef
12.
13.
Zakaria NF, Mohd Noor MT, Abdullah R. Traditional and complementary medicine use among chronic haemodialysis patients: a nationwide cross-sectional study. BMC Complement Med Ther. 2021;21(1):94.PubMedPubMedCentralCrossRef
14.
Posadzki P, Watson LK, Alotaibi A, Ernst E. Prevalence of use of complementary and alternative medicine (CAM) by patients/consumers in the UK: systematic review of surveys. Clin Med (Lond). 2013;13(2):126–31.PubMedCrossRef
15.
Gureje O, Nortje G, Makanjuola V, Oladeji BD, Seedat S, Jenkins R. The role of global traditional and complementary systems of medicine in the treatment of mental health disorders. The Lancet Psychiatry. 2015;2(2):168–77.PubMedPubMedCentralCrossRef
16.
Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. Int J Clin Pract. 2012;66(10):924–39.PubMedCrossRef
17.
Yamashita H, Tsukayama H, Sugishita C. Popularity of complementary and alternative medicine in Japan: a telephone survey. Complement Ther Med. 2002;10(2):84–93.PubMedCrossRef
18.
Siti ZM, Tahir A, Farah AI, Fazlin SM, Sondi S, Azman AH, Maimunah AH, Haniza MA, Siti Haslinda MD, Zulkarnain AK, et al. Use of traditional and complementary medicine in Malaysia: a baseline study. Complement Ther Med. 2009;17(5–6):292–9.PubMedCrossRef
19.
Ock SM, Choi JY, Cha YS, Lee J, Chun MS, Huh CH, Lee SY, Lee SJ. The use of complementary and alternative medicine in a general population in South Korea: results from a national survey in 2006. J Korean Med Sci. 2009;24(1):1–6.PubMedPubMedCentralCrossRef
20.
Lin MY, Chiu YW, Chang JS, Lin HL, Lee CT, Chiu GF, Kuo MC, Wu MT, Chen HC, Hwang SJ. Association of prescribed Chinese herbal medicine use with risk of end-stage renal disease in patients with chronic kidney disease. Kidney Int. 2015;88(6):1365–73.PubMedCrossRef
21.
Tsai MY, Huang YC, Cheng BC, Chin CY, Hsu YT, Lee WC. Prevalence and varieties of complementary and alternative medicine usage among individuals with pre-dialysis chronic kidney disease in Taiwan: an investigative cross-sectional analysis. BMC complementary medicine and therapies. 2024;24(1):11.PubMedPubMedCentralCrossRef
22.
Jeon HO, Kim BH, Kim O. Illness uncertainty and complementary and alternative medicine use in patients undergoing hemodialysis. Nurs Health Sci. 2019;21(3):375–81.PubMedCrossRef
23.
Chen FP, Chen TJ, Kung YY, Chen YC, Chou LF, Chen FJ, Hwang SJ. Use frequency of traditional Chinese medicine in Taiwan. BMC Health Serv Res. 2007;7:26.PubMedPubMedCentralCrossRef
24.
Dehghan M, Namjoo Z, Bahrami A, Tajedini H, Shamsaddini-Lori Z, Zarei A, Dehghani M, Ranjbar MS, Rafiee Sarbijan Nasab F. Rafiee Sarbijan Nasab F: The use of complementary and alternative medicines, and quality of life in patients under hemodialysis: A survey in southeast Iran. Complement Ther Med. 2020;51:102431.PubMedCrossRef
25.
Kilic E, Kavurmaci M. Hemodialysis Patients’ Knowledge of, Beliefs about, and Practices in Using Complementary and Alternative Medicine: An Exploratory Study. Altern Ther Health Med. 2022;28(6):30–4.PubMed
26.
Kemnitz M, Antonini M, Delmas P. Relationship among symptoms, quality of life, and complementary and alternative medicines use among patients undergoing hemodialysis in French-speaking Switzerland. BMC complementary medicine and therapies. 2023;23(1):174.PubMedPubMedCentralCrossRef
27.
Bahall M. Use of complementary and alternative medicine by patients with end-stage renal disease on haemodialysis in Trinidad: A descriptive study. BMC Complement Altern Med. 2017;17(1):250.PubMedPubMedCentralCrossRef
28.
Arjuna Rao AS, Phaneendra D, Pavani ChD, Soundararajan P, Rani NV, Thennarasu P, Kannan G. Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis. Journal of pharmacy & bioallied sciences. 2016;8(1):52–7.CrossRef
29.
Tsai PS, Lee PH, Wang MY. Demographics, training, and practice patterns of practitioners of folk medicine in Taiwan: a survey of the Taipei metropolitan area. J Altern Complement Med. 2008;14(10):1243–8.PubMedCrossRef
30.
Chang MY, Liu CY, Chen HY. Changes in the use of complementary and alternative medicine in Taiwan: a comparison study of 2007 and 2011. Complement Ther Med. 2014;22(3):489–99.PubMedCrossRef
31.
Shih SF, Lew-Ting CY, Chang HY, Kuo KN. Insurance covered and non-covered complementary and alternative medicine utilisation among adults in Taiwan. Soc Sci Med (1982). 2008;67(7):1183–9.CrossRef
32.
Ben Salah G, Farooqui M, Salem Alshammari M, Elghazali A, Kassem L, Ibrahim N, Ben Abdelmalek I, Rasheed MK. Prevalence, types and disclosure of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients in Saudi Arabia. Journal of pharmaceutical policy and practice. 2023;16(1):89.PubMedPubMedCentralCrossRef
33.
Leong F, Hua X, Wang M, Chen T, Song Y, Tu P, Chen XJ. Quality standard of traditional Chinese medicines: comparison between European Pharmacopoeia and Chinese Pharmacopoeia and recent advances. Chinese medicine. 2020;15:76.PubMedPubMedCentralCrossRef
34.
Fan TP, Deal G, Koo HL, Rees D, Sun H, Chen S, Dou JH, Makarov VG, Pozharitskaya ON, Shikov AN, et al. Future development of global regulations of Chinese herbal products. J Ethnopharmacol. 2012;140(3):568–86.PubMedCrossRef
35.
Tsai M-Y, Huang P-Y, Lee W-C, Cheng B-C, Tsai F-J, Liu C-T. Chinese herbal medicine may reduce major adverse cardiovascular events in patients with dialysis hypotension: A taiwan nationwide cohort study. J Tradit Complement Med. 2024;14(5):550–7.
36.
Huang KC, Su YC, Sun MF, Huang ST. Chinese Herbal Medicine Improves the Long-Term Survival Rate of Patients With Chronic Kidney Disease in Taiwan: A Nationwide Retrospective Population-Based Cohort Study. Front Pharmacol. 2018;9:1117.PubMedPubMedCentralCrossRef
37.
Chen YC, Chen HT, Yeh CC, Hung SK, Yu BH. Four prescribed Chinese herbal medicines provide renoprotection and survival benefit without hyperkalemia risk in patients with advanced chronic kidney disease: A nationwide cohort study. Phytomedicine. 2022;95:153873.PubMedCrossRef
38.
Hsieh SC, Lin IH, Tseng WL, Lee CH, Wang JD. Prescription profile of potentially aristolochic acid containing Chinese herbal products: an analysis of National Health Insurance data in Taiwan between 1997 and 2003. Chinese medicine. 2008;3:13.PubMedPubMedCentralCrossRef
39.
Jhuang JR, Chiang CJ, Su SY, Yang YW, Lee WC. Reduction in the Incidence of Urological Cancers after the Ban on Chinese Herbal Products Containing Aristolochic Acid: An Interrupted Time-Series Analysis. Sci Rep. 2019;9(1):19860.PubMedPubMedCentralCrossRef
40.
Mohammadi S, Asghari G, Emami-Naini A, Mansourian M, Badri S. Herbal Supplement Use and Herb-drug Interactions among Patients with Kidney Disease. Journal of research in pharmacy practice. 2020;9(2):61–7.PubMedPubMedCentralCrossRef
41.
Liu PJ, Guo J, Zhang Y, Wang F, Yu K. Effects of oral nutritional supplements on the nutritional status and inflammatory markers in patients on maintenance dialysis: a systematic review and meta-analysis of randomized clinical trials. Clin Kidney J. 2023;16(11):2271–88.PubMedPubMedCentralCrossRef
42.
Juszczak AB, Kupczak M, Konecki T. Does Vitamin Supplementation Play a Role in Chronic Kidney Disease? Nutrients. 2023;15(13):2847.
43.
Ferraro PM, Curhan GC, Gambaro G, Taylor EN. Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones. Am J Kidney Dis. 2016;67(3):400–7.PubMedCrossRef
44.
Maleki M, Mardani A, Manouchehri M, Ashghali Farahani M, Vaismoradi M, Glarcher M. Effect of Chamomile on the Complications of Cancer: A Systematic Review. Integr Cancer Ther. 2023;22:15347354231164600.PubMedPubMedCentralCrossRef
45.
Mardani A, Maleki M, Hanifi N, Borghei Y, Vaismoradi M. A systematic review of the effect of lavender on cancer complications. Complement Ther Med. 2022;67:102836.PubMedCrossRef
46.
Cao X, Zhou J, Liu J, Chen H, Zheng W. Aromatherapy in anxiety, depression, and insomnia: A bibliometric study and visualization analysis. Heliyon. 2023;9(7):e18380.PubMedPubMedCentralCrossRef
47.
Yuan R, Zhang D, Yang J, Wu Z, Luo C, Han L, Yang F, Lin J, Yang M. Review of aromatherapy essential oils and their mechanism of action against migraines. J Ethnopharmacol. 2021;265:113326.PubMedCrossRef
48.
Zhang C, Mu H, Yang YF, Zhang Y, Gou WJ. Effect of aromatherapy on quality of life in maintenance hemodialysis patients: a systematic review and meta-analysis. Ren Fail. 2023;45(1):2164202.PubMedPubMedCentralCrossRef
49.
Maddocks-Jennings W, Wilkinson JM. Aromatherapy practice in nursing: literature review. J Adv Nurs. 2004;48(1):93–103.PubMedCrossRef
50.
Yan CN, Yao WG, Bao YJ, Shi XJ, Yu H, Yin PH, Liu GZ. Effect of Auricular Acupressure on Uremic Pruritus in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial. Evid Based Complement Alternat Med. 2015;2015:593196.PubMedPubMedCentralCrossRef
51.
Jędras M, Bataa O, Gellert R, Ostrowski G, Wojtaszek E, Lange J, Oledzka M. Acupressure in the treatment of uremic pruritus. Dialysis & Transplantation. 2003;32:8–10.
52.
53.
54.
Almutary H. Depression, sleep disturbance, and quality of life in patients undergoing dialysis therapy. Appl Nurs Res. 2022;67:151610.PubMedCrossRef
55.
Sher L. The role of the endogenous opioid system in the effects of acupuncture on mood, behavior, learning, and memory. Med Hypotheses. 1998;50(6):475–8.PubMedCrossRef
56.
Lin JG, Kotha P, Chen YH. Understandings of acupuncture application and mechanisms. Am J Transl Res. 2022;14(3):1469–81.PubMedPubMedCentral
57.
Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. 2014;120(2):482–503.PubMedCrossRef
58.
Garcia GE, Ma SX, Feng L. Acupuncture and kidney disease. Adv Chronic Kidney Dis. 2005;12(3):282–91.PubMedCrossRef
59.
Alwhaibi M, Sambamoorthi U. Sex Differences in the Use of Complementary and Alternative Medicine among Adults with Multiple Chronic Conditions. Evid Based Complement Alternat Med. 2016;2016:2067095.PubMedPubMedCentralCrossRef
60.
Zhang Y, Leach MJ, Hall H, Sundberg T, Ward L, Sibbritt D, Adams J. Differences between Male and Female Consumers of Complementary and Alternative Medicine in a National US Population: A Secondary Analysis of 2012 NIHS Data. Evid Based Complement Alternat Med. 2015;2015:413173.PubMedPubMedCentral
61.
Kristoffersen AE, Stub T, Salamonsen A, Musial F, Hamberg K. Gender differences in prevalence and associations for use of CAM in a large population study. BMC Complement Altern Med. 2014;14:463.PubMedPubMedCentralCrossRef
62.
Bishop FL, Lewith GT. Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use. Evid Based Complement Alternat Med. 2010;7(1):11–28.PubMedCrossRef
63.
Sharp D, Lorenc A, Morris R, Feder G, Little P, Hollinghurst S, Mercer SW, MacPherson H. Complementary medicine use, views, and experiences: a national survey in England. BJGP open. 2018;2(4):bjgpopen18X101614.PubMedPubMedCentralCrossRef
64.
Boerma T, Hosseinpoor AR, Verdes E, Chatterji S. A global assessment of the gender gap in self-reported health with survey data from 59 countries. BMC Public Health. 2016;16:675.PubMedPubMedCentralCrossRef
65.
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J Fam Pract. 2000;49(2):147–52.PubMed
66.
Nowack R, Ballé C, Birnkammer F, Koch W, Sessler R, Birck R. Complementary and alternative medications consumed by renal patients in southern Germany. J Ren Nutr. 2009;19(3):211–9.PubMedCrossRef
67.
Uzdil N, Kılıç Z. Health literacy and attitudes to holistic, complementary and alternative medicine in peritoneal dialysis patients: A descriptive study. Eur J Integr Med. 2022;55:102185.CrossRef
68.
Johansen KL, Chertow GM, Ng AV, Mulligan K, Carey S, Schoenfeld PY, Kent-Braun JA. Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int. 2000;57(6):2564–70.PubMedCrossRef
69.
Anand S, Johansen KL, Grimes B, Kaysen GA, Dalrymple LS, Kutner NG, Chertow GM. Physical activity and self-reported symptoms of insomnia, restless legs syndrome, and depression: the comprehensive dialysis study. Hemodial Int. 2013;17(1):50–8.PubMedCrossRef
70.
Nordstoga AL, Zotcheva E, Svedahl ER, Nilsen TIL, Skarpsno ES. Long-term changes in body weight and physical activity in relation to all-cause and cardiovascular mortality: the HUNT study. Int J Behav Nutr Phys Act. 2019;16(1):45.PubMedPubMedCentralCrossRef
71.
Muhammad Yusuf AS, Abdul Halim AG, Shamsul Azhar S. The Use of Complementary and Alternative Medicine among Malaysian Chronic Kidney Disease Patients. Medicine & Health. 2019;14:219–34.CrossRef
72.
Wardle JL, Adams J. Indirect and non-health risks associated with complementary and alternative medicine use: An integrative review. Eur J Integr Med. 2014;6(4):409–22.CrossRef
73.
74.
Wardle J. Complementary and integrative medicine: The black market of health care? Advances in Integrative Medicine. 2016;3:77–8.CrossRef
75.
Foley H, Steel A, Cramer H, Wardle J, Adams J. Disclosure of complementary medicine use to medical providers: a systematic review and meta-analysis. Sci Rep. 2019;9(1):1573.PubMedPubMedCentralCrossRef
76.
Markell MS. Potential benefits of complementary medicine modalities in patients with chronic kidney disease. Adv Chronic Kidney Dis. 2005;12(3):292–9.PubMedCrossRef
77.
Cohen MH. Legal issues in caring for patients with kidney disease by selectively integrating complementary therapies. Adv Chronic Kidney Dis. 2005;12(3):300–11.PubMedCrossRef
Metadata
Title
Utilization of complementary and alternative medicine by patients undergoing maintenance hemodialysis for chronic kidney disease in Taiwan: a descriptive investigation
Authors
Ming-Yen Tsai
Chieh-Ying Chin
Wen-Chin Lee
Yu-Chuen Huang
Yu-Chen Cheng
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-11912-1

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