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Published in: BMC Complementary Medicine and Therapies 1/2015

Open Access 01-12-2015 | Research article

Perceptions of complementary and alternative medicine among cardiac patients in South Trinidad: a qualitative study

Authors: Mandreker Bahall, Mark Edwards

Published in: BMC Complementary Medicine and Therapies | Issue 1/2015

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Abstract

Background

Complementary and alternative medicine (CAM) has been practiced for centuries owing to the absence or limited availability of conventional medicine. CAM has persisted globally with over USD34 billion spent annually, despite modernization, globalization, technological advancement, and limited supportive evidence. The present qualitative study explores the perception of CAM among cardiac patients with respect to rationale, perceived outcomes, influences, and public health concerns.

Methods

This study used a qualitative, interpretative approach. Twelve cardiac disease patients were recruited from private clinics in South Trinidad and interviewed. The study obtained ethical approval, and all participants provided written consent. The semi-structured interviews were digitally recorded, transcribed, and thematically analyzed. Participants with poor cognitive function, difficulty speaking, and those not understandable owing to language barriers were excluded.

Results

CAM use was based largely on patient perception regardless of the clinical reality. The perceived mode of action and its natural character was responsible for the therapeutic outcomes and uses. Participants reported that CAM provided holistic care, improved the quality of life, overcame the limitations of conventional medicine, satisfied their increased expectation for comprehensive care, and prevented or counteracted adverse effects caused by conventional medicine. Participants reported a lack of scientific information on CAM and stated that policy makers should assist patients through increased research, public health education, and improved integration of CAM and conventional medicine.

Conclusions

The participants’ use of CAM was largely based on perception. CAM was thought to improve therapeutic outcomes, provide holistic care, decrease or prevent complications from conventional medicine, and improve quality of life. Participants acknowledged that they may be ill-informed about the basic concepts or actions of CAM. They urged policymakers to create an environment that assists the public and health care providers in promoting safe and effective CAM practice.
Literature
1.
go back to reference Arslan IO, Ozer ZC, Kulakac O. Use of complementary and alternative medicine in cardiovascular diseases: a literature review. Health Med. 2012;6:2190–9. Arslan IO, Ozer ZC, Kulakac O. Use of complementary and alternative medicine in cardiovascular diseases: a literature review. Health Med. 2012;6:2190–9.
2.
go back to reference Bin YS, Kiat H. Prevalence of dietary supplement use in patients with proven or suspected cardiovascular disease. J Evid Based Complementary Altern Med. Volume 2011(2011), Article ID 632829, doi:10.1155/2011/632829. Bin YS, Kiat H. Prevalence of dietary supplement use in patients with proven or suspected cardiovascular disease. J Evid Based Complementary Altern Med. Volume 2011(2011), Article ID 632829, doi:10.1155/2011/632829.
3.
go back to reference Prasad K. Use of complementary therapies in cardiovascular disease. Am J Cardiol. 2013;3:339–45.CrossRef Prasad K. Use of complementary therapies in cardiovascular disease. Am J Cardiol. 2013;3:339–45.CrossRef
4.
go back to reference Grant SJ, Bin YS, Kiat H, Chang DH. The use of complementary and alternative medicine by people with cardiovascular disease: a systematic review. BMC Public Health. 2012;12:299.CrossRefPubMedPubMedCentral Grant SJ, Bin YS, Kiat H, Chang DH. The use of complementary and alternative medicine by people with cardiovascular disease: a systematic review. BMC Public Health. 2012;12:299.CrossRefPubMedPubMedCentral
5.
go back to reference Barnett H. Complementary and alternative medicine and patient choice in primary care. Quality Primary Care. 2007;4:207–12. Barnett H. Complementary and alternative medicine and patient choice in primary care. Quality Primary Care. 2007;4:207–12.
6.
go back to reference Tachjian A, Maria V, Jahangir A. Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol. 2010;6:515–25.CrossRef Tachjian A, Maria V, Jahangir A. Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol. 2010;6:515–25.CrossRef
7.
go back to reference Liu EH, Turner LM, Lin SX, Klaus L, Choi LY, Whitworth J, et al. Use of alternative medicine by patients undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2000;2:335–41.CrossRef Liu EH, Turner LM, Lin SX, Klaus L, Choi LY, Whitworth J, et al. Use of alternative medicine by patients undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2000;2:335–41.CrossRef
8.
go back to reference de Souza MF M, Gawryszewski VP, Orduñez P, Sanhueza A, Espinal MA. Global burden of cardiovascular disease. Cardiovascular disease mortality in the Americas: current trends and disparities. Heart. 2012;98:1207–12.CrossRef de Souza MF M, Gawryszewski VP, Orduñez P, Sanhueza A, Espinal MA. Global burden of cardiovascular disease. Cardiovascular disease mortality in the Americas: current trends and disparities. Heart. 2012;98:1207–12.CrossRef
9.
go back to reference Clement YN, Morton-Gittens J, Basdeo L, Blades A, Francis M, Gomes N, et al. Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad. BMC Complement Altern Med. 2007;7:4.CrossRefPubMedPubMedCentral Clement YN, Morton-Gittens J, Basdeo L, Blades A, Francis M, Gomes N, et al. Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad. BMC Complement Altern Med. 2007;7:4.CrossRefPubMedPubMedCentral
10.
go back to reference Great Britain, West India Royal Commission Report. London: His Majesty’s Stationery Office. Cmd 6607; 1945 Great Britain, West India Royal Commission Report. London: His Majesty’s Stationery Office. Cmd 6607; 1945
11.
go back to reference Frenkel MA, Borkana JM. An approach for integrating complementary– alternative medicine into primary care. Fam Prac. 2003;3:324–32.CrossRef Frenkel MA, Borkana JM. An approach for integrating complementary– alternative medicine into primary care. Fam Prac. 2003;3:324–32.CrossRef
12.
go back to reference Lin MC, Nahin P, Gershwin EM, Longhurst JC, Wu KK. State of complementary and alternative medicine in cardiovascular, lung, and blood research. Circulation. 2001;103:2038–41.CrossRefPubMed Lin MC, Nahin P, Gershwin EM, Longhurst JC, Wu KK. State of complementary and alternative medicine in cardiovascular, lung, and blood research. Circulation. 2001;103:2038–41.CrossRefPubMed
13.
go back to reference Van den Bulck J, Custers K. Belief in complementary and alternative medicine is related to age and paranormal beliefs in adults. Eur J Public Health. 2010;2:227–30.CrossRef Van den Bulck J, Custers K. Belief in complementary and alternative medicine is related to age and paranormal beliefs in adults. Eur J Public Health. 2010;2:227–30.CrossRef
14.
go back to reference Hassen B, Grimsgaard S, Launsø L, Fønnebø V, Torkel F, Rasmussen NKR. Use of complementary and alternative medicine in the Scandinavian countries. Scand J Prim Health Care. 2005;23:57–62.CrossRef Hassen B, Grimsgaard S, Launsø L, Fønnebø V, Torkel F, Rasmussen NKR. Use of complementary and alternative medicine in the Scandinavian countries. Scand J Prim Health Care. 2005;23:57–62.CrossRef
15.
go back to reference Bodeker G, Kronenberg F. A public health agenda for traditional, complementary, and alternative medicine. Am J Public Health. 2002;10:1582–91.CrossRef Bodeker G, Kronenberg F. A public health agenda for traditional, complementary, and alternative medicine. Am J Public Health. 2002;10:1582–91.CrossRef
16.
go back to reference Salomonsen LJ, Skovgaard L, La Cour S, Nyborg L, Launso L, Fonnebo V. Use of complementary and alternative medicine at Norwegian and Danish hospitals. BMC Complement Altern Med. 2011;11:4.CrossRefPubMedPubMedCentral Salomonsen LJ, Skovgaard L, La Cour S, Nyborg L, Launso L, Fonnebo V. Use of complementary and alternative medicine at Norwegian and Danish hospitals. BMC Complement Altern Med. 2011;11:4.CrossRefPubMedPubMedCentral
17.
go back to reference Hill FJ. Complementary and alternative medicine: the next generation of health promotion? Health Promot Int. 2003;3:265–72.CrossRef Hill FJ. Complementary and alternative medicine: the next generation of health promotion? Health Promot Int. 2003;3:265–72.CrossRef
20.
go back to reference O’Brien K. Complementary and alternative medicine: the move into mainstream health care. Clin Exp Optom. 2004;87(2):110–20.CrossRefPubMed O’Brien K. Complementary and alternative medicine: the move into mainstream health care. Clin Exp Optom. 2004;87(2):110–20.CrossRefPubMed
22.
go back to reference Egede LE, Ye X, Zheng D, Marc DS. The prevalence and pattern of complementary and alternative medicine use in individuals with diabetes. Diabetes Care. 2002;25(2):324–9.CrossRefPubMed Egede LE, Ye X, Zheng D, Marc DS. The prevalence and pattern of complementary and alternative medicine use in individuals with diabetes. Diabetes Care. 2002;25(2):324–9.CrossRefPubMed
23.
go back to reference Kim Y. The pilot study in qualitative inquiry: Identifying issues and learning lessons for culturally competent research. Qualitative Social Work. 2011;10(2):190–206.CrossRef Kim Y. The pilot study in qualitative inquiry: Identifying issues and learning lessons for culturally competent research. Qualitative Social Work. 2011;10(2):190–206.CrossRef
24.
go back to reference Green J, Thorogood N. Qualitative methods for health research. London: Sage; 2009. Green J, Thorogood N. Qualitative methods for health research. London: Sage; 2009.
25.
go back to reference Ministry of Planning and Development Central statistical Office. Port of Spain, Trinidad and Tobago. The Trinidad and Tobago population and housing census Demographic report. 2011. Ministry of Planning and Development Central statistical Office. Port of Spain, Trinidad and Tobago. The Trinidad and Tobago population and housing census Demographic report. 2011.
27.
go back to reference Nichol J, Thompson EA, Shaw A. Beliefs, decision-making, and dialogue about complementary and alternative medicine (CAM) within families using CAM: A qualitative study. J Altern Complement Med. 2011;17(2):117–25.CrossRefPubMed Nichol J, Thompson EA, Shaw A. Beliefs, decision-making, and dialogue about complementary and alternative medicine (CAM) within families using CAM: A qualitative study. J Altern Complement Med. 2011;17(2):117–25.CrossRefPubMed
28.
go back to reference Grossman M. Whole person care and complementary and alternative therapies. In: Tom A, Hutchinson, editors. Whole person care: A new paradigm for the 21st century. New York: Springer Science + Business Media, LLC; 2011. p. 133–48.CrossRef Grossman M. Whole person care and complementary and alternative therapies. In: Tom A, Hutchinson, editors. Whole person care: A new paradigm for the 21st century. New York: Springer Science + Business Media, LLC; 2011. p. 133–48.CrossRef
30.
go back to reference Koç Z, Avci ÍA, Sağlam Z. The use of complementary and alternative medicine by older patients that have chronic diseases. Health Med. 2012;2:413–22. Koç Z, Avci ÍA, Sağlam Z. The use of complementary and alternative medicine by older patients that have chronic diseases. Health Med. 2012;2:413–22.
31.
go back to reference Bishop FL, Yardley L, Lewith GT. Why do people use different forms of complementary medicine? multivariate associations between treatment and illness beliefs and complementary medicine use. Psychol Health. 2006;5:683–98.CrossRef Bishop FL, Yardley L, Lewith GT. Why do people use different forms of complementary medicine? multivariate associations between treatment and illness beliefs and complementary medicine use. Psychol Health. 2006;5:683–98.CrossRef
34.
go back to reference Jiang X, Williams J, Liauw K, Ammit W, Roufogalis A, Duke B, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol. 2005;59:425–32.CrossRefPubMedPubMedCentral Jiang X, Williams J, Liauw K, Ammit W, Roufogalis A, Duke B, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol. 2005;59:425–32.CrossRefPubMedPubMedCentral
35.
go back to reference Taki Y, Yokotani K, Yamada S, Shinozuka K, Kubota Y, Watanabe Y, et al. Ginkgo biloba extract attenuates warfarin-mediated anticoagulation through induction of hepatic cytochrome P450 enzymes by bilobalide in mice. Phytomedicine. 2012;19(2):177–82.CrossRefPubMed Taki Y, Yokotani K, Yamada S, Shinozuka K, Kubota Y, Watanabe Y, et al. Ginkgo biloba extract attenuates warfarin-mediated anticoagulation through induction of hepatic cytochrome P450 enzymes by bilobalide in mice. Phytomedicine. 2012;19(2):177–82.CrossRefPubMed
37.
go back to reference Niggemann B, Grüber C. Side-effects of complementary and alternative medicine. Allergy. 2003;58(8):707–16.CrossRefPubMed Niggemann B, Grüber C. Side-effects of complementary and alternative medicine. Allergy. 2003;58(8):707–16.CrossRefPubMed
38.
go back to reference Paul JHA, Seaforth CE. Harmful plants in Caribbean folk medicine. Focus Altern Complement Ther. 2011;4:261–5.CrossRef Paul JHA, Seaforth CE. Harmful plants in Caribbean folk medicine. Focus Altern Complement Ther. 2011;4:261–5.CrossRef
39.
go back to reference White MA, Verhoef MJ, Davison BJ, Gunn H, Cooke K. Seeking mind, body and spirit healing-Why some men with prostate cancer choose CAM (complementary and alternative medicine) over conventional cancer treatments. Integr Med Insights. 2008;3:1–11.PubMedPubMedCentral White MA, Verhoef MJ, Davison BJ, Gunn H, Cooke K. Seeking mind, body and spirit healing-Why some men with prostate cancer choose CAM (complementary and alternative medicine) over conventional cancer treatments. Integr Med Insights. 2008;3:1–11.PubMedPubMedCentral
40.
go back to reference Knox J, Gaster B. Dietary supplements for the prevention and treatment of coronary artery disease. J Altern Complement Med. 2007;13(1):83–95.CrossRefPubMed Knox J, Gaster B. Dietary supplements for the prevention and treatment of coronary artery disease. J Altern Complement Med. 2007;13(1):83–95.CrossRefPubMed
41.
go back to reference Ernst E. Prevalence of use of complementary/alternative medicine: a systematic review. Bull World Health Organ. 2000;78(2):252–7.PubMedPubMedCentral Ernst E. Prevalence of use of complementary/alternative medicine: a systematic review. Bull World Health Organ. 2000;78(2):252–7.PubMedPubMedCentral
42.
go back to reference Corner J, Yardley J, Maher EJ, Roffe L, Young T, Maslin-Prothero S, et al. Patterns of complementary and alternative medicine use among patients undergoing cancer treatment. Eur J Cancer Care. 2009;3:271–9.CrossRef Corner J, Yardley J, Maher EJ, Roffe L, Young T, Maslin-Prothero S, et al. Patterns of complementary and alternative medicine use among patients undergoing cancer treatment. Eur J Cancer Care. 2009;3:271–9.CrossRef
43.
go back to reference Kreitzer MJ, Snyder M. Healing the heart: Integrating complementary therapies and healing practices into the care of cardiovascular patients. Prog Cardiovasc Nurs. 2002;17:2.CrossRef Kreitzer MJ, Snyder M. Healing the heart: Integrating complementary therapies and healing practices into the care of cardiovascular patients. Prog Cardiovasc Nurs. 2002;17:2.CrossRef
44.
go back to reference Smith JM, Sullivan SJ, Baxter GD. Complementary and alternative medicine: contemporary trends and issues. Phys Ther Rev. 2011;2:91–5.CrossRef Smith JM, Sullivan SJ, Baxter GD. Complementary and alternative medicine: contemporary trends and issues. Phys Ther Rev. 2011;2:91–5.CrossRef
45.
go back to reference Canaway R, Manderson L. Quality of life, perceptions of health and illness, and complementary therapy use among people with type 2 diabetes and cardiovascular disease. J Altern Complement Med. 2013;19(11):882–90.CrossRefPubMedPubMedCentral Canaway R, Manderson L. Quality of life, perceptions of health and illness, and complementary therapy use among people with type 2 diabetes and cardiovascular disease. J Altern Complement Med. 2013;19(11):882–90.CrossRefPubMedPubMedCentral
46.
go back to reference Warren N, Canaway R, Unantenne N, Manderson L. Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management. Health (London). 2013;17(4):323–39.CrossRef Warren N, Canaway R, Unantenne N, Manderson L. Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management. Health (London). 2013;17(4):323–39.CrossRef
47.
go back to reference Manderson L, Canaway R. Serious decisions: chronic conditions and choice of provider. Qual Health Res. 2013;12:1638–48.CrossRef Manderson L, Canaway R. Serious decisions: chronic conditions and choice of provider. Qual Health Res. 2013;12:1638–48.CrossRef
48.
go back to reference Muhamad M, Merriam S, Suhami N. Why breast cancer patients seek traditional healers. Int J Breast Cancer. 2012;2012:689168[On line] F:\Why Breast Cancer Patients Seek Traditional Healers.htm (date accessed 6/03/2015). Muhamad M, Merriam S, Suhami N. Why breast cancer patients seek traditional healers. Int J Breast Cancer. 2012;2012:689168[On line] F:\Why Breast Cancer Patients Seek Traditional Healers.htm (date accessed 6/03/2015).
49.
go back to reference Lee GBW, Charn TC, Chew ZH, Ng TP. Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs. Fam Prac. 2004;21(6):654–60.CrossRef Lee GBW, Charn TC, Chew ZH, Ng TP. Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs. Fam Prac. 2004;21(6):654–60.CrossRef
50.
go back to reference Malik IA, Gopalan S. Use of CAM results in delay in seeking medical advice for breast cancer. Eur J Epidemiol. 2003;18(8):817–22.CrossRefPubMed Malik IA, Gopalan S. Use of CAM results in delay in seeking medical advice for breast cancer. Eur J Epidemiol. 2003;18(8):817–22.CrossRefPubMed
51.
go back to reference Jarman CN, Perron BE, Kilbourne AM, Teh CF. Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder. J Altern Complement Med. 16(3):251–255 Jarman CN, Perron BE, Kilbourne AM, Teh CF. Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder. J Altern Complement Med. 16(3):251255
52.
go back to reference Whayne Jr TF. What should medical practitioners know about the role of alternative medicines in cardiovascular disease management? Cardiovas Ther. 2010;28(2):106–23.CrossRef Whayne Jr TF. What should medical practitioners know about the role of alternative medicines in cardiovascular disease management? Cardiovas Ther. 2010;28(2):106–23.CrossRef
53.
go back to reference Wood MJ, Stewart RL, Merry H, Johnstone DE, Cox JL. Use of complementary and alternative medical therapies in patients with cardiovascular disease. Am Heart J. 2003;145(5):806–12.CrossRefPubMed Wood MJ, Stewart RL, Merry H, Johnstone DE, Cox JL. Use of complementary and alternative medical therapies in patients with cardiovascular disease. Am Heart J. 2003;145(5):806–12.CrossRefPubMed
54.
go back to reference Lorenc A, Ilan-Clarke Y, Robinson N, Blair M. How parents choose to use CAM: A systematic review of theoretical models. BMC Complement Altern Med. 2009;9:9.CrossRefPubMedPubMedCentral Lorenc A, Ilan-Clarke Y, Robinson N, Blair M. How parents choose to use CAM: A systematic review of theoretical models. BMC Complement Altern Med. 2009;9:9.CrossRefPubMedPubMedCentral
55.
go back to reference Mills SY. Regulation in complementary and alternative medicine. BMJ. 2011;7279:158–60. Mills SY. Regulation in complementary and alternative medicine. BMJ. 2011;7279:158–60.
Metadata
Title
Perceptions of complementary and alternative medicine among cardiac patients in South Trinidad: a qualitative study
Authors
Mandreker Bahall
Mark Edwards
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2015
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-015-0577-8

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