The use of alternative therapies in the Saskatchewan stroke rehabilitation population
Tóm tắt
Many patients use alternative therapies. The purpose of this study was to determine the percentage of stroke rehabilitation patients in Saskatchewan using alternative therapies, whether patients found these therapies effective in alleviating stroke-related symptoms, how often those patients who used alternative therapies discuss this fact with their primary care doctor and the main reason why patients might not do so. Telephone questionnaire surveys were conducted with 117 patients who had suffered a stroke and undergone inpatient or outpatient rehabilitation at Saskatoon City Hospital. The study revealed that 26.5% of 117 stroke rehabilitation patients visited alternative practitioners at least once or used some form of unconventional therapy. Only 16.1% of patients found that alternative therapy made them feel much better. Of those who used alternative therapy, 61.3% did not discuss this fact with their primary physician. Many of the respondents (47.3%) who did not inform their physician stated that they did not see the necessity of talking about these treatments and 21.1% did not discuss the issue with their physician because they felt that he or she might disapprove of alternative therapies. A relatively small percentage of stroke patients found alternative therapies beneficial. Doctors should be aware that a significant number of patients will try alternative treatment without discussion with their primary care physician or specialist. The current study suggests that after completing routine questioning, doctors should also ask their patients about their use of alternative therapies and, when appropriate, review issues of safety and efficacy.
Tài liệu tham khảo
Maddocks I: Alternative medicine. Med J Aust. 1985, 142: 547-51.
Fisher P, Ward A: Complementary medicine in Europe. BMJ. 1994, 309: 107-11.
Fulder SJ, Munro RE: Complementary medicine in the United Kingdom: practitioners and consultation. Lancet. 1985, 2: 542-45. 10.1016/S0140-6736(85)90473-8.
Verhoef MJ, Russell ML, Love EJ: Alternative medicine use in rural Alberta. Can J Public Health. 1994, 85: 308-9.
Eisenberg DM, Davis RB, Ettner SL, Appel S, Van Rompay M: Trends in alternative medicine use in the United States, 1990–1997. JAMA. 1998, 280: 1569-75. 10.1001/jama.280.18.1569.
Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco T: Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med. 1993, 328: 246-52. 10.1056/NEJM199301283280406.
Berger E: The Canada health monitor. Survey #4, July – August 1990. Toronto: Price Waterhouse. 1990
Mackie R: Angus Reid Survey. Globe and Mail. Oct. 1997
Varhoef MJ, Sutherland LR: Alternative medicine and general practitioners: opinions and behaviour. Can Fam Phys J. 1995, 41: 1005-11.
Elder NC, Gillcrist A, Minz R: Use of alternative health care by family practice patients. Arch Fam Med. 1997, 6: 181-4. 10.1001/archfami.6.2.181.
Vecchio PC: Attitudes to alternative medicine by rheumatology outpatient attenders. J Rheumatol. 1994, 21: 145-7.
Pioro-Boisset M, Esdaile JM, Fitzcharles MA: Alternative medicine use in fibromyalgia syndrome. Arthritis Care and Research. 1996, 9: 13-7.
Donnelly WJ, Spykerboer JE, Thong YH: Are patients who use alternative medicine dissatisfied with orthodox medicine?. Med J Aust. 1985, 142: 539-41.
Moore J: Why do people seek treatment by alternative medicine?. BMJ. 1985, 290: 28-9.
Wainapel SF, Thomas AD, Kahan BS: Use of alternative therapies by rehabilitation outpatients. Arch Phys Med Rehabil. 1998, 79: 1003-5. 10.1016/S0003-9993(98)90102-2.
Krauss HH, Godfrey C, Kirk J, Eisenberg DM: Alternative health care: its use by individuals with physical disabilities. Arch Phys Med Rehabil. 1998, 79: 1440-7. 10.1016/S0003-9993(98)90241-6.
Astin JA: Why patients use alternative medicine: results of a national study. JAMA. 1998, 279: 1548-53. 10.1001/jama.279.19.1548.
Ko GD, Berbrayer D: Complementary and alternative medicine: Canadian physiatrists attitudes and behavior. Arch Phys Med Rehabil. 2000, 81: 662-7.
Paramore LC: Use of alternative therapies: estimates from the 1994 Robert Wood Johnson Foundation National Access to Care survey. J Pain Symptom Manage. 1997, 13: 83-9. 10.1016/S0885-3924(96)00299-0.
Boiset M, Fitzcharles MA: Alternative medicine use by rheumatology patients in a universal health care setting. J Rheumatol. 1994, 21: 148-52.
Shiflett SC, Krauss HH, Godfrey C: Predictors of usage of alternative therapies in the physically disabled. Annals of Behavioral Medicine. 1999, 21: 5089-
Goldszmidt M, Levitt C, Duarte-Franco E, Kaczorowski J: Complementary health care services: a survey of general practitioners' views. Can Med Assoc J. 1995, 153: 29-35.
Himmel W, Schulte M, Kochen MM: Complementary medicine: are patients' expectations being met by their general practitioners?. Br J Gen Pract. 1993, 43: 232-5.
McRae S: Elevated serum digoxin levels in a patient taking digoxin and siberian ginseng. Can Med Assoc J. 1996, 155: 293-5.
Cheuk MY, Chan JCN, Sanderson JE: Chinese herbs and warfarin potentiation by "Danshen". J Int Med. 1997, 241: 337-9. 10.1046/j.1365-2796.1997.134137000.x.
Rowin J, Lewis SL: Spontaneous bilateral subdural hematomas associated with chronic ginkgo biloba ingestion. Neurology. 1996, 46: 1775-6.
Krauss C: Pataki outlaws herbal stimulant linked to deaths. The New York Times. B1-24 May 1996
Gowley G: Herbal Warning. Newsweek. 60-6 May 1996
Ruschitzka F, Meier PJ, Turina M, Luscher TF, Noll G: Acute heart transplant rejection due to Saint John's wort. Lancet. 2000, 335: 548-9. 10.1016/S0140-6736(99)05467-7.
Yue Q-Y, Bergquist C, Gerden B: Safety of St John's wort (Hypericum perforatum). Lancet. 2000, 355: 576-7.
Visser GJ, Peters L, Rasker JJ: Rheumatologists and their patients who seek alternative care: an agreement to disagree. Br J Rheumatol. 1992, 31: 485-90.
Murray RH, Rubel AJ: Physicians and healers – unwitting partners in health care. N Engl J Med. 1992, 326: 61-4.
Eisenberg DM: Advising patients who seek alternative medical therapies. Ann Intern Med. 1997, 127: 61-9.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6882/2/7/prepub