Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: a systematic review and meta-analysis.
IF 4.2 2区 医学Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE
Jia Wen Chin, Rafidah Abdullah, Benjamin Wei Wang Tan, Koh Wei Wong, Ban-Hock Khor
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引用次数: 0
Abstract
Background: The use of complementary and alternative medicine (CAM) is common among individuals with underlying chronic illnesses.
Objective: This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease (CKD).
Search strategy: PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024.
Inclusion criteria: Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy.
Data extraction and analysis: Two independent reviewers performed the literature screening. The data were extracted from the included studies by one reviewer and cross-checked by another. Discrepancies were resolved by discussion and consensus among two reviewers. Primary information included prevalence of CAM use, types of CAM used, reasons for CAM use, factors associated with CAM use, and disclosure to healthcare providers. Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model.
Results: Forty-one studies were included in this systematic review and meta-analysis. The pooled prevalence of CAM use was 43% (95% confidence interval: 34%, 51%), I2 = 99.46%. The reasons for CAM use included treatment of underlying comorbidities, complications or symptoms, maintenance of general health, and treatment of CKD. Nutritional approaches were the most common CAM modality, with 412 different herbal and dietary supplements reported; psychological and physical approaches included massage therapy, relaxation techniques, and mind-body practices; and other complementary health approaches such as homeopathy, traditional Chinese medicine, and Ayurvedic medicine were also frequently reported. Factors associated with CAM use included sociodemographic characteristics such as older age, female gender, or higher income; disease or therapy factors such as not having diabetes, relying on hemodialysis, or poor adherence to medication; and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM. About 66% (61%, 72%) of CAM users did not disclose the use of CAM to their healthcare providers.
Conclusion: CAM use is prevalent among individuals with CKD, and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm. Please cite this article as: Chin JW, Abdullah R, Tan BWW, Wong KW, Khor BH. Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: A systematic review and meta-analysis. J Integr Med. 2025; Epub ahead of print.
背景：补充和替代医学（CAM）的使用是常见的个体与潜在的慢性疾病。目的：本系统综述和荟萃分析调查了慢性肾脏疾病（CKD）患者中CAM的全球患病率和使用模式。检索策略：检索PubMed， Embase和护理和联合健康文献累积索引Plus，从创建到2024年2月26日。纳入标准：在18岁以上CKD所有阶段或接受任何形式肾脏替代治疗的患者中至少使用一种CAM的原创文章。资料提取和分析：两位独立的审稿人进行文献筛选。数据由一位审稿人从纳入的研究中提取，并由另一位审稿人进行交叉检查。差异通过两位审稿人的讨论和共识得到解决。主要信息包括辅助手段使用的流行程度、使用的辅助手段类型、使用的原因、与辅助手段使用相关的因素以及向医疗保健提供者披露的情况。采用随机效应模型进行meta分析，以确定CAM使用和不披露的总流行率。结果：41项研究被纳入本系统综述和荟萃分析。CAM使用的总患病率为43%(95%可信区间：34%，51%),I2 = 99.46%。使用CAM的原因包括治疗潜在的合并症、并发症或症状、维持一般健康和治疗慢性肾病。营养方法是最常见的辅助治疗方式，共报告了412种不同的草药和膳食补充剂；心理和物理方法包括按摩疗法、放松技巧和身心练习；以及其他辅助保健方法，如顺势疗法、传统中医和阿育吠陀医学，也经常被报道。与辅助治疗使用相关的因素包括社会人口统计学特征，如年龄较大、女性性别或收入较高；疾病或治疗因素，如没有糖尿病，依赖血液透析，或药物依从性差；患者或内部因素，如对CAM的积极态度和认知CAM的安全性。约66%（61%,72%）的CAM使用者没有向其医疗保健提供者披露使用CAM的情况。结论：慢性肾病患者普遍使用CAM，医护人员应公开有效沟通，强调CAM的合理使用，避免潜在危害。本文署名：Chin JW， Abdullah R, Tan BWW, Wong KW, Khor BH。成人慢性肾病患者补充和替代药物使用的患病率和模式：一项系统回顾和荟萃分析集成医学[J]；打印前Epub。
期刊介绍：
The predecessor of JIM is the Journal of Chinese Integrative Medicine (Zhong Xi Yi Jie He Xue Bao). With this new, English-language publication, we are committed to make JIM an international platform for publishing high-quality papers on complementary and alternative medicine (CAM) and an open forum in which the different professions and international scholarly communities can exchange views, share research and their clinical experience, discuss CAM education, and confer about issues and problems in our various disciplines and in CAM as a whole in order to promote integrative medicine.
JIM is indexed/abstracted in: MEDLINE/PubMed, ScienceDirect, Emerging Sources Citation Index (ESCI), Scopus, Embase, Chemical Abstracts (CA), CAB Abstracts, EBSCO, WPRIM, JST China, Chinese Science Citation Database (CSCD), and China National Knowledge Infrastructure (CNKI).
JIM Editorial Office uses ThomsonReuters ScholarOne Manuscripts as submitting and review system (submission link: http://mc03.manuscriptcentral.com/jcim-en).
JIM is published bimonthly. Manuscripts submitted to JIM should be written in English. Article types include but are not limited to randomized controlled and pragmatic trials, translational and patient-centered effectiveness outcome studies, case series and reports, clinical trial protocols, preclinical and basic science studies, systematic reviews and meta-analyses, papers on methodology and CAM history or education, conference proceedings, editorials, commentaries, short communications, book reviews, and letters to the editor.
Our purpose is to publish a prestigious international journal for studies in integrative medicine. To achieve this aim, we seek to publish high-quality papers on any aspects of integrative medicine, such as acupuncture and traditional Chinese medicine, Ayurveda medicine, herbal medicine, homeopathy, nutrition, chiropractic, mind-body medicine, taichi, qigong, meditation, and any other modalities of CAM; our commitment to international scope ensures that research and progress from all regions of the world are widely covered. These ensure that articles published in JIM have the maximum exposure to the international scholarly community.
JIM can help its authors let their papers reach the widest possible range of readers, and let all those who share an interest in their research field be concerned with their study.
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