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Use of traditional, complementary and
alternative medicine in the clinical practice of nephrology
Guillermo Pedreira Robles, Ana Vasco Gómez, Yaiza Martínez Delgado, Cristina Herrera Morales,
Ernestina Junyent iglesias
Nephrology Service of the Hospital del Mar. Barcelona, Sapain.
47th EDTNA/ERCA International Conference
Genoa, Italy, September 2018.
INDEX
Background
Objective
Methods
Results
Discussion
Conclusion
BACKGROUND
BACKGROUND
Traditional and Complementary Medicine (TCM): sum of knowledge, skills and practices based on the theories, beliefs and experiences of different cultures. Whether they are explainable or not, TCM is used to maintain health and prevent, diagnose, improve or treat physical and
mental illnesses.
(World Health Organization, 2013).
BACKGROUND
TCM are a broad set of health care practices that are not part of the health care system of a given country.
Many times, the health professionals don’t know if their patients use remedies from TCM.
This can suppose a potential interference with the prescribed treatment from the reference hospital.
(World Health Organization, 2013).
BACKGROUND
FatigueDiscouragement
DespairAnxiety Depression
PainDecreased appetite
Nausea/vomit Decreased sexual functioning
Skin problems
Neuropathy
BACKGROUND
People with that symptoms are more reactive to possible supplements that improve their situation or optimize their conventional treatment
Pérez Lapuente et al., 2013; Sánchez Quiles et al., 2014
BACKGROUND
People are using TCM and we may not know it.
This can suppose an interference with the prescribed treatment.
OBJECTIVE
OBJECTIVE
To analyse the use and knowledge of Traditional and Complementary Medicine among health
professionals in a nephrology unit.
METHODS
METHODS
• A cross-sectional descriptive study was conducted at the Hospital del Mar Nephrology Department during February 2017.
• Included 62 health professionals.
• Ad hoc questionnaire.
• Analysis: the Student's t-distribution for the comparison of means between parametric variables, the Mann–Whitney U test for nonparametric variables and the Chi-squared test for the comparison of proportions.
• The present study has been approved by the institution's Clinical Research Ethics Committee (number 2018/7797/I).
RESULTS
RESULTS
Age (mean ± ED) 37,61 ± 11,05 years
Sex (%; n)Women: 87,1% (54) Men: 12,9% (8)
Professional category (%; n)Nurses: 54,83% (34)Nursing assistants: 24,19% (15)Nephrologists: 20,97% (13)
Years of experience (%; n)
From 1 to 5 years: 27,42% (17)From 6 to 10 years: 17,74% (11)From 11 to 25 years: 38,71% (24)From 26 to 40 years: 16,13% (10)
RESULTS
I do not know any
7%
I know 1 or 219%
I know more than 374%
How many alternative therapies do you know?
No68%
University education
11%
Training from the
workplace2%
Specialized course
16%
All of them3%
Have you received training on alternative therapies?
32%
RESULTS
I do not use any58%
I use 1 or 227%
I use more than 315%
How many alternative therapiesdo you use?
Yes63%
No10%
I don’t know27%
Do you think that the alternative therapies should be included in the
clinical practice?
42%
RESULTS
Yes23%
No32%
Sometimes45%
Do you recommend patients to use alternative therapies?
37,10%30,65%
9,68%
58,06%
Yes No As a firsttherapeutic line
As acomplementary
treatment
When you recommend them, doyou recommend them from your
personal experience?
How do you recommend them?
68%
RESULTS
Yes8%
No48%
I don't know44%
Do you think that its effect is attributable to the placebo effect?
Yes27%
No73%
Has any patient asked you for information about alternative
therapies?
52%
RESULTS
Yes77%
No8%
I don't know15%
Do you consider important to include specific training of alternative therapies in the
university teaching programs?
Yes50%
No29%
I don't know21%
Do you think that not knowing if your patients use alternative therapies can
interfere with conventional treatment?
50%
RESULTS
Agree90%
Indifferent8%
Disagree2%
Do you agree to advocate the safe, rational and informed use of thistype of treatments and promote
scientific research?
Yes82%
No18%
Would you investigate in this field?
DISCUSSION
DISCUSSION
• The 62 professionals surveyed know a large number of alternative
therapies. This knowledge is related to the training received or the
personal use in their daily life.
74.20%
41.94%
32.26%
• The 67.74% of the professionals affirm that they recommend the use of these therapies at some time.
DISCUSSION
• 20 professionals who have received training:• 17 (85%) recommend the use of TCM.
• 3 (15%) don’t recommend the use of TCM.
• (p=0.002).
• 42 professionals who have not received training:• 25 (59.5%) recommend the use of TCM .
• 17 (40,5%) don’t recommend the use of TCM
• (p=0.217).
CONCLUSION
CONCLUSION
• Professionals with a low training on TCM.
• A high prevalence of professionals that recommends the use of TCM.
• A high number of professionals who do not know the repercussionof these treatments.
• The professionals showed interest in receiving training and in its
inclusion in the clinical practice.
• It would be important to know specifically the use and knowledge of this
type of therapies by the patients.
REFERENCES
• Arjuna Rao A.S.M., Phaneendra D., Divya Pavani Ch., Soundararajan P., Vanitha Rani N., Kannan G. (2016) Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis, J Pharm Bioallied Sci 8(1), 52–57.
• Bahall M., Legall G. (2017) BMC Complementary and Alternative Medicine 17, 144.• Burrowes J.D., Van Houten G. (2005) Use of alternative medicine by patients with stage 5 chronic kidney disease, Adv Chronic Kidney Dis 12(3), 312-25.• Eisenberg D.M., Davis R.B., Ettner S.L., Appel S., Wilkey S., Van Rompay M., Kessler R.C. (1998) Trends in alternative medicine use in the United States, 1990-1997:
results of a follow-up national survey, JAMA 280(18), 1569–1575. • Grant S.J., Sun Bin Y., Kiat H., Hsu-Tung Chang D. (2012) The use of complementary and alternative medicine by people with cardiovascular disease: a systematic
review, BMC Public Health 12, 299. • Kinchen E.V., Loerzel V.L. (2018) Nursing Students’ Attitudes and Use of Holistic Therapies for Stress Relief, Journal of Holistic Nursing 20(10), 1-12.• Kirk J., Dunker K.S. (2014) Dietary Counseling: The Ingredient for Successfully Addressing the Use of Herbal Supplements and Probiotics in Chronic Kidney Disease,
Advances in Chronic Kidney Disease 21(4), 377-384.• Pérez Lapuente M.L., Polo Muñoz R., de Maya Sánchez B., Gómez Sánchez M.P., Meseguer Hernández S., Melero Rubio E. (2013) Las terapias complementarias en una
unidad de hemodiálisis, Rev Enferm Nefrol 16(1), 156-217. • Pressman A.H., Buff S. (2001) Medicina Alternativa. Mexico: Pearson Educación.• Sánchez Quiles F., Gutiérrez Gascón J., del Pino Casado R. (2014) Frecuencia de uso de terapias alternativas/complementarias (TAC) en pacientes con enfermedades
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Guillermo Pedreira Robles
Nephrology Service of the Hospital del Mar.
Barcelona, Sapain.
gpedreira@parcdesalutmar.cat
GRAZIE MILLE
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