Use of complementary or alternative medicine and potential interactions with chronic medications among Chinese survivors of childhood cancer

• Published in: Journal of cancer survivorship 2022-06, Vol.16 (3), p.568-581
• Main Authors: Lam, Chun Sing, Cheng, Yi Man, Li, Hoi Shan, Koon, Ho-Kee, Li, Chi Kong, Ewig, Celeste L.Y., Cheung, Yin Ting
• Format: Article
• Language: English
• Subjects: Alternative medicine; Brain tumors; Cancer; Childhood; Children; Confidence intervals; Drug interaction; Drug interactions; Health Informatics; Health Promotion and Disease Prevention; Herbal medicine; Medicine; Medicine & Public Health; Natural products; Oncology; Pediatrics; Prescription drugs; Primary Care Medicine; Public Health; Quality of Life Research; Solid tumors; Statistical analysis; Survival; Traditional Chinese medicine; Tumors
• ISSN: 1932-2259; 1932-2267
• DOI: 10.1007/s11764-021-01051-5

Purpose This study explored the pattern of complementary or alternative medicine (CAM) use among Chinese survivors of childhood cancer and identified potential drug-CAM interactions and factors predicting CAM use. Methods This cross-sectional study recruited 393 survivors of childhood cancer (male, 57.8%; mean age, 17.7 [SD = 7.3] years; mean years post-treatment, 8.8 [SD = 5.0]) from a public hospital in Hong Kong. Participants reported CAM and over-the-counter medications that they used in the past year. Prescription drug data were extracted from pharmacy dispensing records. Potential interactions between concurrent CAM and chronic medications were identified from well-established CAM-drug/herb-drug interaction databases. A multivariate logistic regression was performed to analyze associations of socio-demographic and clinical factors with CAM use. Results Half ( n = 205/393, 52.2%) of the participants reported the use of CAM. The most popular CAMs were traditional Chinese medicine ( n = 127/205, 62.0%) and natural products ( n = 114/205, 55.3%). Among the 69 survivors (33.7%) concurrently using CAM and chronic medications, one-third ( n = 21/69, 30.4%) were at risk of drug-CAM interactions that are of moderate significance. Adult survivors were more likely to use CAM than pediatric survivors (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.31–4.41). Brain tumor survivors were more likely than other solid tumor survivors to use non-oral therapies (OR, 2.70; 95% CI, 1.01–7.72). Conclusions The prevalence of CAM use among Chinese survivors of childhood cancer was high. A minority of survivors had a risk of clinically significant CAM-drug interactions. Future studies should focus on survivors’ behavior and motivations for CAM use. Implications for Cancer Survivors As the concurrent use of CAM and chronic medications might result in interactions, healthcare providers should proactively identify such interactions and develop referral pathways to promote evidence-based integrative therapies for survivors.