The use of Complementary and alternative medicines two years

The use of Complementary and alternative medicines two years after cancer
diagnosis in France – evidence from the VICAN survey.
Authors
Objectives
Aline Sarradon-Eck1,2, Anne-Déborah Bouhnik1,2, Dominique Rey1,2,3, Marc-Karim Bendiane1,2,3 Patrick
Peretti-Watel1,2 and the VICAN group
1. INSERM, UMR912 «Economics and Social Sciences Applied to Health & Analysis of Medical Information» (SESSTIM), 13006,
Marseille, France.
2. Aix Marseille University, UMR_S912, IRD, 13006, Marseille, France.
3. ORS PACA, Southeastern Health Regional Observatory, 13006, Marseille, France
Background
To evaluate the use of CAM in a representative sample of patients 2 years after a cancer diagnosis.
To determine the profile of CAM-users in terms of :
n nIncrease in the use of Complementary and alternative medicine (CAM), especially in the
context of chronic diseases
n nA growing number of studies focus on the use of CAM in cancer
è èSocio-economic characteristics
è èMedical characteristics
è èSequelae
n nEstimated rates of use varies according to countries and localisations (Molassiotis, 2005) : from
15% to 73% in Europe
n nFew data in France : 34% (Trager-Maury, 2007)
n nHowever, existing results need to be interpreted with caution, mainly due to recruitment bias
Methods
Results
USE OF THE VICAN SURVEY (BOUHNIK ET AL, BMJ OPEN 2015)
FACTORS ASSOCIATED WITH CAM USE n n16.4% of participants used CAM at time of the survey :
»»
45,1% of them used CAM since diagnosis
»»
66.0% reported only one type of CAM
Socio-economic characteristics
»»
22.2% reported 2 types of CAM
»»
11.8% reported more than 2 types of CAM
Gender
Male
Female
Age
<70
70 and more
Social Deprivation Index
Low
Medium
High
Level of education
<High school certificate
≥High school certificate
Missing
Types of CAM used (1/2)
Alternative medical system
Representative sample of patients, two years after cancer diagnosis.
Objective : to describe life conditions of cancer survivors
12 localisations : breast cancer, prostate cancer, colorectal cancer, cervical cancer, endometrial
cancer, melanoma, bladder cancer, kidney cancer, lung cancer, upper aerodigestive tract, non-Hodgkin
lymphoma, thyroid cancer
Selection of patients among individuals registered in one of the three main Health Insurance Schemes
which together cover more than 90% of the French population.
Data collected in 2012 / 4349 patients included (response rate=43.7%)
Questions about CAM use : CAM use at time of the survey (yes/no)
If yes, use of CAM before diagnosis (yes/no) and type of CAM used (open-question)
Homeopathy
Acupuncture
Naturopathy
Qi Gong
Chinese medicine
Tai Chi
Isotherapy
Manipulation and body-based methods
Osteopathy
Manipulative therapy
Foot reflexology
Auriculotherapy
Etiopathy
%
Types of CAM used (2/2)
%
75.5
Mind–body interventions
16.7
64.0
22.1
2.7
1.8
1.8
0.6
0.2
Energy therapy
Magnetic healer
Sophrology
Yoga
Hypnotherapy
Biological decoding
5.8
4.1
3.5
1.4
1.0
0.9
19.7
15.1
2.2
2.0
0.6
0.5
Kinesiology
Relaxation
Meditation
Shamanism
Tibetan medicine
Psychic therapies
Akero therapies
Biologically based therapies
COMBINATION OF THREE SOURCES OF DATA
Herbal medicine
Diets
Aromatherapy
medical survey with the physician
who iniated treatment
Conclusions
Paents-reported outcomes collected
using the CATI system
Estimation of CAM-use in a representative sample of patients, 2 years after diagnosis
lower than what found in other surveys.
0.5
0.5
0.4
0.2
0.1
0.1
14.9
8.1
7.3
0.8
CI (95%)
1
2.7
2.2-3.2
1.5
1
1.4
1.2
1
p
<.001
1.2-1.9
1.1-1.6
1.0-1.5
<.001
0.005
0.121
1
2.0
5.0
<.001
1.7-2.4
1.8-13.6
1
1.4
0.1
1.1-1.6
<0.1-1.0
0.001
0.048
1
1.3
1.3
1.0-1.5
0.4-5.0
0.013
0.655
Sequelae
Fatigue clinically significant
No
Yes
Missing
Perceived pain
No
Yes
Missing
Acknowledgements
Associated factors mainly related to socio-economic characteristics.
members of the VICAN group : Thomas APARICIO, Emmanuel BABIN, François BECK, Robert BENAMOUZIG, Marc-Karim BEN
DIANE, Cyril BERENGER, Dominique BESSETTE, Anne-Déborah BOUHNIK, Philippe-Jean BOUSQUET, Marie-Claude CABANELGICQUEL, Marianick CAVALLINI-LAMBERT, Michèle CHANTRY, Claire CHAUVET, Sébastien CORTAREDONA, Véronique DANGUY,
Michel DORVAL, Jean-Baptiste HERBET, Laetitia HUIART, Xavier JOUTARD, Anne-Gaëlle LE CORROLLER-SORIANO, Julien
MANCINI, Mégane MERESSE, Jean-François MORERE, Herman NABI, Alain PARAPONARIS, Patrick PERETTI-WATEL, Marie
PREAU, Christel PROTIERE, Frédérique RETORNAZE, Dominique REY, Benoit RIANDEY, Luis SAGAON-TEYSSIER, Aurélia TISON,
Valérie SEROR, Archana SINGH-MANOUX, Catherine THIEBLEMONT, Pierre VERGER.
For nearly half of CAM-users, cancer was an initiating factor for using such medicines.
This study was funded by The National Institute of Cancer (INCa),“Contrat de recherche et développement no 05-2011”.
Types of CAM-use and associated factors similar to those encountered in the literature.
Medico-administrave records including
financial reimbursement data and hospital
discharge records (SNIRR-AM database)
0.7
AOR
Contact : [email protected]