Use of Complementary Alternative Medicine in the Largest Mexican-American Border City
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1 Use of Complementary Alternative Medicine in the Largest Mexican-American Border City José O. Rivera, Pharm.D. Melchor Ortiz, Ph.D. Mark E. Lawson, M.D., M.P.H. Kalpana M. Verma, M.D. Acknowledgements: José C. Rodriguez, CPhT
2 Objective To evaluate use of Complementary Alternative Medicine (CAM) in.. The Largest Mexican-American Border City
3 Eisenberg and Colleagues Two National Surveys Conducted By Phone They Found Increase of CAM use 33.8 % to 42.1 % Disclosure to physicians 39.8 % to 38.5 % Increase Hispanic participants 6 % to 10 % Isenberg and Colleagues JAMA 1998
4 These figures do not represent the El Paso region All non-english speaking individuals were excluded, along with those who did not have a telephone in their home Isenberg and Colleagues JAMA 1998
5 Astin, J.A. Conducted a Mail Survey Designed to evaluate reasons for using CAM Astin JA. JAMA 1998;279
6 Dissatisfaction was not a predictor of use Only 44% of responders relied primarily on alternative medicine Astin JA. JAMA 1998;279
7 Their Findings People who used had More education Poorer health status A holistic orientation to health A transformational experience Astin JA. JAMA 1998;279
8 Their Most Common Health Conditions Associated with CAM Use Anxiety Back Problems Chronic Pain Urinary Tract Problems Astin JA. JAMA 1998;279
9 Again Only 7.5% of the people surveyed were fluent English speaking Hispanic participants Astin JA. JAMA 1998;279
10 Survey answered by, National Family Opinion Inc. This group maintains a panel of people who routinely complete surveys This sample is not representative of the general population Astin JA. JAMA 1998;279
11 Other surveys Marsh and Hentages-West Texas Chesney-Galveston These surveys do not reflect the demographics of the El Paso region Marsh WW, Hentges K. Am Family Physician 1998
12 Anderson, R. Conducted a field study of a Mexican Sobador His results showed that the Mexican Sobador Met medical standards for safety Anderson R. So Si Med 1987;24
13 Zuckerman, M. J. Wanted to identify healthcare seeking behaviors of Hispanics versus non- Hispanic whites with relation to bowel complaints He found that Hispanics were much more likely to selfmedicate with folk remedied than non-hispanic whites. Zuckerman MJ. Digestive Diseases ans Science 1996;41
14 Our Study Prospective Observational study 547 Participants Semi structured bilingual interview and questionnaire Multiple profit and not for profit hospitals and clinics in El Paso, Las Cruces and Chaparral New Mexico Rivera JO. et al.
15 Alternative Medicine used in this region Providers Herbal Medicine Nutritional and Commercial Products
16 Who uses CAM? 77 % of the Border Population surveyed 87 % Hispanic 13 % White 65 % Females 35 % Males Continued
17 Who uses CAM? 53.9 % Mexican American U.S. born 29.3 % Mexican Non-U.S. born 3.6 % Other Ages 18 to 82 years
18 Income Less than 10,000 10,000 to 20,000 20,000 to 30,000 40,000 to 50, % 30 % % %
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25 What Providers? Massage Therapy (Sobador) Herbalist Chiropractor Lifestyle Diet Acupuncture Naturalist Urine Therapy 19.4 % 12.4 % 11.8 % 7.8 % 6.8 % 6.6 % 0.4 % Complementary Alternative Providers
26 Where did you learn about this? Friend Family Doctor Book Advertisement % % 7.45 % 3.89 % 1.35 % Complementary Alternative Providers
27 Where did you get treatment? Mexico USA % % Complementary Alternative Providers
28 Did you tell your Doctor? % % YES NO Complementary Alternative Providers
29 Did it work? YES NO % % Complementary Alternative Providers
30 Herbal Products Aloe Vera Cactus Celery Chamomile Chicken Poultice Cinnamon Corn silk Eucalyptus Flor de Jamaica Garlic Lemon Marijuana Mullein Nopal Oregano Peppermint Perejil Potato Poultice Rue Rosa de Castilla Tila
31 What Herbal products? Chamomile Aloe Vera Peppermint Lime Garlic Oregano % 8.45 % 8.08 % 6.57 % Herbal Products
32 What is Chamomile? Manzanilla Herbal Products
33 Who uses it? Men (Gastric Problems) Women (Menstrual Cramps) Children (Pink eye) Babies (Colic) Herbal Products
34 Aloe Vera Skin Problems (Burns, Cuts, Rashes) It is now, not only used topically but as a drink Herbal Products
35 Peppermint Gastric problems Herbal Products
36 Lime Colds Sore Throat Herbal Products
37 Garlic Blood thinner Blood pressure Herbal Products
38 Oregano Cough Colds Herbal Products
39 Cactus (Nopal) Diabetes Decreases sugar in the blood Herbal Products
40 How did you learn? Family Friend Book Advertisement Doctor % % 12.12% 7.57 % 1.51% Herbal Products
41 Where did you get it? Mexico USA 9.60 % % Herbal Products
42 Did you tell your Doctor? YES NO % % Herbal Products
43 Did it work? YES NO Still using % 2.47 % 2.24 % Herbal Products
44 Home remedies that have been known to cause negative outcomes Lead based products azarcon, greta, albayalde used for empacho Gordolobo, chaparral used for respiratory and gastrointestinal problems have been associated with liver injury Herbal Products
45 Nutritional and Commercial Products Vitamins Uña de Gato Cartilago de Tiburon Ginseng Noni Metabolife Performance Inhancers
46 Vitamins Vitamin B-12 Vitamin C Vitamin D Vitamin E Max Memory Stress Nutritional and Commercial Products
47 How did you learn? Family Friend Advertisement Book Doctor 0 % 5 % 6 % 28 % 0 %
48 Where did you get it? USA Mexico % %
49 Did you tell your Dr.? YES NO % %
50 Did it work? Yes % No 4.14 % Still using 0.46 %
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55 Do you buy drugs in Mexico? Yes % No %
56 Why so much Use? Is it the Price of Medical Care? Is it that people have lost faith in the Medical profession? None of the above
57 Our Study Has Shown. Wide range of CAM use Mexican-Americans appear to have a higher usage rate of CAM Education was the biggest factor
58 Furthermore Friends influence friends to use CAM providers Family influence family members to use herbal products Books influence people to use commercial nutritional products
59 Conclusion Since many of the herbal products used can have significant effects on different disease states and drug therapies. It is imperative that surgical patients be evaluated for herbal use.
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