title: Use of herbal remedies by multiple sclerosis patients: a nation-wide survey in Italy.
abstract: Though recent progress in multiple sclerosis (MS) treatment is remarkable, numerous unmet needs remain to be addressed often inducing patients to look for complementary and alternative medicines (CAM), especially herbal remedies (HR). HR use, scarcely investigated in MS, may cause adverse reactions (AR) and interfere with conventional treatment. We performed a survey aimed at evaluating use and attitudes towards HR and factor associated to HR use. Other CAM use and attitudes have been investigated as well. Multiple-choice questionnaires were distributed to MS out patients attending 14 Italian referral Centers. Multivariable logistic regression was used to identify HR use determinants. Present/past HR use for either MS or other diseases was reported in 35.6 % of 2419 cases (95 % CI 36.0-40.0 %). CAM use was reported in 42.5 % of cases. Independent predictors of HR use were represented by higher education, geographic area, dissatisfaction with conventional treatment of diseases other than MS and benefit perception from CAM use. Both HR and CAM use were not always disclosed to the healthcare professional. In conclusion, HR and other CAM appear to be popular among MS patients. The involvement of the healthcare professionals appears to be scarce with potential risk of AR or interference with conventional treatments.
authors.affiliation: Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Loraschi
authors.affiliation: Multiple Sclerosis Center, IRCCS Neuromed, Pozzilli, IS, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Bellantonio
authors.affiliation: Multiple Sclerosis Centre, "San Bortolo" Hospital, Vicenza, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bortolon
authors.affiliation: Multiple Sclerosis Center, Montichiari Hospital, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Capra
authors.affiliation: 1 Division of Neurology, Multiple Sclerosis Centre, A.O.U. City of Health and Science of Turin, Turin, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Cavalla
authors.affiliation: Struttura Semplice "Sclerosi multipla" Az Ospedale-Università "Ospedali riuniti", Foggia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Costantino
authors.affiliation: Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lugaresi
authors.affiliation: Department of Neurology, San Raffaele Hospital, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Martinelli
authors.affiliation: Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Marrosu
authors.affiliation: Department of Medical and Surgical Science and Advanced Technologies, GF Ingrassia, Neurosciences Section, Multiple Sclerosis Center, University of Catania, Catania, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Patti
authors.affiliation: Multiple Sclerosis Center of Bergamo, USS Malattie Autoimmuni, Azienda Ospedaliera Papa Giovanni XXIII of Bergamo, Piazza OMS 1, 24127, Bergamo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rottoli
authors.affiliation: Neurology and Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Salvetti
authors.affiliation: Neurology Unit, Department of Neuroscience, University of Modena, Nuovo Ospedale Civile S. Agostino Estense, Estense, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Sola
authors.affiliation: Neurology Unit, Department Head and Neck, ASL3 Genovese, Genoa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Solaro
authors.affiliation: Biometry and Statistics Service, IRCCS Fondazione Policlinico S Matteo, Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Klersy
authors.affiliation: Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Marino
authors.affiliation: Multiple Sclerosis Center, Gallarate Hospital, Gallarate, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Zaffaroni
authors.affiliation: Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy. marco.cosentino@uninsubria.it.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-6978-7775
authors.initials: M
authors.lastname: Cosentino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D015999:Multivariate Analysis; D008517:Phytotherapy / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Complementary alternative medicine; Herbal remedies; Multiple sclerosis; Nation-wide survey; Questionnaire; Unmet needs