Complementary and alternative medicine use amongst patients with cardiovascular disease in Singapore.
BACKGROUND
Data on complementary and alternative medicine (CAM) use in patients with cardiovascular disease (CVD) are lacking. We aim to investigate the prevalence of CAM use among patients with CVD attending a tertiary centre for cardiovascular care, their attitudes and beliefs towards CAM, and factors associated with CAM usage.


METHODS
A cross-sectional, self-administered written survey was conducted on consecutive patients attending outpatient cardiovascular clinics at our tertiary institution over 2 months from June to July 2014. Information gathered included demographic data and various aspects of CAM use.


RESULTS
A total of 768 responses (562 males, mean age 57 ± 13 years, 74 % Chinese, 6 % Malay, 14 % Indian) were included. The prevalence of CAM use in the cohort was 43.4 % (333/768). Biologically-based systems (29.4 %) was the most common type of CAM used. Some patients (19.0 %) used multiple types of CAM simultaneously. External influences (78.1 %) were cited more than internal influences (47.8 %) to affect CAM use. Malay ethnicity (compared to Chinese) was the only significant negative multivariate predictor of CAM use (OR = 0.531 (95 % CI 0.147 to 0.838), p = 0.018). A significantly higher proportion of CAM users compared to non-CAM users were non-compliant to medications (35.6 %, n = 114 vs. 20.5 %, n = 84, p < 0.001) and consults (41.4 %, n = 130 vs. 28.1 %, n = 112, p < 0.001) respectively.


CONCLUSIONS
The usage of CAM is prevalent amongst our patients with CVD. CAM use was associated with poorer reported compliance to medications and consults. Understanding the factors influencing CAM use amongst CVD patients provides medical professionals with an opportunity to better discuss CAM use and potentially enhance the patient-physician interaction.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Tse Yean
http://orcid.org/0000-0001-8078-2839
TY
Teo
National Heart Center Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
Jonathan
J
Yap
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Tong
T
Shen
National Heart Center Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. yeo.khung.keong@singhealth.com.sg.|Duke-NUS Graduate Medical School, Singapore, Singapore. yeo.khung.keong@singhealth.com.sg.
Khung Keong
KK
Yeo
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000628:therapy*; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012846:Singapore / Q000208:ethnology
Cardiovascular disease; Communication; Complementary and alternative medicine; Singapore