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

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Abstract

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.

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Funding

The research was supported by grant number 03170047 from the Food and Health Bureau Hong Kong (Health and Medical Research Fund Research Fellowship). The funder had no role in study design, data collection/analysis/interpretation or manuscript preparation.

Author information

Authors and Affiliations

  1. School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Chun Sing Lam, Yi Man Cheng, Hoi Shan Li, Celeste L.Y. Ewig & Yin Ting Cheung

  2. School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Ho-Kee Koon

  3. Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Chi Kong Li

  4. Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Chi Kong Li

  5. Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Hong Kong, Hong Kong

    Chi Kong Li

Authors
  1. Chun Sing Lam
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  2. Yi Man Cheng
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  4. Ho-Kee Koon
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  5. Chi Kong Li
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  6. Celeste L.Y. Ewig
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  7. Yin Ting Cheung
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by CS Lam, YM Cheng, and HS Li. The first draft of the manuscript was written by CS Lam, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Celeste L.Y. Ewig or Yin Ting Cheung.

Ethics declarations

Ethics approval

This study was approved by the Joint Chinese University of Hong Kong–New Territories East Cluster Clinical Research Ethics Committee (Ref. No. 2018.427).

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Informed consent was obtained from all the individual participants included in the study.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

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Lam, C.S., Cheng, Y.M., Li, H.S. et al. Use of complementary or alternative medicine and potential interactions with chronic medications among Chinese survivors of childhood cancer. J Cancer Surviv 16, 568–581 (2022). https://doi.org/10.1007/s11764-021-01051-5

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  • DOI: https://doi.org/10.1007/s11764-021-01051-5

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