L DE SOUZA1,2, N GRAY2,3,4, J WAUGH2, R KRISHNASAMY2,5
1Griffith University, Southport, Australia, 2Sunshine Coast University Hospital, Birtinya, Australia, 3Sunshine Coast Health Institute, Birtinya, Australia, 4University of the Sunshine Coast, Birtinya, Australia, 5University of Queensland, St Lucia, Australia
Background: Complementary and alternative medicines (CAM) have been increasingly popular in Australia, with use approaching 65% particularly in patients with complex chronic disease. Studies in other countries have estimated CAM use in kidney transplant recipients (KTRs) to be as high as 40%, but this has not been assessed in Australia.
Aim: To measure the prevalence of complementary medicine use including vitamins and herbal tea in a chronic KTR population.
Methods: A cross-sectional study was performed involving KTRs presenting to routine outpatient appointments at three sites. A purpose-built questionnaire for recording CAM use was created for data collection by trained nursing staff. Demographic data, comorbidities, primary kidney disease, prescribed medications, and transplant details were collected from medical records.
Results: The baseline survey was completed by 127 KTRs, representing 58% of the eligible population. Mean age was 56 (SD 5) years, and 76% were male. Common comorbidities included diabetes (35%) and ischemic heart disease (21%). 44% of patients received their transplant within the last 5 years. A total of 34 (27%) patients reported use of any form of CAM. 8 (6.5%) reported use of preparations such as curcumin, wheatgrass, bupleurum and cannabis and 25 (19.7%) reported use of vitamins C, D, E or K2. Of the 3 patients who had biopsy proven evidence of rejection within the past year, none reported using CAM.
Conclusions: The incidence of KTRs using non-prescribed CAM is low in this study population. This may reflect under-reporting due to a poor understanding of what constitutes CAM, or a motivated population who have responded to education from nephrology services. Clinician knowledge of CAM use remains important to recognise potentially significant drug interactions and toxicity.
Dr Laura De Souza is a final year Basic Physician Trainee after having graduated from Griffith University and currently completing training at the Sunshine Coast and South Brisbane network hospitals. She will begin renal Advanced Training in 2021 at Cairns Hospital and Health Service. She plans to incorporate a career in nephrology with aspects of palliative care medicine and also explore how best to practice sustainable medicine within the future sphere of nephrology.