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Younis Khaled Y. Albanna

 Awareness and Knowledge of Health Care Professionals and Obese Adults of Complementary and Alternative Medicine Used to Manage Obesity in Jordan
Younis Khaled Y. Albanna
A Thesis Submitted in
Partial Fulfillment of the Requirements for the degree of
Master of Science in Pharmaceutical Sciences
University of Petra
June 2015
Awareness and Knowledge of Health Care Professionals and Obese Adults of Complementary and Alternative Medicine Used to Manage Obesity in Jordan. Background: Complementary and Alternative Medicine (CAM) according to National Center for Complementary and Alternative Medicine (NCCAM 2015) is “a group of different medical and health care systems, practices, and products that are not generally considered part of conventional medicine". Obesity has become a worldwide epidemic. It affects people in developed as well as developing countries. Obesity is defined as a metabolic disorder characterized by an excessive increase in body mass. It is considered a risk factor for numerous prevalent diseases such as diabetes mellitus type 2, hyperlipidemia, coronary heart diseases, hypertension, gallbladder disorders, osteoarthritis and certain types of cancer. Obesity can be controlled by differant methods, dietary intervention and non-dietary intervention. The latter includes medicines and CAMs.
Aims: Awareness and knowledge of Health Care Professionals (HCPs) namely physicians, pharmacists and nutritionists as well as obese adults about finished CAMs used to control weight in Jordan were studied. Furthermore, this study aimed to identify the source of information HCPs and obese adults rely on to obtain knowledge on CAMs to control weight.
Methods: A semi-structured, face-to-face interview-based study was conducted in three Jordanian cities: Amman, Zarqa and Irbid. The study setting involved out-patient clinics, community pharmacies and nutrition centers. Four interview guides were constructed, one for each; physicians, nutritionists, pharmacists, and a forth for the overweight/obese adults. This was preceded by a pilot study to test the applicability and feasibility of the study tool (Interview guide). It involved one prominent practitioner from each population; a physician, a nutritionist a pharmacist and an obese adult.
Results: Sixty HCPs as well as 50 obese adults were interviewed in the three cities. More than half of Pharmacists (55%, p <0.05) believed that CAMs could be used effectively to control weight compared to other HCPs. Ninety five percent of physicians did not prescribe CAMs to control weight due to many reasons. Additionally, more than half of nutritionists (55%) did not  recommend CAMs to control weight, while the majority of pharmacists (90%) recommended CAMs to control weight. HCPs-Patients discussions were also studied. Seventy five percent of physicians, 45% of nutritionists and 5% of pharmacists did not provide their patients with information about CAMs to control weight. HCPs reported that female adults (62%) were more likely to consult them to control their weight compared to males (2%). In terms of age, most HCPs reported that 87% mid-age adults were more likely to consult them to control their weight compared to other ages. In terms of weight state, 82% of HCPs believed that there was no difference between obese and overweight adults that seeked help about CAMs to control weight. In terms of health state, 57% of HCPs stated that there was no differance between ill adults and healthy adults in seeking help about CAMs to control weight.  Eighty five percent of physicians used books as references, while 80% of physicians used internet search engines as a reference. Ninety percent of nutritionists used internet search engines as references on CAMs. All obese-overweight female participants declared they used CAMs to control weight compared to 60% of male participants. Participants' references were also investigated. It was found that pharmacists and friends (50%) were the main source of information on CAMs. Conclusion: The findings of this study highlighted the need for more information resources about CAMs. Moreover, there is an obvious need for continuous professional education about CAM targeting physicians, nutritionists and pharmacists. Furthermore, more CAM-related research is needed to understand their use in Jordan and the parameters that impacted them.