Complementary and Alternative Medicine Use and its Impact on Quality of Life among Cancer Patients in Freetown, Sierra Leone: Considerations for a Resource-Limited Setting

Cancer patients are increasingly resorting to complementary and alternative medicine (CAM) to alleviate the effects of the disease and enhance their quality of life (QoL). However, to our knowledge, no study has investigated CAM use and its impact on QoL in patients with cancer in Sierra Leone. Therefore, this study aimed to assess the prevalence of and associated factors with CAM use, and compare the quality of life between CAM users and non-users.

This cross-sectional descriptive study was conducted at three health facilities in Freetown viz Connaught Hospital Ola During Children's Hospital, and the Water and Stone Clinic. Data were collected through face-to-face interviews, using an adapted questionnaire. The QoL was assessed using the European Organization for Research and Treatment of Cancer tool. Descriptive analysis was employed, and binary logistic regression tests were used to explore the associated factors of CAM use, with statistical significance set at p<0.05.

In total, 204 participants completed the study. The prevalence of CAM use was 48.5%. Among the various CAMs examined in this study, herbal medicines (48.8%) followed by special foods (19.4%) were the most commonly used forms of CAM. The primary reason for CAM use was the management of cancer complications (43.4%). Over half of the CAM users did not disclose their CAM use to their doctors (53.5%). There was a statistically significant association between CAM use and tertiary education (AOR=2.68, 95%CI=1.31-5.49, p=0.007) and chemotherapy treatment (AOR=1.91, 95%CI= 1.06-3.46, p=0.032). There was no considerable impact of CAM on QoL, although financial difficulty was statistically significant among CAM users compared with non-CAM users.

This study revealed that CAM use is prevalent among cancer patients, with herbal medicines being the most commonly used form, followed by special foods and prayers.  Patients primarily obtain information about CAM from family, friends, and relatives, and most do not discuss CAM use with their doctors. Tertiary education and chemotherapy were found to be predictors of CAM use. Regarding the impact of CAM on QoL, only financial difficulty was statistically significant.