Complementary and Integrative Medicine Use among Migraine Patients Using a Modified Version of I-CAM- QP: A Cross-Sectional Study

Farinaz  Farhoudi; Alireza  Salehi; Maryam  Poursadeghfard; Mohammadali  Moghimizadeh; Rasool  Hasanabadi; Marjan  Sarami; Farhad  Emadi

doi:10.18502/tim.v11i2.22051

Farinaz Farhoudi Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Alireza Salehi Department of MPH,, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Maryam Poursadeghfard Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammadali Moghimizadeh Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Rasool Hasanabadi Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Marjan Sarami Department of MPH,, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Farhad Emadi Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

DOI: https://doi.org/10.18502/tim.v11i2.22051

Keywords: Complementary and alternative medicine; H5eadache; I-CAM-Q; I-CAM-QP; Migraine headache; Persian medicine

Abstract

This study aimed to determine the prevalence and associated factors of complementary and alternative medicine (CAM) use among patients with migraine using a culturally-adapted Persian version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-QP). In this cross-sectional study, 310 patients attending two neurology referral clinics were screened. After excluding 66 individuals who did not meet International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria and three incomplete questionnaires, 241 patients with ICHD-3–confirmed migraine were analyzed. The core four domains of the I-CAM-QP were preserved (CAM providers, practitioner-based therapies, herbal/supplement use, and self-help practices). Modifications were limited to contextual adaptation and included the addition of migraine-specific clinical variables, incorporation of locally prevalent Traditional Persian Medicine modalities (e.g., cupping, phlebotomy, leech therapy, lifestyle modification), reinstatement and expansion of provider categories to distinguish physician and non-physician practitioners, and supplementary items assessing disclosure and safety-related aspects of CAM use.

Participants were predominantly female (78.4%), with a mean age of 38.10 ± 10.18 years and mean disease duration of 10.77 ± 8.7 years. Overall, 91.7% reported using at least one CAM modality in the preceding 12 months. Herbal medicines and dietary supplements were most common (86.7%), with herbs alone reported by 68%. Increasing age was independently associated with higher odds of total CAM use among patients with episodic migraine (AOR 1.08; 95% CI 1.00–1.16) and self-help CAM practices (AOR per year increase: 1.03; 95% CI: 1.00–1.06). Greater mean headache pain intensity was independently associated with visiting a CAM provider (AOR 1.22; 95% CI 1.02–1.47). Additionally episodic migraine was associated with self-help practices (AOR: 2.45; 95% CI: 1.22–4.09). CAM use was highly prevalent and largely self-directed, underscoring the need for structured patient–physician communication in routine migraine care.