{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:51:10Z","timestamp":1792759870823,"version":"4.5.0"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic obstructive pulmonary disease (COPD) is a heterogeneous and chronic condition characterized by irreversible airflow obstruction. Health literacy may influence the use of complementary and alternative medicine (CAM). This study aims to investigate the role of health literacy in the use of CAM among COPD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted at Ankara University School of Medicine, Department of Chest Diseases, involving patients with COPD between August 2024 and June 2025. Clinical COPD Questionnaire (CCQ) and Health Literacy Scale-Short Form (HLS-SF) were used to assess disease severity and health literacy, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 190 patients, inadequate and limited health literacy was more common among CAM users compared to non-users (n = 54\/89, 61% vs n = 37\/101, 37%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007). CAM users were also more likely to have insufficient social support (n = 24\/89, 25%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.047), cough (n = 79\/89, 89%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.049), history of ICU admission (n = 19\/89, 21%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), use of long-term oxygen therapy and noninvasive ventilation (n = 50\/89, 56%\n                      <jats:italic>p<\/jats:italic>\n                      = &lt;0.001; n = 26\/89, 30%,\n                      <jats:italic>p<\/jats:italic>\n                      = &lt;0.001, respectively), had higher rates of GOLD E classification (47\/89, 55%,\n                      <jats:italic>p<\/jats:italic>\n                      = &lt;0.001), and had higher median CCQ total scores as 2.78 [Interquantiler Range (IQR): 1.4-4.1, p = 0.002]. Inadequate and limited health literacy was significant predictors of CAM use (OR: 3.78; 95% CI: 1.25-11.4,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.018; OR: 6.78, 95% CI: 1.63-28.0,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008, respectively), as well as GOLD E classification (OR: 2.71, 95% CI: 1.14-6.45,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.024) and insufficient social support (OR: 2.56, 95% CI: 1.00-6.50,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.048) after adjusting for age, sex, education, and comorbidities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study revealed the association between COPD symptom severity and frequent exacerbation, insufficient social support, along with lower health literacy and the use of CAM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14799731251382230","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:07:21Z","timestamp":1759190841000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Patients with chronic obstructive pulmonary disease and the use of complementary and alternative medicine: The role of health literacy in T\u00fcrkiye"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9349-3075","authenticated-orcid":false,"given":"Mustafa","family":"Ers\u00f6zl\u00fc","sequence":"first","affiliation":[{"name":"Department of Chest Diseases, Ankara University School of Medicine, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1625-7357","authenticated-orcid":false,"given":"Elif","family":"Ak\u0131nc\u0131 Ayd\u0131nl\u0131","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Ankara University School of Medicine, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1362-438X","authenticated-orcid":false,"given":"Elif","family":"Sel\u00e7uk","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Ankara University School of Medicine, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9656-131X","authenticated-orcid":false,"given":"Elif","family":"\u015een","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Ankara University School of Medicine, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"e_1_3_7_2_2","article-title":"Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for Prevention, Diagnosis and Management of COPD: 2024 Report","author":"Global Initiative for Chronic Obstructive Lung Disease (GOLD)","year":"2024","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for Prevention, Diagnosis and Management of COPD: 2024 Report. GOLD. 2024. https:\/\/goldcopd.org\/2024-gold-report\/.","journal-title":"GOLD"},{"key":"e_1_3_7_3_2","article-title":"WHO Global Report on Traditional and Complementary Medicine 2019","author":"Integrated Health Services (IHS), Traditional, Complementary and Integrative Medicine (TCI)","year":"2019","unstructured":"Integrated Health Services (IHS), Traditional, Complementary and Integrative Medicine (TCI). WHO Global Report on Traditional and Complementary Medicine 2019. World Health Organization. 2019. https:\/\/www.who.int\/publications\/i\/item\/978924151536.","journal-title":"World Health Organization"},{"key":"e_1_3_7_4_2","first-page":"5","article-title":"Complementary and alternative healthcare: is it evidence-based?","volume":"2","author":"Tabish SA","year":"2008","unstructured":"Tabish SA. 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