Are users of complementary and alternative medicine sicker than non-users?

Higher utilization of complementary and alternative medicine (CAM), both in cross-sections and over time, is commonly related to better socioeconomic status and to increased dissatisfaction with conventional medicine and its values. Little is known about health differences between users and non-users of CAM. The objective of the paper is to explore the difference in health measured by the SF-36 instrument between users and non-users of CAM, and to estimate the relative importance of the SF-36 health domains scales to the likelihood of consulting CAM providers. Interviews were used to collect information from a sample of 2000 persons in 1993 and 2500 persons in 2000, representing the Israeli Jewish urban population aged 45-75 in those years. Bivariate and logistic regression analyses were used to explore the above associations. The results show that while users of CAM enjoy higher socioeconomic status and younger age, they tend to report worse health than non-users on the eight SF-36 health domains scales in both years. However, controlling for personal characteristics, lower scores on the bodily pain, role-emotional and vitality scales are related to greater likelihood of CAM use in 2000. In 1993, no scale had a significant adjusted association with the use of CAM. The conclusions are that CAM users tend to report worse health. With CAM becoming a mainstream, though somewhat luxurious, medical practice, pain and affective-emotional distress are the main drivers of CAM use.     

Is the scientific publishing of complementary and alternative medicine objective?

Bias expressed by conventional journals against the field of "alternative," "integrative," or "complementary" medicine has been said to drive the appearance of new journals dedicated to this field. We examined two examples of recent articles on complementary and alternative medicine that appeared in two major medical journals in 1998. One is an editorial on the risks of alternative medicine, published in The New England Journal of Medicine and the other is a study on Therapeutic Touch, published in the Journal of the American Medical Association. We evaluated whether information and opinions presented in this editorial and article are objective or not. We found that these examples reflect, at best, misinformation or misunderstanding of the field, or at worst, disingenuousness. We consider the possibility that this apparent bias may be due to the fact that some of the concepts implicit in alternative medicine are outside the current biomedical framework. Yet, it is only by exploring knowledge outside the boundaries of existing dogmas that real (as opposed to incremental) progress can occur.     

Who uses complementary and alternative medicine in Israel?

OBJECTIVE: To describe the Israeli complementary and alternative medicine users and examine whether they are the same or different from non-users. DESIGN: This analysis was conducted on data collected from the use of health services module (n=2,365) of the Israeli National Health Interview Survey conducted 2003-2004. The questionnaire was based on the European Health Interview Survey and was administered over the telephone by trained interviewers. SUBJECTS: This survey was conducted on a random sample of the Israel general population age 21 years or more. OUTCOME MEASURES: Chi-square tests and logistic regression analyses were conducted. Complementary and alternative medicine was defined as self-reported use of homeopath, acupuncturist, chiropractor/osteopath, naturopath, or other complementary and alternative provider services for the subjects' own health needs in the last 12 months. RESULTS: Almost 6 percent of Israelis reported using complementary and alternative medicine. Use increased with income. Users were more likely to visit any doctor or a specialist in the prior 4 weeks to the survey compared to nonusers. Users self-reported similar use of pain medications compared to nonusers. CONCLUSIONS: These findings inform the international debate regarding if and how complementary and alternative medicine services should be covered by national health insurance.     

How frequently do patients with multiple sclerosis use complementary and alternative medicine?

OBJECTIVE: The purpose of the study was to examine the prevalence and characteristics of the utilisation of complementary and alternative medicine (CAM) by patients with multiple sclerosis (MS). DESIGN: Cross-sectional study using a semi-structured interview. SETTING: One hundred and fifty-four MS patients were examined by interview to collect sociodemographic and disease-related variables as well as aspects of their usage of CAM. The investigation was completed by data from neurological examination. MAIN OUTCOME MEASURES: Reported utilisation of CAM by MS patients. RESULTS: At the time of the investigation 61.7% (n = 95) of the MS patients reported that they were currently using CAM. Most of the therapies utilised (90.3%; n = 205) were complementary and only 9.7% (n = 22) were alternative choices. Users of complementary medicine were more severely affected by the disease than non-users, but no sociodemographic differences between users and non-users were found. Concerning the efficacy of CAM, 65.8% (n = 146) of MS patients reported improvement, 32.9% (n = 73) no influence, and 1.3% (n = 3) worsening of their condition. 4.5% (n = 10) of the CAM therapies were accompanied by slight side-effects. CONCLUSION: A large proportion of MS patients use unconventional treatments, yet clinical studies on the efficacy of CAM in these cases have not been undertaken. Therefore, further research on their motivation and on objective effects of CAM is required.     

What's cooking with garlic: is this complementary and alternative medicine for hypertension?

PURPOSE: To define complementary and alternative medicine (CAM); describe one type of CAM, garlic (Allium sativum L); and discuss its effects on blood pressure as a treatment for hypertension. DATA SOURCES: Literature review from professional journals, abstracts, natural therapy books, and the World Wide Web (Internet). Information from the following professional organizations and agencies: The World Health Organization, Agency of Healthcare Research and Quality, National Cancer Institute, National Center for Complementary and Alternative Medicine, American Botanical Council, and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. CONCLUSION: Garlic is widely used throughout the world as a CAM. It is one of the most popular herbal products sold in the United States. However, while some studies have shown small positive effects in reducing blood pressure, there are insufficient scientific data to draw conclusions regarding its efficacy on clinical blood pressure outcomes. Thus, healthcare providers should be cautious in recommending this herbal product as an antihypertensive CAM. IMPLICATIONS FOR PRACTICE: CAMs may be used by clients for a variety of conditions including hypertension. Healthcare providers must be cognizant of the use, efficacy, adverse affects, and scientific evidence concerning CAM in order to provide safe and effective practice as well as appropriate and accurate information to their clients.     

Is complementary and alternative medicine use associated with cancer screening rates for women with functional disabilities?

ObjectivesThe purpose of this study was to examine the associations of complementary and alternative medicine (CAM) use with mammogram and Pap test rates and functional disabilities (FDs).DesignCross-sectional study.SettingData were derived from the 2012 National Health Interview Survey (n = 6576).AnalysisFDs was defined as physical and/or social limitations. The weighted logistic regression models were performed using SAS software. Study covariates were age, race, education, marital status, usual source of care, and insurance.ResultsOf 6576 women, a majority were Caucasian (87%), with GED or less (40%), married (50%), having usual source of care (96%) and health insurance (91%), and with FDs (56%). The results indicated that some CAM practices were negatively associated with increased mammogram and Pap test rates while other CAM practices were positively associated. The results indicated that CAM practices that contribute to musculoskeletal problems such as acupuncture and massage were associated with the increased mammogram and Pap test rates. Contrary, women who used chiropractic manipulation, biofeedback, guided imagery, and energy hearing therapy were less likely to obtain cancer screenings regularly regardless of having FDs.ConclusionsThe use of several CAM therapies was more likely to be associated with mammogram and Pap test frequency, indicating that the CAM use may be associated with better screening rates due to the improvement of musculoskeletal problems. It is important to determine how each CAM therapy improves secondary health conditions in clinical trials to increase cancer screening rates for women with FDs.     

Square pegs and round holes? A review of economic evaluation in complementary and alternative medicine

INTRODUCTION: Economic evaluation, linking the costs and consequences of an intervention to indicate the potential benefits of alternative interventions, is becoming established as one of the core tools for decision making in health care. As knowledge of the safety and effectiveness of complementary and alternative medicine (CAM) interventions increases, economic evaluation within CAM has a heightened significance. OBJECTIVE: To explore whether the present framework for economic evaluation fits CAM and what modifications if any are needed for its application. Design: Systematic review. METHODS: A comprehensive search of four databases was undertaken (NHS Economic Evaluation Database, AMED, MEDLINE, CINAHL). Studies were included if they took the form of a comparative analysis of costs and consequences of a CAM treatment and were written in English. Each study was reviewed using a set of methodological questions to judge their quality as economic evaluations. RESULTS: A total of 19 studies were identified, of which 9 were cost-effectiveness studies, 7 cost-consequence studies, 2 cost-minimization studies, and 1 cost-benefit analysis. Seventeen (17) of the studies involved CAM treatments being used alongside mainstream or conventional treatments. The majority of the treatments aimed to alleviate pain, including chronic pain, back pain, neck pain, and migraine. Only a small minority of studies addressed wider outcomes of particular relevance to CAM disciplines. Nine (9) adopted a service provider perspective only, 7 included wider sickness absence costs and 3 patient costs. Only 1 study included costs to relatives. The quality of the cost and benefit dimensions of the studies was mixed. CONCLUSIONS: A CAM sensitive approach to economic evaluation is required. This needs to include a focus on outcomes that explore the range of effects of CAM treatment, an exploration of the client's perspective and not just that of the service provider and study designs that facilitate the individualized practitioner approach so central to CAM treatment.     

Nurses’ communication regarding patients’ use of complementary and alternative medicine

Background

: Many people integrate complementary and alternative medicine (CAM) into their health care. Nurses potentially play a significant role in communicating with patients about their CAM utilisation.

Trick or treat? Australian newspaper portrayal of complementary and alternative medicine for the treatment of cancer

Purpose  

Many cancer patients within developed nations cite the media as informing their decisions to use complementary and alternative medicine (CAM). The present study describes (1) Australian newspaper coverage of CAM use for cancer between 1998 and 2007; (2) trends in reporting frequency and characteristics; and (3) how the Australian press framed stories on CAM use for cancer.