Survey of Complementary and Alternative Medicine continued...
[South Med J 93(4):375-381, 2000. © 2000 Southern Medical Association]

Results

Use of Complementary and Alternative Medicine

Table 1 provides the number and proportion of respondents who reported lifetime and recent CAM use by specific therapy groupings. Complementary or alternative medicine therapies were grouped according to similarity of the therapies and presented by prevalence of use. In this population, almost 52% reported use of at least one CAM therapy in their life-time, and 44% reported use of at least one of the listed CAM therapies during the past 12 months. The most commonly reported CAM therapy grouping, classified as personal therapies, included home remedies, herbal therapy, vitamins, or homeopathy (27.5% reported use during their lifetime). This grouping was followed closely by relaxation therapies (25.7% reported lifetime use of massage therapy, imagery, or visualization). One in every 5 surveyed had used a chiropractor in their lifetime, while 1 in 12 had used a chiropractor in the past 12 months. A much smaller proportion (4.6% lifetime use) reported using healing therapies (including healers, spiritual healing, Native American healers, or energy healing), commercial weight loss programs (4.5%) or life-style diets (4.3%), self-help or support groups (2.6%), and hypnosis or biofeedback (1.9%). Less than 1% of those interviewed reported any use of other types of CAM therapies (data not shown).
 

Reasons for CAM Use

Respondents who reported using a CAM therapy were asked whether they used this treatment primarily to stay healthy or to treat some health problem. Overall, 47% of reported CAM use was to maintain health rather than as treatment for a specific health condition, though as the data in Table 2 indicate, there was significant variation by type of CAM treatment. A large majority of those who used life-style diets (85.1%) and commercial weight loss programs (75.6%) did so primarily to stay healthy, and a majority of the use of healing therapies (59.8%) and relaxation therapies (55.9%) was to maintain health. Slightly less than half of the use of personal therapies was to maintain health, and a relatively high percentage of such use was for treatment of allergies or other respiratory problems (17.7%). Those using chiropractors were disproportionately using this therapy to treat a specific health condition (87.7%), most of which involved a musculoskeletal or neurologic problem. The relatively high percentage of those who used a self-help group to treat "other" health problems represents participants in cancer survivor groups.
 

Demographics of CAM Use

Table 3 provides demographic characteristics of those ever using or recently using any CAM therapy. Women were significantly more likely than men to use CAM therapies. White respondents were more likely to report at least one CAM use than were black respondents; however, there were not significant differences in recent CAM use by race. Middle-aged and older respondents were significantly more likely to use a CAM therapy than those younger than 30. Almost 50% of those with some college education were recent CAM users, compared with approximately a 40% CAM use rate among those with a high school education or less. Divorced or separated respondents were significantly more likely to report CAM use than were married, widowed, or single respondents. Living in an urban or rural area was not significantly associated with CAM use.

 Using these background characteristics as independent variables in logistic regression models of lifetime and past 12 month use of CAM therapies shows age to be the most important predictor of CAM use at some point during a lifetime, while higher education is the best predictor of CAM use during the past 12 months. Race, income, and sex were not significant correlates of CAM use after adjusting for age and education.
 

Satisfaction With Alternative Therapies

Table 4 provides the results of respondents' assessment of CAM effectiveness (extremely, very, somewhat, not too, or not at all effective), whether they reported a bad experience with any CAM therapy, and whether they would recommend the treatment to a friend or family member. As the figure for any CAM use indicates, 63.3% of users perceived their therapy to be very or extremely effective, though there was some variation among types of CAM therapies. Those 68 using commercial weight loss programs were least likely to report this therapy as extremely or very effective (44.9%), whereas the 73 respondents using a range of healing therapies were most likely to rate these therapies as effective (79.3%). About 10% of those using commercial weight loss programs and 10% of those using hypnosis or biofeedback reported a bad experience with these therapies. Those using healing therapies were significantly more likely to perceive this therapy to be effective relative to all other therapies, while those using commercial weight loss programs were significantly less likely to report this therapy as effective. Less than 5% of CAM users reported a bad experience with the CAM therapy. Those using hypnosis or biofeedback and those using commercial weight loss programs were most likely to report a bad experience. More than 85% of CAM users said they would recommend these therapies to friends or family members. Those using commercial weight loss programs were least likely to recommend this therapy (69.4%), while those using relaxation techniques (92%) were most likely to recommend the therapy.
 

Physician Involvement With Alternative Therapies

Table 5 presents the proportion of CAM users whose physician or other health care professional recommended the CAM therapy. Those whose health care professional did not recommend the CAM therapy were also asked whether they had informed their physician about their CAM use. We combined this information to provide the proportion of CAM use of which doctors were unaware. These data show distinctions in the types of alternative therapies that physicians recommend and, consequently, in the percentage of physicians who are aware of the use of these complementary treatments. Physicians recommended bio-feedback for 39.3% of users of this therapy and for one third of those using life-style diets, self-help groups, and relaxation techniques. Physicians were least likely to recommend healing therapies (7.4%), and thus physicians were least likely to be informed of their patients' use of healing therapies (72.9%). Physicians were most likely to be aware of self-help or support group participation and life-style diets.

 Users of CAM therapies received information about these treatments from a number of different sources. While about 1 in 5 users identified a medical doctor as the primary source of their information about CAM therapies, a similar percentage (20.1%) cited a spouse or other relative as their source of information. Smaller percentages mentioned magazines (16.4%), a friend or neighbor (9.2%), their own experience (8.8%), television (6.0%), books (5.3%), newspapers (4.2%), or other health care professionals (4.1%).
 

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