CAM Survey Targets Diverse Audience
November 1, 1999
CAM Survey Targets Diverse Audience
November 1999; Volume 1: 95
Source: Druss BG, Rosenheck RA. Association between the use of unconventional therapies and conventional medical services. JAMA 1999;282:651-656.
Design, Setting, and Subjects: Survey of 16,068 adults participating in the 1996 medical expenditure panel survey (MEPS), which surveys the U.S. civilian non-institutionalized population to estimate health care use, expenditures, sources of payment, and insurance coverage. In this subsample, 4% of the interviews were administered in Spanish. The survey examined only therapies delivered through a practitioner and asked about acupuncture; nutritional advice or lifestyle diet; massage therapy; herbal remedies purchased; biofeedback training; training or practice of meditation, imagery, or relaxation techniques; homeopathic treatment; spiritual healing or prayers; hypnosis; and traditional medicine (Chinese, Ayurvedic, American Indian, etc.), and other complementary and alternative medicine (CAM) treatments.
Funding: National Institute of Mental Health grant K08MH01556.
Results: In 1996, 59.5% of survey respondents used only conventional care; 1.8% used only unconventional care; 6.5% visited both unconventional and conventional practitioners; 32.2% used neither conventional nor unconventional care.
Those who used both conventional and unconventional care were more likely to be female, white, better educated, and live in the West. The most commonly used unconventional therapy was chiropractic, used by 3.3% of the survey population. Massage was used by 2% of the survey population, herbal remedies by 1.8%, spiritual healing by 1.4%, nutritional advice by 1.1 %, acupuncture by 0.6%, meditation by 0.5%, homeopathy by 0.4%, hypnosis by 0.1%, biofeedback by 0.1%, and other therapies by 0.4%. Compared to those who used unconventional therapies only, those who used both types of therapies were significantly more likely to use chiropractic services (42.8% vs. 28.1%) and significantly less likely to use spiritual healing (1.3% vs. 22.6%). Among users of both types of therapies, 8.8% were referred by a physician and 19.7% had informed a physician that they were using CAM therapies.
Comments: It is commonly argued by opponents of CAM therapies that an indirect danger is that patients will not receive conventional treatment for curable conditions. This study provides data that the majority of those receiving CAM treatment are also receiving conventional care.
One advantage of this survey over the Eisenberg survey1 is that Spanish speakers and individuals without telephones were included; the literature still lacks a multilingual survey that would more accurately reflect the U.S. population. This survey found a lower rate of unconventional therapy use than have previous telephone surveys. As the authors point out, one reason may be the focus on practitioner-based therapies (self-prescribed therapies were not included). The other reason that the authors posit is that non-English speaking participants were surveyed; however, this reasoning makes little sense to me, as CAM usage among minority populations is usually higher than among white populations.
Only a very small percentage of the population saw CAM providers exclusively. This survey notes that 2.5% of those who received CAM treatments had these treatments provided by a physician. It is noted that subsequent analyses classified unconventional services provided by a physician as conventional, which seem-ed a bit odd.
It was surprising to note the substantial proportion of respondents (32.2%) who used neither conventional nor unconventional care. In this survey, this number is four times higher than those who used unconventional treatments (alone or adjunctively). This is a rarely asked question. It would be interesting to correlate the physical and mental health status of those who see no practitioners with those who seek medical or CAM care; is it a healthier, more avoidant, or more male group that avoids all types of care?
References
1. Eisenberg DM, et al. Trends in alternative medicine use in the United States, 1990-1997. JAMA 1998;280:1569-1575.
November 1999; Volume 1: 95
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content