Alternative Medicine Usage Research Articles

Health care utilization among complementary and alternative medicine users in a large military cohort

BackgroundComplementary and Alternative Medicine use and how it impacts health care utilization in the United States Military is not well documented. Using data from the Millennium Cohort Study we describe the characteristics of CAM users in a large military population and document their health care needs over a 12-month period. The aim of this study was to determine if CAM users are requiring more physician-based medical services than users of conventional medicine.MethodsInpatient and outpatient medical services were documented over a 12-month period for 44,287 participants from the Millennium Cohort Study. Equal access to medical services was available to anyone needing medical care during this study period. The number and types of medical visits were compared between CAM and non-CAM users. Chi square test and multivariable logistic regression was applied for the analysis.ResultsOf the 44,287 participants, 39% reported using at least one CAM therapy, and 61% reported not using any CAM therapies. Those individuals reporting CAM use accounted for 45.1% of outpatient care and 44.8% of inpatient care. Individuals reporting one or more health conditions were 15% more likely to report CAM use than non-CAM users and 19% more likely to report CAM use if reporting one or more health symptoms compared to non-CAM users. The unadjusted odds ratio for hospitalizations in CAM users compared to non-CAM users was 1.29 (95% CI: 1.16-1.43). The mean number of days receiving outpatient care for CAM users was 7.0 days and 5.9 days for non-CAM users (p < 0.001).ConclusionsOur study found those who report CAM use were requiring more physician-based medical services than users of conventional medicine. This appears to be primarily the result of an increase in the number of health conditions and symptoms reported by CAM users.

The use of complementary and alternative medicine among chronic renal failure patients

The aim of this study is to evaluate the factors affecting the use and frequency of use of complementary and alternative medicine among chronic renal failure patients. The use of complementary and alternative medicine in the general population and patients with chronic renal failure has increased significantly. Despite this, there is limited information concerning the use of complementary and alternative medicine among chronic renal failure patients. Cross-sectional survey. The research was carried out at the nephrology and internal medicine outpatient clinics. Two hundred and six chronic renal failure patients admitted to the outpatient clinics were included in the study. Mean outcomes measures were the frequency and type of complementary and alternative medicine use, demographic and disease-related characteristics affecting complementary and alternative medicine use and the reasons for using complementary and alternative medicine. The data were evaluated by Pearson's chi-square test and Fisher's exact test. While 2·9% of the patients had been using complementary and alternative medicine before the renal disease occurred, 25·2% of the patients reported that they had at least once used complementary and alternative medicine methods after the renal disease occurred. A significant difference was found between complementary and alternative medicine usage and age, gender, place of living, occupational status and educational background (p < 0·05). While most of the patients using complementary and alternative medicine (78·3%) stated that they used such methods as a cure for their disease, 46·1% used body-mind techniques. The results of our study showed that one-fourth of the chronic renal failure patients were using complementary and alternative medicine, mainly body-mind techniques. In addition, the study proved that most of the patients do not discuss their complementary and alternative medicine usage with their doctors and nurses. It is essential that nephrology doctors and nurses should ask specific questions about complementary and alternative medicine usage while taking anamnesis on the patients' disease and nutritional status and that the nephrology team should expand their knowledge on complementary and alternative medicine methods to ensure patient and treatment safety.

Influenza vaccination among chiropractic patients and other users of complementary and alternative medicine: Are chiropractic patients really different?

ObjectivePrevious studies suggest a possible association between using chiropractic care and lower influenza vaccination rates. We examined adult influenza vaccination rates for chiropractic patients to determine if they are different than those for users of other complementary and alternative medicine (CAM). MethodWe used the 2007 National Health Interview Survey to examine influenza vaccination rates among adult respondents who were considered high priority for the influenza vaccine (n=12,164). We separated respondents into clinically meaningful categories according to age and whether or not they had recently used chiropractic care, some other type of CAM, or neither. We used adjusted logistic regression to determine whether user status predicted influenza vaccination. ResultsOnly 33% of younger and 64% of older high priority Chiropractic Users were vaccinated in 2007; these rates approximated those of Non-CAM Users. However, younger Non-Chiropractic CAM Users were more likely than Non-CAM Users to have been vaccinated (p-value=0.05). In adjusted logistic regressions, we found statistically insignificant differences when comparing Chiropractic Users to Non-CAM Users for younger adults (OR=0.93(95% CI:0.76–1.13), or for older adults OR=0.90 (95% CI:0.64–1.20). ConclusionChiropractic Users appear no less likely to be vaccinated for influenza; whereas, younger Non-chiropractic CAM Users are more likely than Non-CAM Users to be vaccinated.

The Knowledge, Attitudes and Usage of Complementary and Alternative Medicine of Medical Students

The increasing use of CAM by patients has led to an increase in teaching about CAM in medical school in the US. In preparation for initiation of a new curriculum in Integrative Medicine at the David Geffen School of Medicine at UCLA a cross sectional survey was used to assess medical students': (i) familiarity, (ii) opinions, (iii) personal use and (iv) willingness to recommend specific CAM modalities, using a five point Likert scale of an established measure. A total of 263 first, second and third year medical students at UCLA completed surveys. Third year students reported less personal use of CAM and less favorable attitudes towards CAM than first year students. Since this was a cross-sectional rather than longitudinal study this may be a cohort effect. However, it may reflect the increased curricular emphasis on evidenced-based medicine, and subsequent student dependence on randomized clinical trials to influence and guide practice. This will need to be addressed in curricular efforts to incorporate Integrative Medicine.

Usage of Complementary and Alternative Medicine (CAM) among Osteoarthritis Patients Attending an Urban Multi-Specialist Hospital in Lagos, Nigeria

Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. To determine the pattern of usage of CAM among OA patients in Nigeria. Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period st st of 1 May to 31 October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.

Patient-Reported Adverse Drug Reactions and Drug-Drug Interactions: A Cross-Sectional Study on Malaysian HIV/AIDS Patients

Objective: This study aimed to explore the adverse drug reactions (ADRs) reported by patients and to identify drug-drug interactions (DDIs) among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Subjects and Methods: This cross-sectional study was conducted at the Medication Therapy Adherence Clinic, Hospital Sungai Buloh, an HIV/AIDS referral centre. The patients were randomly selected and were encouraged to describe ADRs caused specifically by any of the prescribed antiretroviral drugs (ARDs). Sociodemographic characteristics were recorded from the patients’ medical records. In addition data on antiretroviral treatment (ART), DDIs and other conventional medication were also documented. Results: A total of 325 randomly selected HIV/AIDS patients with a mean age of 22.94 years participated in the study. The most frequently prescribed ARDs were lamivudine (64.6%), zidovudine (40.6%) and efavirenz (42.5%). Commonly reported ADRs were fatigue (54.8%), allergic reactions (41.5%), weight loss (41.5%), dry mouth (35.1%) and memory loss (35.1%). Female (87.8%), non-complementary and alternative medicine (CAM) users (87.3%) and participants below 50 years old (81.1%) were identified as having a higher prevalence of ADRs compared to males (79.6%), CAM users (78.7%) and participants aged 50 years or more (77.5%). Patient age was found to be significantly associated (p = 0.048) with the ADRs. In addition, a total of 44 cases of DDIs belonging to category D were also found in this study. Conclusions: This study enabled us to identify the most common ADRs and DDIs associated with the use of ART. Safe and effective treatment depends on the healthcare providers’ knowledge of the same.

The association of complementary alternative medicine use with anxiety, depression and quality of life in Turkish cancer patients

Aim of the study: The purpose of this study is to investigate the complemen tary/alternative medicine (CAM) usage and the factors affecting this among can cer patients in the western region of Turkey. 220 adult cancer patients par ticipated in the study and 93 patients (42.3%) were found to use at least one CAM method. Material and methods: Our study was done by face-to-face communication in auniversity hospital, in Turkey. Oncolo gy patients’ primary diseases, sociode mographic characteristics, complemen tary alternative medicine usage, psychological conditions and quality of life were evaluated with proper psy chological scales. Patients using and not using CAM were compared with re spect to Beck Depression, State Trait Anx iety and Beck Hopelessness scores. No statistically significant difference was de tected between/among the groups in BDI (12.0 ±8.4, 11.9 ±8.7, p = 0.96), BHS (5.5 ±4.9, 4.8 ±4.4, p = 0.27) or STAI (43.7 ±8.0, 44.3 ±8.2, p= 0.64) scores. Pa tients using and not using CAM were compared with respect to WHOQOLBREF quality of life scores. There was no statistically significant difference be tween/among the groups in WHOQOLBREF sub-group scores (physical, psy chological, social relations, environment, standardized by culture (environment), general health). Results: Nearly half of the patients (42.3%) in this region were found to be using at least one of the CAM methods. The patients mostly preferred herbal methods, with the leading product be ing stinging nettle ( Urtica dioica ). The severity of disease (recurrence and dis semination) and patients’ knowledge of the diagnoses were the most important factors affecting the CAM usage. Conclusions: The usage of CAM by on cology patients and the effects of CAM on the present medication prescribed by oncology practitioners must be remem bered when they are admitted to poly clinics. Also it must be known that pa tients with advanced stage and patients with recurrence are more likely to use complementary alternative medications than early stage patients. Therefore on cology patients must be informed about CAM besides their clinical situations. At least physicians should give answers about the CAM to their patients.

Binational Care-Seeking Behavior and Health-Related Quality of Life Among HIV-Infected Latinos in the U.S.-Mexico Border Region

Although binational health care-seeking is common among HIV-infected Latinos living near the U.S.-Mexico border, information is lacking on whether regional indicators of health access are associated with Health-Related Quality of Life (HRQL). This study examined health care-seeking behaviors across four HRQL domains (emotional well-being, cognitive functioning, physical functioning, and pain) using linear regression. HIV-infected Latinos (n = 239) were recruited from U.S. community clinics situated near the border shared by California with Mexico. In general, the Spanish-speaking (81%) and male-dominant (84%) population had positive indicators of HRQL. AIDS diagnosis predicted poorer HRQL (cognitive functioning, physical functioning, and pain), as did receipt of traditional medications and/or herbs in Mexico (physical functioning and pain). Staying for 1 or more months in Mexico in the past year was associated with higher cognitive functioning and less pain. Border-related factors were inconsistently implicated in HRQL measures. Improved understanding of complementary and alternative medicine usage by HIV-infected Latinos is warranted.

Family strategies for managing childhood cancer: using complementary and alternative medicine in Jordan

This paper is a report of a study that examined the use of complementary and alternative medicine therapies among children with cancer in Jordan. Complementary and alternative medicine use by oncology patients has been gaining acceptance in the developed countries and developing countries. Healthcare professionals are becoming increasingly aware that patients use complementary and alternative medicine either covertly or overtly. A descriptive cross-sectional design was used with parents of children with cancer under treatment and follow-up in a paediatric oncology department in Jordan between August 2007 and April 2008. Parents of 69 children with cancer in Jordan were surveyed for their use of complementary and alternative medicine with their children. A total of 65.2% of the sample had used at least one type of complementary and alternative medicine during the course of their child's treatment. The use of biological and nutritional complementary and alternative medicine was 70.5% among the users. Use of body and soul complementary and alternative medicine strategies was reported for 22.2% of the children using complementary and alternative medicine. Twenty per cent of the sample used body movement complementary and alternative medicine for their children. A total of 45.5% of complementary and alternative medicine users perceived benefits in using complementary and alternative medicine for their children with cancer. However, 40% of complementary and alternative medicine users had stopped using complementary and alternative medicine for multiple reasons. Parents used complementary and alternative medicine to support their children's medical treatment and to use all possible methods to cure their children. The reason for parents not using complementary and alternative medicine included not being aware of complementary and alternative medicine. Most of the patients have not discussed the issue of using complementary and alternative medicine with the medical staff.

Health need and the use of alternative medicine among adults who do not use conventional medicine

BackgroundWe hypothesize that a substantial portion of individuals who forgo conventional care in a given year turn to some form of alternative medicine. This study also examines whether individuals who use only alternative medicine will differ substantially in health and sociodemographic status from individuals using neither alternative medicine nor conventional care in a given year. To identify those factors that predict alternative medicine use in those not using conventional care, we employed the socio-behavioral model of healthcare utilization.MethodsThe current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia.Results19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although 39.5% of these individuals (14.7 million) reported having one or more problems with their health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine. Users of alternative medicine had more health needs and were more likely to delay conventional care because of both cost and non-cost factors compared to those not using alternative medicine. While individual predisposing factors (gender, education) were positively associated with alternative medicine use, enabling factors (poverty status, insurance coverage) were not.ConclusionsWe found that a quarter of individuals who forgo conventional care in a given year turn towards alternative medicine. Our study suggests that the potential determinants of using only alternative medicine are multifactorial. Future research is needed to examine the decision process behind an individual's choice to use alternative medicine but not conventional medicine and the clinical outcomes of this choice.

Improving Clinical Communication and Promoting Health through Concordance-Based Patient Education

In recent years, communication education has been used as a means of improving the clinician–patient relationship and promoting health. The focus of these interventions has primarily centered on clinician training. An area that has received less focus, although equally important, is training patients to be good communicators. The purpose of the paper is to first introduce clinician–patient ‘concordance’ as a conceptual framework for patient communication education. Second, we provide a review and critique of the literature on existing patient communication interventions. Finally, we conclude with a discussion of two specific patient populations that face challenges and obstacles in clinician–patient communication and preliminary work we are doing in these areas: complementary and alternative medicine users and the medically underserved.

Use of complementary and alternative medicine by patients with arthritis

The aims of this study were to determine the prevalence of complementary and alternative medicine use in patients with arthritis, the types of complementary and alternative medicine used, pertinent socio-demographic factors associated with complementary and alternative medicine use and its perceived efficacy. Arthritis is a major health issue, and the use of complementary and alternative medicine among patients with arthritis is common. This is a descriptive cross-sectional study. Data were obtained from 250 patients with arthritis at the physiotherapy and immunology clinics Atatürk University Hospital in eastern Turkey between May-July 2005 using a questionnaire developed specifically for this study. The instrument included questions on socio-demographic information, disease specifics and complementary and alternative medicine usage. Seventy-six per cent of participants reported use of at least one form of complementary and alternative medicine in the previous year. Complementary and alternative medicine users and non-users were not significantly different in most socio-demographic characteristics including age, gender, marital status and education level with the exception of economic status. We categorised treatment into six complementary and alternative medicine categories: 62.6% of patients used thermal therapies; 41.5% used oral herbal therapies; 40.5% used hot therapies; 32.6% used externally applied (skin) therapies; 28.4% used massage and 12.6% used cold therapies. All forms of complementary and alternative medicine except thermal and oral herbal therapies were perceived as very effective by more than half of study participants. Complementary and alternative medicine therapy is widely used by patients with arthritis and has perceived beneficial effects. It is important for nurses and other health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing care to patients with arthritis because of possible interactions with other treatments, delays in seeking care and the potential for poor quality products. It is also essential for health professionals to discuss treatment options with patients and to monitor treatment efficacy.

Trade offs: A framework analysis of factors affecting adherence to orthodox medicine in complementary and alternative medicine users with chronic health conditions

Background A large proportion of individuals use complementary and alternative medicine (CAM) but little is known how patients co-manage CAM with orthodox medicine (OM). This qualitative study explored the use of CAM amongst participants with chronic conditions to identify how and why it affects their use of OM. Method Individuals were recruited from the practices of acupuncturists, nutritionists and homeopaths in South of England between 2006 and 2009. Face-to-face semi-structured interviews were undertaken with 35 individuals with a range of chronic health conditions who were currently use CAM. The data was analysed using the Framework Approach. Results Data saturation was achieved. An explanatory model explaining the use of CAM amongst individuals affects how they use OM for a range of chronic conditions will be described. Eight different types of CAM use, which were affected by their range of factors including their beliefs and experiences of CAM, were identified: (1) Specific use, where individuals used CAM for a specific illness but OM for other health problems. (2) Enabling use where individuals used CAM to counteract side effects of OM. (3) Preventative use, where CAM use allows a reduction of OM. (4) Avoidance use, where individuals used CAM to prevent the need for OM. (5) Changeable use, where individuals switched between CAM and OM. (6) Joint use, where individuals used CAM and OM at the same time. (7) CAM as a replacement of OM. (8) Use of CAM as a treat. Most participants demonstrated that they used CAM in more than one way or would switch between different uses, and no participants abandoned OM totally. Conclusion Communication between patients and their conventional physicians about patient's use of CAM is often limited. This detailed model explains for the first time, how individuals with chronic illness manage their health by using conventional and complementary systems of healthcare, and the factors that affect the trade off of one system against the other. As such, it will provide a valuable insight for clinicians and could be used as a framework to stimulate communication to maximise the management of patient's ill health.

The prevalence of dietary‐related complementary and alternative therapies and their perceived usefulness among cancer patients

The present study aimed to directly assess and compare the usage, benefits and side-effects of dietary-related complementary and alternative medicine (CAM) use among adult cancer patients and non-cancer adults in Norwich, UK. Self-administered questionnaires were completed by 98 cancer patients and 92 non-cancer adults to compare demographics, types of CAM usage with reasons, benefits, side-effects and CAM information sources. The groups were matched for gender, age, marital status, education and household income. The mean ages were 62.7 and 59.7 years, respectively, with slightly more female than male participants. CAM use was high in both groups (47% in cancer and 53% in non-cancer respondents, P > 0.05). The most widely-used diet-related CAM among both groups was the large intake of fruit, vegetables and juice, multivitamins, fish oils and glucosamine. Fish oil intake was significantly higher in the non-cancer group (P < 0.05), whereas selenium and beta-carotene supplements were significantly higher in the cancer group (P < 0.01 and P = 0.02, respectively). The main reasons for using CAM were to boost the immune system and to improve quality of life (P > 0.05). Reported benefits included increased optimism and hope for the cancer group and increased optimism and pain relief for the non-cancer group. Diet-related CAM is used frequently by both cancer patients and non-cancer adults, with many reported benefits and few reported side-effects. Significant differences between the groups included a higher prevalence of fish oil used by the non-cancer group, and a higher use of selenium and beta-carotene supplements in the cancer group.

Complementary and alternative medicine use among long‐term lymphoma survivors: A pilot study

No published survey has specifically addressed the beliefs, knowledge, and usage of complementary and alternative medicine (CAM) in long-term (5-20 years) lymphoma survivors alone. In this pilot project, 95 subjects were randomly selected from a population of 2,475 long-term lymphoma survivors and mailed a questionnaire. The median time from lymphoma diagnosis to completion of the questionnaire was 11 years (range 6-20). Overall, 68% (95% CI: 54-80%) of the long-term lymphoma survivors reported that they have used CAM, a rate higher than the estimated usage rate reported for the general population The most commonly used modalities were chiropractic (39%, 95% CI: 27-53%) and massage therapy (21%, 95% CI: 12-34%). Less than 10% used meditation (5%, 95% CI: 1-15%) and relaxation (7%, 95% CI: 2-17%). In terms of common herbal usage, 5% (95% CI: 1-15%) had used St. John's Wort and 7% (95% CI: 2-17%) had used shark cartilage. Although none of the patients reported that CAM usage was directed specifically towards treating their lymphoma, 4% (95% CI: 0-12%) of patients reported that CAM could cure cancer, and 14% (95% CI: 6-26%) reported that CAM could increase their feeling of control over their health. This pilot study suggests that long-term lymphoma survivors appear to use CAM at a rate higher than the general population. The use of potential agents of risk by the survivors and the lack of access to potentially beneficial modalities highlights the need for further study of CAM in this population.

Use of Complementary and Alternative Medicine: A survey in Turkish Gastroenterology Patients

BackgroundThe study examined complementary and alternative medicine (CAM) usage by patients attending a Turkish gastroenterology outpatient clinic.MethodsThe survey was conducted on 216 patients presenting with gastrointestinal problems during their first visit to the clinic using a 31 item, self-report questionnaire between May and October 2005. Data included information on patient demographics and their gastrointestinal symptoms, as well as items to identify CAM use and patient satisfaction with these therapies.ResultsSeventy-nine patients (36.6%) reported using one or more forms of CAM. The most commonly used therapy was herbal therapy, usually taken as a tea or infusion. These were used by 27 people (29%) in this subgroup. Common indicators for their use were epigastric pain, constipation, bloating and dyspepsia or indigestion. CAM use among upper GI patients was marginally higher than lower GI patients (41.8% versus 41.2%), but the highest usage was amongst patients with liver disease where 53.8% reported using one or more CAM therapy. About half of the patients learned about CAM from their relatives or friends, with more women than men using the therapies (p < 0.05). Clinical characteristics such as diagnosis, duration of symptoms and prior surgical intervention did not differ between users and non-users of CAM therapies. Multivariate analysis showed that being female and higher educational status were positively associated with CAM usage (p < 0.05).ConclusionCAM usage in our sample of gastrointestinal patients was lower than that described in other countries and other chronic disease groups. This could be due to their low perceived efficacy, or the relatively transient duration of symptoms experienced by the sample. Healthcare professionals need however, to be aware of CAM usage in order to educate patients appropriately about possible adverse effects or drug-interactions.

PO29-FR-12 The joint usage of conventional medicine and alternative medicine for migraine in Taiwan: a ten-year retrospective study

PO29-FR-12 The joint usage of conventional medicine and alternative medicine for migraine in Taiwan: a ten-year retrospective study

Beyond a Generic Complementary and Alternative Medicine: The Holistic Health Care- Conventional Medicine Continuum

This article explores whether complementary and alternative medicine (CAM) users view CAM as a unified concept or individualize the modalities. A survey about the beliefs and concerns surrounding the use of 22 CAM modalities was posted to a random sample of 1,308 people in five rural and two metropolitan localities in Victoria, Australia. The response rate was 40% (n = 459). Overall, 91% of respondents were found to either have used one CAM modality (85%, n = 386) or be open to future use (6%, n = 33). Respondents did not view CAM as a unified concept. Each modality was used by people with different characteristics and beliefs about health care. However, it was practical to divide the 22 CAM modalities into four categories that we have named natural remedy, wellness, accepted, and established modalities. The four categories lie along a set of continua extending from natural remedy modalities and ‘‘holistic health care’’ beliefs at one end to established modalities and a belief in the tenets of conventional medicine at the other. We were able to develop a model to show this diagrammatically.

Self-Reported Health Symptoms and Conditions Among Complementary and Alternative Medicine Users in a Large Military Cohort

To describe medical symptom and condition reporting in relation to complementary and alternative medicine (CAM) use among members of the US military. CAM was defined as health treatments not widely taught at US medical schools or typically available at US hospitals. By using data from the Millennium Cohort Study, we included participants who completed a survey from 2004 to 2006 (n=86,131) as part of this cross-sectional analysis in which we sought to identify demographic characteristics and types of health-related symptoms and conditions associated with CAM use. Chi-square tests were used to compare health assessed by self-reported symptoms and conditions among those not reporting CAM use with those reporting practitioner-assisted or self-administered CAM. Of 86,131 participants, 30% reported using at least one practitioner-assisted CAM therapy, 27% reported using at least one self-administered CAM therapy, whereas 59% did not report using any CAM therapy. Both women and men who used CAM reported a greater proportion of specific health conditions and health-related symptoms compared with those not reporting CAM use (p<0.05). These findings illustrate that a relatively young adult occupational cohort of military personnel using CAM therapies also report multiple comorbidities which may indicate chronic illness management and poorer overall health.

Access to Conventional Mental Health and Medical Care Among Users of Complementary and Alternative Medicine With Bipolar Disorder

This research examined the role of perceived barriers to treatment as a potential contributor to the increasing use of complementary and alternative medicine (CAM) among mentally ill populations. The study examined a sample of 435 patients receiving care through the Veterans Administration Health System and having a current diagnosis of bipolar disorder (I, II, NOS), cyclothymia, or schizoaffective disorder-bipolar subtype. Access to care and use of any of 14 CAM therapies within the past year were studied. Physical CAM users reported slightly better mental health service access related to getting to mental health services and obtaining emergency mental health services when needed. Effect sizes for these differences were small (r(pb) = 0.09 and 0.13, respectively). Similarly, oral and cognitive CAM users indicated that they were slightly more likely to go without medical services when needed because they were too expensive. These effect sizes were also very small (r(pb) = 0.12 and 0.10, respectively), suggesting no clinical significance. Patients who reported use of oral and/or cognitive CAM therapies were slightly more likely than nonusers to go without medical care because of excessive costs. Patients having non-Veterans Affairs insurance reported no differences in rates of CAM use. Overall, no discernable trends were observed to suggest that CAM use among this sample was associated with service access.