Complementary Alternative Medicine Practitioners Research Articles

Important knowledge items with regard to the benefits of exercise for patients with epilepsy: Findings of a qualitative study from Palestine

ObjectivesPhysicians and complementary alternative medicine (CAM) specialists are not formally educated/trained on the benefits of exercises for people living with epilepsy (PWE). This study was performed to develop a consensus-based knowledge items on the benefits of exercises for PWE that physicians and CAM specialists need to know. MethodsKnowledge items were collected after an extensive review of the scientific literature and from in-depth interviews with key contacts in the domain (6 primary healthcare providers, 4 neurologists, 4 exercise and medicine specialists, 4 CAM practitioners, 4 researchers who did studies on the benefits of exercise for PWE, and 4 PWE). Items collected were reviewed by 12 researchers who did studies on exercise for PWE. A Delphi technique was followed among a panel of 50 members to develop the consensus-based core list. ResultsThe final consensus-based core list contained 64 items that were grouped into the following categories: 1) general items recommending exercise for PWE, 2) benefits of exercise on prevention of seizures, 3) benefits of exercise on antiepileptic therapy, 4) benefits of exercise in preventing comorbidities associated with epilepsy, 5) benefits of exercise in improving quality of life of PWE, and 6) psychosocial benefits of exercise for PWE. ConclusionThis consensus-based core list might guide educators, trainers, or authorities while designing educational or training courses to increase knowledge of physicians in primary healthcare and CAM specialists with regard to the benefits of exercise for PWE. Further investigations are needed to determine if such consensus-based core list might improve care and wellbeing of PWE.

From parallel to partnership

PurposeIn the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a deeply rooted philosophical conflict. This qualitative study works to identify factors that health-care leaders can use, which will build a pathway to greater integrative practice between medical doctors and CAM practitioners – from parallel existence to partnership – by examining the tensions between biomedical medicine and naturopathic medicine. The purpose of this study is to offer short-term suggestions for partnership and long-term recommendations for better understanding.Design/methodology/approachAn original qualitative study using semi-structured with CAM practitioners and biomedical practitioners.FindingsAreas of conflict that are preventing synergy are identified and a pathway for health-care leaders to follow to create greater integration and partnerships is suggested.Research limitations/implicationsThis is a qualitative and exploratory study that has significant limitations on generalizability.Practical implicationsThis study suggest steps that both types of health-care practitioners can take to increase their success at working together on an individual level, a group level, an organizational level and on an industry-wide basis, as well as provide a specific pathway to create greater integrative practice for health-care leaders.Social implicationsThe results indicate that stronger partnerships between different types of medical practitioners increase patient choice, patient satisfaction and outcomes.Originality/valueIncreasing interested in CAM modalities is driving more contact between CAM practitioners and biomedical practitioners. This contact is best established in partnership between practitioners rather than in parallel. This original research outlines the sources of conflict and provides recommendations for encouraging greater synergy.

Knowledge, attitudes, and usage of complementary-alternative medicine (CAM): A national survey of clinical psychologists in Indonesia

This nationwide cross-sectional study aimed to explore Indonesian clinical psychologists’ (CP) knowledge, attitudes, and usage of complementary-alternative medicines (CAM). A link to the online survey was emailed to all 1045 registered CP in the Indonesian Clinical Psychology Association database. Participants were asked about: CAM knowledge, attitudes towards CAM, and CAM usage activities (personal purpose, recommendation, referral, and the use of CAM in practice). Two hundred and seventy-four CP completed the questionnaire (mean of age = 35.4 years, SD = 7.87) and were predominantly female (n = 237, 86.5%). Participants reported low CAM knowledge and positive attitudes towards CAM. Almost half of the participants reported personal experiences of using CAM as the main resource of CAM knowledge. The majority of participants (n = 239, 87.2%) had used CAM personally, had recommended CAM (n = 230, 83.9%), had made a referral to a CAM practitioner (n = 143, 52.2%), and had used CAM in their clinical practice (n = 180, 65.7%). Spiritual-religious therapy was the most often used method by participants. In exploring prediction models, it was found that age, knowledge of, together with attitudes towards CAM contributed to the prediction of CAM usage activities. In conclusion, despite low CAM knowledge, CP in Indonesia reported positive attitudes towards CAM and most had used CAM. Findings from this study might be used by professional organizations, psychology faculties, and the government to review the basic competency of CP and regulation in integrating CAM to psychology services.

Determinants of use of care provided by complementary and alternative health care practitioners to pregnant women in primary midwifery care: a prospective cohort study.

BackgroundPregnant women visit complementary/alternative health care practitioners in addition to regular maternal health care practitioners. A wide variation has been reported with regard to rates and determinants of use of complementary/alternative medicine (CAM), which may be due to heterogeneous populations. The aim of this study was to examine the prevalence and determinants of use of CAM practitioners by a homogeneous population of low-risk pregnant women in the Netherlands.MethodsData from the population-based DELIVER study was used, concerning 1500 clients from twenty midwifery practices across the Netherlands in 2009 and 2010. CAM use was measured based on patient reports. Potential determinants were derived from Andersen’s behavioural model of health care utilization.ResultsThe prevalence of CAM practitioner use by low-risk pregnant women was 9.4 %. Women were more likely to use CAM if they had supplementary health care insurance (OR 3.11; CI 1.41-6.85), rated their health as ‘bad/fair’ (OR 2.63; CI 1.65-4.21), reported a chronic illness or handicap (OR 1.93; CI 1.14-3.27), smoked during pregnancy (OR 1.88; CI 1.06-3.33), or used alcohol during pregnancy (OR 2.30; CI 1.46-3.63).ConclusionsCAM is relatively frequently used by low-risk pregnant women. Determinants revealed in this study diverge from other studies using heterogeneous populations. Maternal health care practitioners must be aware of CAM use by low-risk pregnant women and incorporate this knowledge into daily practice by actively discussing this subject with pregnant women.

Using a mixed methods research design to investigate complementary alternative medicine (CAM) use among women with breast cancer in Ireland

AimTo investigate complementary and alternative medicine (CAM) use among women with breast cancer in Ireland using a mixed methods modified sequential explanatory design. MethodsSemi-structured interviews were conducted with oncology professionals (n = 20) and CAM practitioners (n = 20) and this was followed by a survey of 406 women with breast cancer using the ‘Use of Complementary and Alternative Therapies Survey’ questionnaire (UCATS) (Lengacher et al., 2003). Follow up interviews were subsequently undertaken with a subset of this survey sample (n = 31). ResultsOver half of those surveyed (55.7%, n = 226) used some form of CAM since diagnosis. The most frequently used therapies were massage, herbal supplements (including herbs with oestrogenic properties), antioxidants, relaxation, counselling, health supplements, reflexology, reiki and support groups. Dietary interventions were used primarily to reduce symptoms and/or side effects while reduction of psychological stress was the primary reason for use of stress-reducing therapies. Most respondents reported that the CAM therapies they had used were helpful. The qualitative data elaborated on and provided clarification of the survey results. ConclusionsSimilar to international studies, CAM is popular among women with breast cancer in Ireland. As such, the challenge for Irish oncology professionals is to identify low risk CAM therapies that are likely to benefit patients while educating patients and themselves on therapies which may be of concern. This study clearly illustrates the benefits of using a mixed methods approach to enhance our understanding of a complex clinical issue and thus we recommend that this method should be the method of choice when planning health services research.

Health-care seeking behaviour among persons with diabetes in Uganda: an interview study

BackgroundHealthcare-seeking behaviour in patients with diabetes mellitus (DM) has been investigated to a limited extent, and not in developing countries. Switches between different health sectors may interrupt glycaemic control, affecting health. The aim of the study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine (CAM) and traditional healers, in Ugandans diagnosed with DM. Further, to study whether gender influenced healthcare-seeking behaviour.MethodsThis is a descriptive study with a snowball sample from a community in Uganda. Semi-structured interviews were held with 16 women and 8 men, aged 25-70. Data were analysed by qualitative content analysis.ResultsHealthcare was mainly sought among doctors and nurses in the professional sector because of severe symptoms related to DM and/or glycaemic control. Females more often focused on follow-up of DM and chronic pain in joints, while males described fewer problems. Among those who felt that healthcare had failed, most had turned to traditional healers in the folk sector for prescription of herbs or food supplements, more so in women than men. Males more often turned to private for-profit clinics while females more often used free governmental institutions.ConclusionsHealthcare was mainly sought from nurses and physicians in the professional sector and females used more free-of-charge governmental institutions. Perceived failure in health care to manage DM or related complications led many, particularly women, to seek alternative treatment from CAM practitioners in the folk sector. Living conditions, including healthcare organisation and gender, seemed to influence healthcare seeking, but further studies are needed.

Advice Offered by Practitioners of Complementary/ Alternative Medicine

The current popularity of complementary/alternative medicine (CAM) generates many challenges to medical ethics. The one discussed here is the advice offered by CAM practitioners. Using selected examples, the author tries to demonstrate that some of the advice issued through the popular media or provided by acupuncturists, chiropractors, herbalists, homeopaths, pharmacists, and doctors is misleading or dangerous. This, the author argues, can impinge on the main principle of medical ethics: beneficence, nonmaleficence, and autonomy. We should work toward correcting this deplorable situation.

How the public is being misled about complementary/alternative medicine

Complementary/alternative medicine (CAM) is a hugely popular subject. Hardly a day goes by that the popular press does not report about one aspect of CAM or another. Currently there are approximately 41 million (!) web sites bombarding the public with information on this topic. Numerous studies have shown how unreliable, and indeed dangerously misleading, this information often is.1,2 To make matters worse, patients cannot rely either on conventional healthcare professionals, who tend to be ill-informed about this subject,3 or on CAM practitioners, who often over-estimate the value of their treatments.4 They cannot even trust the UK ‘official’ patient guide5 (sponsored by the Department of Health), which is promotional, uninformative and inaccurate.6 It is hardly surprising, therefore, that despite the plethora of information, 77% of patients feel ‘insufficiently informed about CAM’.7 In this article, I will try to outline how the public is being misled about CAM.

Adult vaccination coverage levels among users of complementary/alternative medicine – results from the 2002 National Health Interview Survey (NHIS)

BackgroundWhile many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged ≥ 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage.MethodsData from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and ≥ 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics.ResultsOverall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001).ConclusionVaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.

Familiarity breeds discontent: Senior hospital doctors’ attitudes towards complementary/alternative medicine

Studies have shown that many general medical practitioners refer their patients to complementary/alternative medicine (CAM) practitioners and believe in the therapeutic benefit of these modalities. However, there is less information concerning the beliefs and practices of senior hospital doctors. In view of the increasing institutionalization of CAM and moves to incorporate CAM into secondary and tertiary healthcare settings, the objective of this study is to understand the attitudes and practices of senior hospital doctors, a sector whose members are often responsible for formulating and implementing institutional policy. A questionnaire was administered to 294 directors of hospital departments and their deputies on their attitudes and practices concerning CAM. Response rate was 70%. Almost all general hospitals in Israel participated in the study. The findings show, in general, that while senior hospital physicians in Israel hold positive attitudes towards CAM, they are not well disposed towards co-operation with CAM practitioners. Incorporating a CAM clinic into the hospital site does not seem to enhance clinical co-operation between conventional physicians and CAM practitioners. In hospitals that had functioning CAM clinics, doctors were consistently and significantly more opposed to co-operation with CAM than in hospitals without CAM clinics.

Pediatricians' attitudes, experience and referral patterns regarding Complementary/Alternative Medicine: a national survey.

BackgroundTo assess pediatricians' attitudes toward & practice of Complementary/Alternative Medicine (CAM) including their knowledge, experience, & referral patterns for CAM therapies.MethodsAn anonymous, self-report, 27-item questionnaire was mailed nationally to fellows of the American Academy of Pediatrics in July 2004.648 of 3500 pediatricians' surveyed responded (18%).ResultsThe median age ranged from 46–59 yrs; 52% female, 81% Caucasian, 71% generalists, & 85% trained in the US. Over 96% of pediatricians' responding believed their patients were using CAM. Discussions of CAM use were initiated by the family (70%) & only 37% of pediatricians asked about CAM use as part of routine medical history. Majority (84%) said more CME courses should be offered on CAM and 71% said they would consider referring patients to CAM practitioners. Medical conditions referred for CAM included; chronic problems (headaches, pain management, asthma, backaches) (86%), diseases with no known cure (55.5%) or failure of conventional therapies (56%), behavioral problems (49%), & psychiatric disorders (47%). American born, US medical school graduates, general pediatricians, & pediatricians who ask/talk about CAM were most likely to believe their patients used CAM (P < 0.01).ConclusionPediatricians' have a positive attitude towards CAM. Majority believe that their patients are using CAM, that asking about CAM should be part of routine medical history, would consider referring to a CAM practitioner and want more education on CAM.

How Do Private CAM Therapies Affect Integrative Health Care Settings in a Publicly Funded Health Care System?

“Integrative health care” (IHC), combining various aspects of Western biomedicine and complementary/alternative medicine (CAM), is a relatively new development in health care systems. IHC is recognized internationally, yet the occurrence of private CAM therapies and their various effects on IHC settings has not extensively been analyzed. This paper presents findings from a larger study of three IHC settings in Canada conducted between 2002 and 2003. The main research question addressed here is: How have private CAM therapies affected IHC settings combining CAM and biomedicine in a publicly funded health care system? Drawing on ethnography, 38 in-depth interviews are drawn upon, including those with 15 biomedical and eight CAM practitioners, 13 patients and two health care managers. Ethnographic observation and document analysis was conducted at each site. Findings illustrated that patients could not consistently afford unfunded CAM treatments, resulting in the premature termination of an integrative care plan. CAM practitioners from the private sector could not uniformly attend group rounds, resulting in disrupted care co-ordination. Certain biomedical institutions viewed CAM as a commodity from which to generate revenue and lower budgetary deficits. This study argues that the unfunded nature of CAM therapies in public health systems, although CAM has therapeutic value, does not contribute to an equitable partnership when attempting to integrate biomedicine and CAM. Future analyses of IHC need to take into account the complexities of health system context that continues to shape IHC.

THE RELATIONSHIP BETWEEN MARRIAGE AND FAMILY THERAPISTS AND COMPLEMENTARY AND ALTERNATIVE MEDICINE APPROACHES: A QUALITATIVE STUDY

In this article, we delineate the qualitative phase of a mixed-method research study focused on understanding the relationship between Clinical Members of the American Association for Marriage and Family Therapy (MFT) and complementary alternative medicine (CAM). Based on an analysis of the data derived from telephone interviews with 54 respondents, we describe four themes: definitional issues, depth of awareness of CAM, fit with MFT, and ethical considerations. Our discussion focuses on the findings of this phase, considerations from the quantitative phase, and reflections on the research study as a whole. While acknowledging the limitations of the study, we conclude that the growing awareness of and involvement with CAM approaches and practitioners among MFTs suggest a need for further education for both professionals and clients. We also note the importance of additional research support for the use of CAM practices.

Adolescents’ knowledge of and beliefs about herbs and dietary supplements: a qualitative study

Objective To explore adolescents’ knowledge of and beliefs about dietary supplements, including herbs, and over-the-counter (OTC) medications. Methods Eighteen focus groups with 81 adolescents in Monroe County, New York, explored teens’ familiarity with and beliefs about CAM, specifically dietary supplements. We asked about general health beliefs and opinions of OTC medications to provide a framework for understanding how dietary supplements are conceptualized. Groups were conducted with suburban adolescents, urban minority adolescents, adolescents with chronic illness, (asthma, eating disorders, and diabetes), and patients of complementary/alternative practitioners (“CAM practitioners”). Transcripts were analyzed for themes relating to prevention (“ staying healthy”) and treatment of illness (“ getting better”); direct quotations are used to illustrate adolescents’ views. Results Most adolescents are familiar with “herbal medicine,” “herbal remedies,” or “nutritional supplements,” and are able to name specific products or complementary/alternative medicine (CAM) therapies; however, many are unfamiliar with the term “alternative medicine.” Adolescents are more familiar with remedies or CAM therapies commonly used by people from their own cultural or ethnic background. Older suburban females and those with chronic illnesses are more familiar with herbs and supplements than other adolescents. Most supplement use is conceptually linked with treating illness rather than with preventive care. Conclusions Most adolescents are familiar with culturally based herbal products and nutritional supplements, used for treatment of illnesses, and not for preventive care. Providers and researchers should consider chronic illness status and culture/family tradition, and clarify terms, when asking adolescents about self-care, OTCs, or CAM.

Uncharted ground: Patterns of professional interaction among complementary/alternative and biomedical practitioners in integrative health care settings

The development of “integrative health care” (IHC) settings combining various aspects of Western biomedicine and complementary/alternative medicine (CAM) is a relatively recent phenomenon among biomedical and CAM professions. While IHC is recognised internationally and occurs in many different contexts (e.g. clinic or hospital), patterns of interaction between biomedical and CAM practitioners, and the nature of IHC settings, are largely unknown. This paper presents findings from a research study of two newly established IHC settings in Canada. The main research question was: how are biomedical and CAM practitioners integrating or not integrating with each other at the level of professional interaction in IHC settings? Using a case study design, in-depth interviews were conducted with 13 biomedical and eight CAM practitioners during 2002–2003, and ethnographic observation and document analysis was conducted at each site. Drawing from closure theory of the professions, comparative analysis of the sites revealed that biomedical practitioners enact patterns of exclusionary and demarcationary closure, in addition to the use of “esoteric knowledge”, by: (a) dominating patient charting, referrals and diagnostic tests; (b) regulating CAM practitioners to a specific “sphere of competence”; (c) appropriating certain CAM techniques from less powerful CAM professions; and (d) using biomedical language as the primary mode of communication. CAM practitioners, in turn, perform usurpationary closure strategies, by: (a) employing their own “esoteric knowledge” in relation to biomedicine and other CAM professions; (b) appropriating biomedical language and terminology; (c) increasing their professional status by working with biomedicine; and (d) referring among CAM practitioners to increase patient flow. The findings suggest that when attempts are made to integrate biomedicine and CAM, dominant biomedical patterns of professional interaction continue to exist. Despite continued patterns of social closure, biomedical and CAM practitioners continue to provide a certain form of integrative care that may be of benefit to patients, albeit not as integrative as current models of integration would prefer.

Use of complementary/alternative medicine by men diagnosed with prostate cancer: prevalence and characteristics

Objectives To ascertain the prevalence of the use of complementary/alternative medicine (CAM) among a random sample of Ontario (Canadian) men diagnosed with prostate cancer and to explore in what way users of CAM differ from nonusers. Methods A questionnaire was mailed to a random sample of 696 men diagnosed with prostate cancer. Results The final response rate was 78.8%. Almost one third (29.8%) reported using CAM for their prostate cancer care. Natural health products (most commonly vitamin E, saw palmetto, and selenium) were used by 26.5% of the respondents. CAM therapies were used by 17.0% of the men (most commonly dietary changes), and only 9.1% visited CAM practitioners. Three characteristics appear to differentiate CAM users from nonusers. Men who had attended support groups were much more likely to use CAM. Men who had more advanced disease, and those who believed in the efficacy of CAM, but were not concerned about potential adverse effects of CAM, were also more likely to use CAM. CAM use was not related to education, income, or geographic location. Conclusions The data suggest that CAM use is no longer a phenomenon restricted to a unique segment of the population that is highly educated and enjoys a high family income. CAM use appears to be more related to other factors such as support group attendance, disease characteristics, and beliefs about CAM. Our findings highlight the need for urologists to ask all their patients about their use of CAM.

An approach for integrating complementary-alternative medicine into primary care.

Despite family practitioners frequently being requested to assist their patients with advice on or referrals to complementary-alternative medicine (CAM), there is an absence both of evidence about the efficacy of nearly all specific treatments or modalities and of guidelines to assist with the integration of conventional and CAM therapies. The aim of this article is to suggest a comprehensive and rational, best-evidence strategy for integrating CAM by primary care practitioners into primary care, within the context of the limitations of the current knowledge base and the local milieu. The suggested approach was developed by a combination of literature review, key informant interviews, focus groups, educational presentations for family practice residents and practitioners, and field testing. An iterative model was utilized whereby more refined drafts of the suggested approach were subjected to later discussants and groups, as well as further field testing. Drafts of the strategy were utilized in consultations of patients requesting advice on alternative medicine in a primary care setting and in a CAM clinic. Both family physicians and CAM practitioners provided useful comments and recommendations throughout the process. These can be categorized in terms of knowledge, attitudes and skills. Our strategy suggests that patients requesting advice on the use and integration of CAM modalities as part of their health care should be evaluated initially by their primary care physician. The physician's responsibilities are to evaluate the appropriateness of that use, and to maintain contact, monitoring outcomes. Advice on referrals should be based on the safety of the method in question, current knowledge on indications and contraindications of that modality, and familiarity and an open dialogue with the specific therapist. Given patients' demands and utilization of CAM therapies, despite the lack of evidence, there is an increasing need to address how CAM therapies can be integrated into conventional medical systems. These suggestions should respond to patient's expectations and needs, but at the same time maintain accepted standards of medical and scientific principles of practice.

The challenge of educating physicians about complementary and alternative medicine.

The rapid growth of complementary/alternative medicine (CAM) predated both the 1992 establishment of the Office of Alternative Medicine at the National Institutes of Health and the release of Dr. David Eisenberg's 1993 groundbreaking article on the widespread use of CAM. Since these two watershed events, the use of nontraditional medical modalities has seen exponential expansion. Most physicians are not prepared to respond knowledgeably about CAM modalities, and, indeed, sorting out the viable CAM modalities can be a difficult task. Additional factors are poor and inadequate dialogue between physicians and CAM practitioners, doubts about CAM practitioners' competence, a lack of readily identifiable and recognizable qualifications of such practitioners, and the risk of offering unrealistic hope of a cure. All these factors place the patient in a sometimes perilously uncertain position. Incorporating systematic presentation of CAM information into the curricula of medical schools would provide future physicians the necessary tools and knowledge to enable their patients to use CAM modalities appropriately, with limited risks.

Regulation of complementary/alternative medicine: a Canadian perspective

Increased use of complementary/alternative medicine (CAM) therapies by Canadians combined with increasingly forceful lobbying from both practitioner groups and the public have made the regulation of CAM practitioners an important issue for Canadian policy makers. A variety of challenges (including regulatory structures that are difficult to change, fear of adding costs to an already under-funded healthcare system and the lack of internal cohesion of some CAM practitioner groups) are currently hindering attempts to implement new policy. However, an environment of health regulation review and renewal as well as public support for regulation may have created a window of opportunity for investigating policy options. Currently in Canada, health care providers are regulated by individual provinces. This means that although some CAM practitioners are either regulated (e.g. chiropractors) or not regulated (e.g. herbalists, homeopaths) in all provinces; others (e.g. naturopathic practitioners, acupuncture/TCM practitioners) are regulated in some provinces, but not others. Harmonization of regulations and scopes of practice for CAM practitioners across Canada is one of the biggest future challenges.

Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions.

To determine the prevalence of use of complementary/alternative medicine (CAM) by breast cancer survivors in Ontario, Canada, and to compare the characteristics of CAM users and CAM nonusers. A questionnaire was mailed to a random sample of Ontario women diagnosed with breast cancer in 1994 or 1995. The response rate was 76.3%. Overall, 66.7% of the respondents reported using CAM, most often in an attempt to boost the immune system. CAM practitioners (most commonly chiropractors, herbalists, acupuncturists, traditional Chinese medicine practitioners, and/or naturopathic practitioners) were visited by 39.4% of the respondents. In addition, 62.0% reported use of CAM products (most frequently vitamins/minerals, herbal medicines, green tea, special foods, and essiac). Almost one half of the respondents informed their physicians of their use of CAM. Multiple logistic regression analysis determined that support group attendance was the only factor significantly associated with CAM use. CAM use is common among Canadian breast cancer survivors, many of whom are discussing CAM therapy options with their physicians. Knowledge of CAM therapies is necessary for physicians and other health care practitioners to help patients make informed choices. CAM use may play a role in the positive benefits associated with support group attendance.