Factors influencing the use of complementary and alternative medicine and whether patients inform their primary care physician

Summary

Objectives

Use of complementary and alternative medicines (CAMs) is widespread. Several studies have explored why individuals chose to use CAM but there are fewer data to explain how its use ‘dovetails’ with conventional medicine. This study aimed to determine the prevalence of CAM use in the adult population in Australia and the proportion that seek advice or tell their primary care physician after CAM use, and also to investigate which demographic characteristics, health behaviours and health status are associated with CAM use and disclosure.

Design

A cross sectional survey. Methods: a random sample of 1261 adults was interviewed as part of 2010 Queensland Social Survey, which contained questions about CAM use, frequency of use, types of CAM used, reasons for use, discussing and reporting CAM use with the doctor and confidence in CAM use. Relationships were explored using bivariate and multiple logistic regression. Main outcome measures: use of CAM; sought advice from doctor before CAM use; informed doctor after CAM use.

Results

61.7% of respondents had used self-prescribed CAM or visited a CAM practitioner. Being female and being younger predicted CAM use. Being male and in better health predicted seeking advice from the doctor before and also after CAM use.

Conclusion

Our results confirm the relatively high use of CAM in Queensland, Australia and found that a significant proportion of people did not seek advice from their primary care physician before using CAM, or disclose its use afterwards. These factors should be taken into account in the doctor–patient consultation.

Introduction

The use of complementary and alternative medicines (CAMs) is widespread. In western industrialised countries the proportion of the population that uses CAM ranges from 10 to 52%.1, 2, 3, 4, 5, 6 In Australia especially there is evidence that the popularity of CAM is growing, and that it is a large and increasing component of health care.7, 8, 9 CAM users are more likely to be female,1, 2, 7, 9, 10, 11, 12, 13, 14 have higher income,1, 4, 5, 7, 9, 12 be better educated,1, 7, 11, 12, 15 be in paid employment,1, 9 be in poorer health,15, 16 have chronic conditions,4, 12, 17, 18 belong to certain ethnic groups¹⁵ and geographic regions.2, 7, 9, 12, 16, 19 CAM use also varies by cigarettes or alcohol use.² It is higher in people with a greater sense of control over their health.12, 20 People are more likely to use CAM if they believe that there are health benefits; if there is support from others regarding its use and if they are not discouraged by potential barriers.2, 21, 22 People also use CAM to avoid the unpleasant side effects of some drugs or because of the limitations of conventional medicine.10, 22 Fewer published data, however, have explained how CAM ‘dovetails’ with conventional medicine.22, 23, 24

Although several studies have explored the determinants of CAM use, fewer investigators have examined the factors associated with seeking advice from the doctor before or after CAM use. This is a cause for concern, especially if patients seek advice from herbalists when taking medications prescribed by their doctor, thereby running the risk of serious adverse drugs interactions.⁴ Studies from the US and Australia suggest that such non-disclosure is high and that it has not decreased in recent years.3, 7, 21 This may relate to the characteristics of the patient,¹² the doctor–patient consultation style,²⁵ and/or fears of medical scepticism about CAM use.17, 26 There is a common perception among users of CAM that it ‘will do no harm’, which may not be true.1, 7, 23, 24, 26 These issues indicate that more empirical research is needed to explore the characteristics of CAM users and factors influencing whether people inform their primary care physician before and after use.

The aims of this study were to determine the prevalence of CAM use in the adult population in Queensland, Australia, and the proportion who seek advice or tell their primary care physician after CAM use; and to investigate which demographic characteristics, health behaviours and health status are associated with CAM use and disclosure.