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CAMbrella work package 4

CAM use – the patients’ perspective

The objectives of this work package were to:
• address the prevalence of CAM use in Europe, taking into account regional and national variations, and creating a summary of current information about prevalence of CAM use and its trajectory
• identify the major conditions treated with CAM, based on existing literature as well as suggesting future research strategy to overcome relevant evidence gaps
• explore the reasons why patients choose CAM through a systematic review of survey material and existing databases
• identify a standardised questionnaire for CAM use in at least 3 European languages that will provide a consistent EU approach to a widespread, but clearly defined range of CAM.

There are reliable data in a few countries but in the majority of the 27 EU member states there is no data. Reported prevalence rates of CAM use were between 0.3% and 86%.

Prevalence rates of the main therapies in use were reported as follows:
• Herbal medicine (31 studies): prevalence rates varied from 5.9 – 48.3% of the population studies. However herbal medicine was not well defined (it may be included in naturopathy, folk medicine or traditional Chinese medicine) and variously categorised as medical herbalism, herbal remedies, herbal teas, phytotherapy. Some specific herbs were reported by name such as St John’s Wort.
Homeopathy (25 studies): prevalence rates varied from 2 – 27% of the populations studied.
• Chiropractic (17 studies): sometimes reported as “Chiropractic or osteopathy” (1 study), as one of a group of CAMs (4 studies) and as “manual or manipulative treatments” (2 studies). Prevalence rates were 0.4 – 20.8% of the populations studied.
• Acupuncture (14 studies): was poorly defined. Prevalence rates were 0.44 – 23% of the populations studied. Eight further studies reported acupuncture as part of groups of CAMs.
• Reflexology (11 studies): Prevalence rates varied from 0.4 – 21% of the populations studied.
• Dietary supplements: calcium supplement use was reported in 9 studies. Use of all other dietary supplements, vitamins, minerals, fish oils, glucosamine and other products was reported heterogeneously in groups, singly or combinations of supplements in 28 papers. It was not possible to distinguish whether the dietary supplements were bought over the counter or prescribed at consultations.

The complete work package reports can be downloaded here.
- A systematic literature review of CAM prevalence in the EU
- A pilot feasibility study of a questionnaire to determine EU wide CAM use

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