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Review shows an increasing use of CAM

A systematic review by a research group from Austria and the USA demonstrates that the interest in complementary and alternative medicine (CAM) has increased during the past decade and the attitude of the general public is mainly positive.

The studies examined 10 different countries, including Austria, Switzerland, Germany, Denmark, Italy, Great Britain, Canada, USA, Australia and South Korea. Between 5% and 74.8% of the population uses CAM, the average prevalence being 32.2%. The data also demonstrate an increase of CAM usage from 1990 through 2006 in all countries investigated. For instance in Germany surveys show a steady increase of CAM utilization since 1970. In 1970 about 14% of respondents had used some form of CAM over the past 3 months; this amount doubled to 28% in 1997 and ascended to 34% in 2002.

The authors found a higher utilization of homeopathy and acupuncture in German-speaking countries. The data demonstrate that chiropractic manipulation, herbal medicine, massage, and homeopathy were the therapies most commonly used by the general population. More users were women, middle aged, and more educated. CAM users have more active coping styles and are more interested in making treatment decisions.

The ailments most often associated with CAM utilization included back pain or pathology, depression, insomnia, severe headache or migraine, and stomach or intestinal illnesses. Medical students were the most critical toward CAM. Compared to students of other professions (ie, nursing students: 44.7%, pharmacy students: 18.2%), medical students reported the least consultation with a CAM practitioner (10%).

In most countries, CAM is not covered by national insurance systems, and users pay almost all costs out of pocket. This willingness to pay reflects the public’s general acceptance of CAM and also suggests that CAM therapies have benefits that outweigh their costs.

The authors cite several other studies which concluded that the large majority of physicians had received no education in CAM but did want some education on the subject. Although knowledge levels were low, half of physicians believed in the efficacy of CAM. A majority felt that CAM should be taught as a topic course during a medical student’s training (medical students 84%, GPs 75%, hospital doctors 60%).

Another study examined the reasons for communication gaps between physicians and patients about CAM and found that patients and physicians had different reasons for nondisclosure. Physicians believed that patients felt CAM discussions were unimportant and physicians would not understand, discontinue treatment, discourage or disapprove of the use. Patients attributed nondisclosure to their uncertainty of its benefit and never being asked about CAM. The authors of another study concluded that more than half the physicians (63%) stated that the patient initiated the discussion about benefits and risks of CAM therapy.

Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD (2012) Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner Journal, 12:45-56.[PubMed]

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