Disclosure of CAM use to medical practitioners: a review of qualitative and quantitative studies
Section snippets
Background
Studies on the use of complementary and alternative medicine (CAM) throughout the Western world have documented that people use CAM either in addition to, or instead of, seeing a medical practitioner.1, 2, 3 These studies have considered CAM use from various perspectives including regional trends, sociodemographic predictors, chronic illnesses, use by ethnic groups, and use by children.4
The studies revealed that not all people communicate their use of CAM with their medical practitioner when
Methods
An international literature search was conducted on the terms ‘complementary medicine’, ‘complementary therapies’, ‘alternative medicine’ and ‘alternative therapies’. An individual search was also conducted on 38 individual therapies, including those most well-known such as Acupuncture, Chiropractic, Homeopathy and Naturopathy. These were drawn from two major texts on Complementary and Alternative Therapies.7, 8 Databases searched were Medline, Cinahl, Sociofile and Psycinfo, and searching
Results
Table 1 gives an overview of the methodologies used in the 12 selected articles. Most of the studies included in this review were cross-sectional and used either convenience or consecutive sampling of patients attending medical clinics as the basis for the investigation. Four studies focussed on use by cancer patients, three on patients with other ailments, and three on use by general clinic patients. Four studies focussed on women, and one on men. Only one study was a general population study
Discussion
This review of 12 research studies has found non-disclosure rates of 23–72%. This wide variation may be attributed to difference in study design. There is variance in patient populations, such as differences in gender and sampling frames, and the definitions and types of CAM included in the study. Adler, for instance, gives no indication of specific therapies being referred to, defining complementary and alternative medicine as “all health care resources to which people have recourse other than
Conclusion
A review of 12 research studies into patient communication of CAM use to their medical practitioner has found non-disclosure rates of 23–72%, and three main reasons for non-disclosure. These are concern about a negative response from the medical practitioner, the fact that the medical practitioner does not ask, and the perception that because medical practitioners work within a biomedical framework they have no knowledge of CAM.
Medical practitioners need to understand the beliefs and concerns
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