Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects

Abstract

BackgroundThe use of complementary and alternative medicine (CAM) is growing. However the factors contributing to changes over time and to birth cohort differences in CAM use are not well understood.SettingWe used data from 10186 participants, who were aged 20–69 years at the first cycle of data collection in the longitudinal component of the Canadian National Population Health Survey (1994/95-2010/11). We examined chiropractic and other practitioner-based CAM use with a focus on five birth cohorts: pre-World War II (born 1925–1934); World War II (born 1935–1944); older baby boomers (born 1945–1954); younger baby boomers (born 1955–1964); and Gen Xers (born 1965–1974). The survey collected data every two years on predisposing (e.g., sex, education), enabling (e.g., income), behavior-related factors (e.g., obesity), need (e.g., chronic conditions), and use of conventional care (primary care and specialists).ResultsThe findings suggest that, at corresponding ages, more recent cohorts reported greater CAM (OR = 25.9, 95% CI: 20.0; 33.6 for Gen Xers vs. pre-World War) and chiropractic use than their predecessors (OR = 2.2, 95% CI: 1.7; 2.8 for Gen Xers vs. pre-World War). There was also a secular trend of increasing CAM use, but not chiropractic use, over time (period effect) across all ages. Factors associated with cohort differences were different for CAM and chiropractic use. Cohort differences in CAM use were partially related to a period effect of increasing CAM use over time across all ages while cohort differences in chiropractic use were related to the higher prevalence of chronic conditions among recent cohorts. The use of conventional care was positively related to greater CAM use (OR = 1.8, 95% CI: 1.6; 2.0) and chiropractic use (OR = 1.2, 95% CI: 1.1; 1.4) but did not contribute to changes over time or to cohort differences in CAM and chiropractic use.ConclusionThe higher CAM use over time and in recent cohorts could reflect how recent generations are approaching their healthcare needs by expanding conventional care to include CAM therapies and practice for treatment and health promotion. The findings also underscore the importance of doctors discussing CAM use with their patients.

Täydentävien ja vaihtoehtoisten (CAM) hoitojen käyttö Suomessa

“…Kanadalaisessa tutkimuksessa hyödynnettiin väestötason terveyskyselyä, joka mahdollisti 16 vuoden seurantatutkimuksen. Siinä todettiin CAM-hoitojen käytön lisääntyneen 5% yli kymmeneen prosenttiin vuosien 1994-1995 ja 2010-2011 välillä (32) Tutkiessamme uskoa CAM-hoitojen parantavuuteen muodostimme summamuuttujan kysymyksestä "Ovatko seuraavat hoidot/keinot mielestänne sellaisia, joilla voidaan parantaa jokin sairaus tai sairauksia?" (Kyllä/Ei) valitsemalla siihen CAM-hoitoja kuvaavat osiot.…”

Complementary medicine use and its cost in Australians with type 2 diabetes: the Fremantle Diabetes Study Phase II

“…9 This change is consistent with data, largely from North America, suggesting recent substantial increases in CM use in the community as a whole. 12,13 Nutritional supplements were the most common CM in the FDS2 cohort, with omega-3 fatty acids or fish oil being taken by almost a quarter of participants using CM. Based on conservative estimates, the median annual cost of CM in FDS2 participants using them was just over $100, but some Complementary medicine use in diabetes participants were spending thousands of dollars on CM each year.…”

“…9 There is evidence that CM use has since increased in the general population in developed countries. 12,13 In addition, there have also been significant changes in conventional pharmacotherapies used by patients for type 2 diabetes and its comorbidities, 14 in tandem with a recent reduction in rates of complications 15 that may influence the decision to use CM. We have, therefore, evaluated baseline CM use and its associates in participants in Phase II of the FDS (FDS2) conducted between 2008 and 2011.…”

Use of complementary and alternative medicine in patients with inborn errors of metabolism: A single‐center study

“…This is consistent with similar studies, as most patients use CAM together with their prescribed conventional therapy and not in place of, which is also known as integrative medicine. 2,21,22 However, about one-fourth of participants reported using CAM because they were not satisfied with their conventional medical therapy, or lack thereof. Studies have shown that patients may use CAM because they gradually lose confidence or satisfaction in conventional care for chronic diseases.…”

“…Previous studies have demonstrated increased CAM use in females, adults, and those with higher education when compared to CAM Non-users. 11,21,22 Comparisons between CAM Users and CAM Non-users were not performed due to our limited sample size, therefore making the study underpowered to adequately analyze these comparisons. These comparisons are warranted in future studies.…”