Justifications for using complementary and alternative medicine reported by persons with musculoskeletal conditions: A narrative literature synthesis

Abstract

BackgroundComplementary and alternative medicine (CAM) is very popular with patients frequently combining it with orthodox health care. The high prevalence of CAM use and satisfaction with CAM reported by patients directly challenges an orthodox system that can only approve such use if it results from the application of biomedical concepts and science. Studies highlighting this as a cultural, sociological and historical phenomenon emphasise the value of choice for consumers of health care. Musculoskeletal conditions typify common problems for which the effectiveness of orthodox care is often unclear. We postulated that the reasons people give for using or not using CAM for musculoskeletal conditions, would therefore indicate the full range of expectations that people have of health care. Furthermore, these reasons would indicate how much people feel orthodox health care is or is not meeting their expectations. Therefore, this study aims to investigate people’s reasons for choosing or avoiding CAM for non-traumatic musculoskeletal conditions.MethodsA systematic search and narrative synthesis was conducted of published qualitative and quantitative studies related to CAM and non-traumatic musculoskeletal conditions.ResultsWe identified 169 relevant papers detailing 152 separate studies, from which 1486 justifications were extracted concerning CAM use. Content analysis resulted in 11 distinct categories across four themes: practical aspects of care, clinical effectiveness, non-clinical outcomes of care, and a person’s philosophy of illness and care. People provided similar rationales for both using and avoiding CAM, emphasising that, whilst CAM is perceived by many patients with musculoskeletal conditions to fill gaps in care (such as practitioner time or quality of the therapeutic relationship), orthodox care also seeks to deliver these aspects of care. However, people who used CAM also highlighted its alignment with their general philosophy and ideas about illness and health care, and often emphasised CAM’s capacity to give them control over their condition and its treatment.ConclusionCurrently, CAM appears to have a significant role for patients with common painful long-term conditions in providing choices to enable individual needs to be met.

Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone

“…Our analyses also shows Ebola survivors who are T&CM users hold the view that T&CM has fewer side effects than conventional medicine mirroring similar findings in the literature on T&CM use among HIV/AIDS patients [37] and individuals with musculoskeletal conditions within [38] and outside [25] of Africa. Moreover, our analysis suggests that Ebola survivors who use T&CM are highly likely to be driven by belief in the notion that T&CM is more natural than conventional medicine.…”

“…The contemporary literature across sub-Saharan Africa suggests that people seek T&CM due to disenchantment with conventional medicine, the negative attitude of healthcare providers to cultural traditions (including T&CM), drug availability, long distance to and inequity in accessing health facilities as well as long waiting times [4]. In addition, beliefs related to safety, efficacy, holism and the sense of control of one’s health have been identified as possible predictors of T&CM use among different illness groups outside of Africa [24,25,26,27].…”

Association of significant risk perception with the use of complementary and alternative medicine: A cross-sectional study in Hispanic patients with rheumatoid arthritis

“…Cultural and personal backgrounds have been reported to be influential factors for CAM use and patients may receive recommendations to use CAM by other family members who have had previous experiences with CAM [15]. Patients primarily rely on their social networks for information regarding CAM strategies [62,63] and are willing to try therapies even without the approval of their physicians [64]. In our study, while the majority of CAM users referred to being satisfied with the care provided by their rheumatologists (94.2%) and agreed that CAM should be disclosed to him/her (73.3%), few (31.4%) patients actually disclosed CAM use.…”

Efficacy and safety of a supplement combination for hand osteoarthritis pain: protocol for an internet-based randomised placebo-controlled trial (The RADIANT study)

“…The current recommendations of management strategies for HOA include non-pharmacological and pharmacological treatment modalities (ie, limited duration of analgesics particularly non-steroidal anti-inflammatory drugs (NSAIDs)) targeting symptom alleviation (eg, pain reduction);9 10 however, high-quality trials are still scarce. Due to the limited management regimens available, many people turn to complementary and alternative medicines (CAMs) for symptomatic relief 11 12. The prevalence of CAMs use varies from 40% to 69% depending on the population studied 13 14.…”