When one door closes, another door opens: Physician availability and motivations to consult complementary and alternative medicine providers

BackgroundMental health issues in children have become a serious public health concern in the U.S. within the past few decades. Emerging evidence suggests that Complementary and Alternative Medicine (CAM) can be beneficial for various mental health issues. However, little is known about the prevalence, reasons, and associated factors of CAM use among this population in the U.S. The purpose of this study is to examine the characteristics of CAM use among U.S. children with mental health issues.MethodsUtilizing the 2012 National Health Interview Survey data, we used descriptive analysis, Wald F-statistics, and multivariable survey logistic regression models to examine the prevalence, patterns, and associated factors of CAM use in children aged 4–17 (n = 10,233) adjusting for the complex sampling design.ResultsCAM use is more popular among children with mental health issues compared with those without (19.2% vs. 10.1%, p < 0.001). Herbal remedies (9.1%), mind-body therapies (5.5%), and chiropractic care (5.3%) were the most frequently used modalities. Primary reasons for children to use CAM are because they are helpful (69.2%), natural (55.9%), and holistic (44.7%). The majority of CAM users perceived CAM therapies are helpful. Predictors of CAM use are children who are female, whose parents had a higher educational level and socioeconomic status, and who had at least one co-morbid medical condition. Only 18.4% of CAM usage was recommended by medical doctors.ConclusionsApproximately 10 million parents of children with mental health issues reported the use of CAM therapies, mainly because of their desire for a more natural and holistic healthcare approach. Given that the majority of CAM users perceived CAM therapies as helpful, future studies should investigate the unique contributions of CAM in pediatric psychiatric care. Because a low percentage of CAM use was recommended by medical doctors, educational interventions designed to equip medical professionals with CAM knowledge and experience will be conducive to improving effective patient-physician communication in clinical settings. Since CAM use is reported as more prevalent by parents’ of children with higher education and family income, effective strategies designed to reduce disparities in accessing promising CAM therapies are warranted.

Section: Discussioncontrasting

confidence: 99%

Complementary and alternative medicine use among children with mental health issues: results from the National Health Interview Survey

Wang

Preisser

Chung

et al. 2018

“…In addition, a plausible explanation of the difference in visit rates is the inter study variation of definitions and methodology, for instance the inclusion or exclusion of chiropractors as CAM practitioners [6–8, 21]. Differences in availability and access to CAM providers, conventional psychiatric care, and other sources of mental care in different countries, geographical contexts, and health care systems might also influence the differences in CAM visit rates [22]. …”

Section: Discussionmentioning

confidence: 99%

The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey

Hansen

Kristoffersen

2016

BackgroundDepression has been identified as one of the most frequent predictors of CAM use. However, limited data exist about the use of CAM providers among people with anxiety/depression in Norway. The aim of this study was to investigate the use of CAM providers, and the use of CAM providers and psychiatric outpatient services in combination, among people with self-reported anxiety and/or depression.MethodsWe used questionnaire data from 12,982 participants (30–87 years) in the cross-sectional sixth Tromsø Study (conducted in 2007-8). Eligible for analyses in our study were 1685 participants who reported suffering from anxiety and/or depression. By descriptive statistical methods, we estimated the use of CAM providers, psychiatric outpatient services, and the combination of these. By logistic regressions we studied the association between the use of these services and gender, age, income, education, and self-reported degree of anxiety/depression.ResultsDuring the previous year, 17.8 % of people with anxiety/depression visited a CAM provider once or more, 11.8 % visited psychiatric outpatient services, and 2.5 % visited both. Men with anxiety/depression were less likely to visit CAM providers compared to women (odds ratio [OR] 0.40, confidence interval [CI] 0.30–0.55), whereas higher educated people were more likely to visit compared to the lowest educated (OR 1.47, CI 1.02–2.13). The use of CAM providers was not associated with the degree of anxiety/depression. For those who used both CAM providers and psychiatric specialist services during the previous year, severe anxiety/depression was strongly associated with use compared to moderate disease (OR 7.53, CI 2.75–20.65).ConclusionsPeople with severe anxiety/depression seem to use CAM providers and psychiatric services additionally, whereas those with moderate disease seem to use these services more as alternative pathways. CAM provider treatment might be a substitute for conventional care, particularly in patients with moderate disease.

“…A few studies have elaborated on patient characteristics for the motivation of CAM use, thus identifying psychosocial factors as age, educational level and health behaviour as influencing CAM use [12]. International studies on the role of CAM in primary healthcare, especially in terms of natural health practitioners, are inconsistent [13, 14]. This suggests substantial influences on acceptance are due to culture and tradition as well as to differences in national health systems.…”

Section: Introductionmentioning

confidence: 99%

Complementary and alternative medicine (CAM) as part of primary health care in Germany–comparison of patients consulting general practitioners and CAM practitioners: a cross-sectional study

Krug

Herrmann

Joos³

2016

BackgroundIn Germany, complementary and alternative medicine (CAM) in primary health care is offered by general practitioners (GPs) and by natural health practitioners, so called ‘Heilpraktiker’ (HPs). Considering the steadily growing number of unregulated HPs, the aim of the study was to assess characteristics of patients consulting HPs in comparison to patients consulting GPs.MethodsIn a cross-sectional study, patients of randomly selected GPs and HPs were asked to complete a questionnaire about their health care status, health care behavior, and symptoms rated on the Measure Yourself Medical Outcome Profile (MYMOP-D). Patient groups were compared based on health care provider (HP, GP with high use of CAM (CAM-GP), and GP with no/little use of CAM (nCAM-GP)) using Kruskal-Wallis tests and analyses of variance (ANOVA).ResultsAltogether, 567 patients (91 of 11 HPs, 223 of 15 CAM-GPs, 253 of 19 nCAM-GPs) filled in the questionnaire. Patients of HPs had a higher education level and were more often female. The most common reason for encounter among all three groups were musculoskeletal problems (30.2–31.1 %). Patients seeing HPs reported more psychological (4.4 % vs. 17.8 %), but less respiratory problems (19.9 % vs. 7.8 %), and longer symptom duration (>5 years: 21.1 % vs. 40.7 %), than patients of nCAM-GPs.ConclusionsThe high percentage of patients with psychological illness and chronic health problems consulting HPs demonstrates the urgent need for action with regard to CAM therapy in primary care and regulation of natural health practitioners. Appropriate measures with regard to quality and patient safety should be taken given the growing numbers of HPs and the absence of a regulatory body.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1402-8) contains supplementary material, which is available to authorized users.