David M. Eisenberg, MD; Ronald C. Kessler, PhD; Maria I. Van Rompay, BA; Ted J. Kaptchuk, OMD; Sonja A. Wilkey, MD; Scott Appel, MS; Roger B. Davis, ScD
Acknowledgments: The authors thank Marcia Rich for her technical assistance in preparing this manuscript; the staff of DataStat, Inc., for their assistance with telephone data collection; and John Astin, PhD, for his thoughtful suggestions.
Grant Support: In part by National Institutes of Health (grant U24 AR43441-02S1A1), Bethesda, Maryland; the American Society of Actuaries, Schaumburg, Illinois; and unrestricted educational grants from the John E. Fetzer Institute, Kalamazoo, Michigan, the Friends of Beth Israel Deaconess Medical Center and the Kenneth J. Germeshausen Foundation, Boston, Massachusetts, the J.E. and Z.B. Butler Foundation, New York, New York, and The American Specialties Health Plan, San Diego, California.
Requests for Single Reprints: David M. Eisenberg, MD, Center for Alternative Medicine Research and Education, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Eisenberg, Kaptchuk, Wilkey, and Davis, Ms. Van Rompay, and Mr. Appel: Center for Alternative Medicine Research and Education, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.
Dr. Kessler: Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115.
Eisenberg D., Kessler R., Van Rompay M., Kaptchuk T., Wilkey S., Appel S., Davis R.; Perceptions about Complementary Therapies Relative to Conventional Therapies among Adults Who Use Both: Results from a National Survey. Ann Intern Med. 2001;135:344-351. doi: 10.7326/0003-4819-135-5-200109040-00011
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Published: Ann Intern Med. 2001;135(5):344-351.
Little is known about perceptions of complementary and alternative medical (CAM) therapy relative to conventional therapy among patients who use both.
To document perceptions about CAM therapies among persons who use CAM and conventional therapies.
Nationally representative, random-household telephone survey.
The 48 contiguous U.S. states.
831 adults who saw a medical doctor and used CAM therapies in 1997.
Perceptions about helpfulness and patterns of CAM therapy use relative to conventional therapy use and reasons for nondisclosure of CAM therapies.
Of 831 respondents who saw a medical doctor and used CAM therapies in the previous 12 months, 79% perceived the combination to be superior to either one alone. Of 411 respondents who reported seeing both a medical doctor and a CAM provider, 70% typically saw a medical doctor before or concurrent with their visits to a CAM provider; 15% typically saw a CAM provider before seeing a medical doctor. Perceived confidence in CAM providers was not substantially different from confidence in medical doctors. Among the 831 respondents who in the past year had used a CAM therapy and seen a medical doctor, 63% to 72% did not disclose at least one type of CAM therapy to the medical doctor. Among 507 respondents who reported their reasons for nondisclosure of use of 726 alternative therapies, common reasons for nondisclosure were â€œIt wasn't important for the doctor to knowâ€ (61%), â€œThe doctor never askedâ€ (60%), â€œIt was none of the doctor's businessâ€ (31%), and â€œThe doctor would not understandâ€ (20%). Fewer respondents (14%) thought their doctor would disapprove of or discourage CAM use, and 2% thought their doctor might not continue as their provider. Respondents judged CAM therapies to be more helpful than conventional care for the treatment of headache and neck and back conditions but considered conventional care to be more helpful than CAM therapy for treatment of hypertension.
National survey data do not support the view that use of CAM therapy in the United States primarily reflects dissatisfaction with conventional care. Adults who use both appear to value both and tend to be less concerned about their medical doctor's disapproval than about their doctor's inability to understand or incorporate CAM therapy use within the context of their medical management.
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