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Two Surveys: Thomson-Medstat Puts Use at 37%, NCCAM-AARP Finds Seniors Still Not talking PDF Print E-mail
Written by John Weeks   

Tales of Two Surveys on CAM Use: Thomsen-Medstat Puts Use at 37%, NCCAM-AARP Finds Seniors Not Talking to Their Docs ...

Summary:  Two recently published surveys on complementary and alternative medicine use report that use is stable relative to a 2002 study, at 37%, and that seniors, at least, are still not talking to their physicians about their use of alternative medicines. The first survey was engaged by Thomson-Medstat and the latter by the AARP in association with NIH National Center for Complementary and Alternative Medicine. Interestingly, the Thomson-Medstat survey found that more than twice as high a percentage of those surveyed were talking with their doctors about their use of CAM as was found in the AARP-NCCAM survey of seniors ... With use highest in $100,000 plus households, action for CAM recognition shapes up as intra-class warfare, uh, dialogue ...
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Image1.    Seniors Not Talking to their MDs about CAM

"Older Americans Not Discussing Complementary and Alternative Medicine Use with Doctors."
The title of the press release from AARP and the NIH National Center for Complementary and Alternative Medicine is blunt.

The study was conducted based on prior research showing
that "people 50 and older tend to be high users of complementary and alternative medicine," said Cheryl Matheis, AARP Director of Health Strategies. The core finding: 77% don't talk about CAM use with their doctors.

Reasons for non-communication vary.

  • Physicians never asked (42%).
  • Patients didn't know they should talk with their doctors (30%).
  • Lack of time (19%).
  • Another 29% were a combination of belief that their doctor wouldn't know anything or that the doctor would have been dismissive.

NCCAM deputy director Chesney
Likelihood of talking about it was higher among women and among those with higher incomes and more education. When those surveyed did speak to their doctors, conversation tended to focus on effectiveness, safety and potential interactions. The importance of the latter topic was underscored by the high-incidence of polypharmacy among surveyed seniors. Nearly 75% take one or more prescription medications. 20% take more than five. 59% are on over-the-counter medications.

The survey of 1559 individuals aged 50 and over produced these additional findings:

  • 45% use massage, chiropractic manipulation or other bodywork
  • 42% used herbal medicines or other dietary supplements
  • 15% use mind-body practices including hypnosis and meditation
  • 14% use naturopathy, acupuncture, homeopathy
  • 10% use energy therapies, and
  • 2%  use other therapies.

These seniors were using CAM for more than one reason. For instance, 66% used CAM to treat specific conditions, 65% used for overall wellness, 45% to supplement a conventional treatment, 42% to prevent illness and 2% for something else. Most had mixed reasons.

Margaret A. Chesney, Ph.D., NCCAM’s Deputy Director is quoted as summarizing the meaning of the findings this way: “An open dialogue between consumers and their physicians is critical to ensuring safe and appropriate integrated care." For a complete copy of the survey report, you will find the PDF download here.

2.    General Population Shows Use and Dialogue with Patients High

ImageA Thomson-Medstat survey of 23,000 adults provides yet another look into CAM use in households in the United States. Headline findings were:

  • 37% of households "regularly" use CAM
  • highest use by race, at 47%, were those of "mixed race"
  • General wellness was the top reason given, though condition-specific reasons "ranged from headaches to diabetes."
  • 64% said their medical doctors were aware of their CAM use.
  • 42% said at least some of the costs of paying for CAM were covered by insurance
  • Nearly half (49.6%) of households with over $100,000 of income used some alternative care in the previous year.
  • Utilization dropped to 30% in households with $15,000-$24,999 a year, and to 18% in those without a high school diploma.
  • Herbal medicines (23%) and "massage/chiropractic" (22%) topped use, followed by mind-body practices (6.5%), a category of naturopathy-acupuncture-Ayurveda (3.2%) and then energy therapies (2.6%). 

The most important reasons for use were general wellness (40.8%), treatment of an illness (32.5%), supplement traditional care (10.2%), prevent an illness (9.9%) and other (5.4%). (Unlike the AARP-NCCAM survey, respondents could only check one box here.)

The authors conclude: 
"Despite widespread concern about the lack of FDA oversight over the alternative healthcare marketplace and the potential for adverse reactions between traditional medications and alternative supplements, the most highly educated and well paid Americans continue to drive the growth of the alternative medicine movement. It is instructive to note that the demographic group with arguably the most healthcare resources at its disposal is the most likely to seek alternatives outside the bounds of traditional Western medicine." (bold added)
Data for this "Research Brief" were aggregated from the 2006 PULSE survey. This survey, according to Thomson-Medstat, is the nation's largest ongoing, privately sponsored consumer health survey. The core finding is roughly aligned with that of a 2002 CDC survey which put use at 36%. The PDF download is available here.

Thanks to Lou Sportelli, DC and Sita Ananth, MHA, for bringing these surveys to my attention.

Comments: Fascinating to see the apparent difference in levels of communication with physicians between these two surveys. Only 23% of the seniors spoke with their doctors while 64% of the general population in the said their doctors "were aware of their CAM use." The different phrasing in the question leaves open the possibility of doctors somehow becoming aware of CAM without one needing to talk to them. Notably, the wish for such telepathic intervention is favored by people who like to avoid conflict.

It is hard to explain the differences in use of different types of therapies and practitioners except by not-evident differences in questions. It appears that the AARP-NCCAM survey reported all types of therapies used (this adding up to over 100%) while the Thomson-Medstat survey use percentages add up to less than 100%. Sorry, no clarity on this.

One fascinating suggestion from the Thomson-Medstat survey is that we see a connection between
individuals who have no high school diploma and medical doctors who view CAM as quackery: neither, presumably, uses much. On the other hand, the upper social class and educational experience of conventional medical doctors aligns them neatly with the well-to-do, with the most healthcare options, who are, in the words of the Thomson-Medstat study, "driving demand for alternative modalities."

Thus, the battle for CAM recognition and use by typically well-to-do medical doctors and hospital leaders continues to shape up as intra-class warfare ... uh, dialogue.

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