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"Alternative Medicine" in the Spotlight: High Use by Consumers, Higher Use by Health Professionals PDF Print E-mail
Written by John Weeks   

Media Spotlights Alternative Medicine: High Use by Consumers, Higher Use by Health Professionals

Summary: Two reports this summer have given "alternative treatments" and "CAM" their most significant media attention in years. Consumer Reports surveyed 45,000 and examined use in 11 common conditions. This Integrator culls data relative to which treatments for which conditions "helped a lot" relative to prescription drugs and OTCs. Just after the Consumer Reports wave of coverage, a team linked from Allina Hospitals & Clinics, the Penny George Institute and U Minnesota reported findings of complementary and alternative medicine (CAM) use by healthcare workers. The coverage was more widespread. The authors anticipate what they discovered will have significant, positive implications for the integrative care movement.
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Two recent survey reports have produced the most significant media coverage "alternative therapies" and "complementary and alternative medicine" (CAM) have received in years. One was of consumers. The other was of healthcare workers. Each were based on huge data sets. Here is a brief look, with links, and some comments, on each.

Image
45,000 report on use of alternative treatments
1.  Consumer Reports: Where alternative therapies "helped a lot" compared to prescriptions


Consumer Reports published a 15 page article in July entitled Alternative Treatments: More than 45,000 readers tell us what helped. Use was found to be high. The media re-published findings widely. Examples were KABC Los Angeles, the Hartford Current, Seattle's KOMO News ("Effective Alternative Therapies") and the Cleveland Plain Dealer. The latter article's headline concluded that these treatments are "real competition for prescriptions", underscoring the "alternative" nature.

   
Notably, treatments related to CAM
providers and CAM disciplines rather than
CAM self-care receive the highest marks.
  

  
The article breaks down patient use on 11 common conditions. (See left side of page here for links to individual condition reports.) Each condition-specific account has 3 columns: type of treatment, the percent of use, and a ranking of whether the modality or practitioner "helped a lot." A chief finding was that use remains high even though consumers tend to experience prescription medications as more frequently "helping a lot."

A significant exception was in the area of back pain and neck pain. In each condition, chiropractic is viewed as "helping a lot" by nearly two-thirds of users. This compares with just about half of prescription drug users. For many of the conditions, 30% or more users of various alternative practitioners found the therapy "helped  lot." The table below captures some of these data. The report concludes with a User's Guide to Hand-on Therapies.
Comment: Three thoughts. First, did the consumers have an option besides "helped a lot," such as "helped some"? If yes, what were the combined positive responses and how did these compare with conventional treatment? I will contact the magazine. Second, it would be curious to have consumers report on whether they experienced any adverse effects of the treatments selected. Third, notably, treatments related to CAM providers and CAM disciplines rather than CAM self-care receive the highest marks. 
____________________________

Perceptions of Value in "Helping a lot"
of CAM therapies as compared to Prescriptions and OTCs

Extracted from Consumer Reports Alternative Treatments


Conditions where a
higher % of users
said CAM "helped a lot"
vs prescriptions

  - Back pain - chiropractic (65%) [prescriptions 53%]
- Neck pain - chiropractic (64%, deep tissue massage (58%),
Swedish massage (51%) [prescriptions 49%]
- Fibromyalgia - deep tissue massage (54%) [prescriptions 52%]
     _______________________________

Other conditions
and therapies
where over 30%
said CAM use
"helped alot"
  - Allergies - chiropractic (42%), deep breathing (31%)
[prescriptions 72%; OTC 52%]
- Anxiety
- yoga (46%), meditation (42%), deep breathing (37%)
[prescriptions 72%; OTC 19%]
- Back pain - deep tissue massage (51%), yoga (49%),
Pilates (49%), acupressure (45%), acupuncture (41%),
Swedish massage (41`5), Shiatsu (36%), progressive
relaxation (32%)
[OTCs 29%]
- Cold and Flue 
chiropractic (47%), deep breathing (37%),
Goldenseal (36%)
[prescriptions 77%; OTC 37%]
- Depression
Meditation (36%), yoga (35%)
[prescriptions 69%; OTC 15%]
- Digestive problems
probiotics (35%)
[prescriptions 69%; OTC 42%]
- Fibromyalgia
chiropractic (35%)
[prescriptions 52%; OTC 22%]
- Headache 7 migraine
  chiropractic (45%), deep tissue (40%),
acupuncture (34%), acupressure (32%), yoga (31%)
[prescriptions 77%; OTC 51%]
- Insomnia
  (none above 30% - meditation best, at 24%)
[prescriptions 64%; OTC 20%]
- Irritable bowl syndrome
probiotics (31%)
[prescriptions 59%; OTC 30%]
- Neck pain
yoga(45%), acupuncture (44%)
[prescriptions 49%; OTC 25%]
- Osteoarthritis
deep tissue (50%), yoga (50%),
chiropractic (46%), acupuncture (46%)
[prescriptions 53%; OTC 29%]


________________________________


Image
System's team leads study
2. Healthcare workers: Will their use of CAM drive the integrative care movement?


The reach of the study of health profession use is apparent when searching for the Consumer Report article, above. A prominent link is a Consumer Reports article on a separate article entitled "Many doctors and nurses embrace alternative therapies."

From the conclusion of the authors, the reach of these findings may go much further, effecting healthcare change. They write: "Personal CAM use by healthcare workers may influence the integration of CAM with conventional healthcare delivery."

On August 19, 2011 announcement, a team of researchers from Allina Hospitals & Clinics, the Penny George Institute and the University of Minnesota announced their findings of their analysis of 2007 National Health Interview Survey from the Center for Disease Prevention and Control (CDC). They sorted for a subset of the population and published "Personal Use of Complementary and Alternative Medicine (CAM) by U.S. Healthcare Workers." Core finding: 76% of healthcare workers used CAM in the previous year. This compared to 63% in the general population. The top conditions for which CAM was sought by healthcare workers reflect the general population as captured in the Consumer health survey: back pain, neck pain and joint pain.

Image
Knutson: Study co-author
The "healthcare workers" were described as those "employed in hospitals and ambulatory care settings." The lead author was Pamela Jo Johnson, MPH, PhD, with the Center for Healthcare Innovation at Allina Hospitals & Clinics.

The article was published in the peer-reviewed Health Services. It quickly reached the consumer-reviewed pages of newspapers, TV spots, blogs, and magazines.
Lori Knutson, RN, BSN, HN-BC, a co-author, shared some of the flavor of the media uptake. "The study findings went out on the AP news line on Friday morning" the 19th, she writes in an email. Knutson adds: "By Friday night I had done interviews with the New York Times, CBS, MSNBC, and NBC." Scores of stories have continued to roll out since. Among these are accounts from Akron, Ohio to HealthDoctrine to Crouse Hospital News in Syracuse to US News & World Report to News Medical Net to MassageMag.com.

The final paragraph in the report speaks to authors' view that these finding may have significant ramifications for the movement toward "integrative care." They write:
"Even with these limitations, our results are suggestive of why CAM therapies are increasingly integrated into healthcare. There is evidence that personal use of CAM by healthcare workers is related to the provision of, referral for, or general openness to the integration of CAM therapies in healthcare practices. For example, Tracy et al. reported a strong correlation between personal use of specific CAM therapies among critical care nurses and the use of those same CAM therapies in practice. Thus, personal use of CAM by healthcare workers may be a principal determinant in the movement toward "integrative care" - the mainstreaming of CAM with allopathic medicine. Additionally, in the context of recent federal health reform changes, in 2014 when the health insurance exchanges begin, states may be more ready to license practitioners of various CAM therapies and thus require insurance coverage for CAM. The possibility of such institutionalized changes of CAM's role in healthcare, as well the need for a healthy healthcare workforce, strongly suggests the need for further research to understand the reasons for healthcare workers' CAM use as well as the possible benefits and risks of such use. CAM use is a significant and growing component of healthcare and health promotion and as such necessitates the same due diligence in education, training, and research as any other healthcare practice."
Comment: I shared the findings with Sean Sullivan, JD, co-founder of the employer-based Institute for Health and productivity Management. He quipped: "This is like public school teachers who send their kids to private schools." My guess is that the authors are right in their conclusion. Personal practices and professional services will move toward better alignment. These healthcare workers who use integrative treatments have always been the "CAM champions" in health systems. These new data will empower these advocates further.

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