Steady Five-Year Prevalence Points To Need For More Rigorous Evaluation
BOSTON, MA--In a comparison of complementary and alternative medicine (CAM) use by adults in 1997 and 2002, researchers from Harvard Medical School found more than one in three U.S. adults (36.5 and 35.0 percent, respectively) used at least one form of CAM.
The continued widespread use of individual and multiple CAM therapies underscores the need to rigorously evaluate the safety, efficacy, and cost-effectiveness of these approaches, according to the study's lead author Hilary Tindle, Harvard Medical School (HMS) research fellow, and co-author David Eisenberg, director of the Division for Research and Education in Complementary and Integrative Medical Therapies and the Osher Institute at HMS.
The study results appear in the January/February issue of the medical journal Alternative Therapies in Health and Medicine.
The study compared results of the National Health Interview Survey in 2002 and a survey conducted by researchers at HMS (Eisenberg et al.) in 1997. The two surveys were similar but not identical. Prior to this study, there had been no head-to-head comparison using a common definition of CAM.
"Our research over the past 14 years has shown a consistent level of usage by adult Americans," said Dr. Eisenberg. "While there have been a few notable changes in which CAM therapies people are using, the overall number of adults employing some type of CAM has remained remarkably consistent since we began our surveys in 1990. This says to us that these therapies are part of the fabric of modern day health care, and that we need to do more research on their safety and effectiveness - just as we would with any other therapeutic options," concludes Eisenberg.
Over the five-year period between the two most recent surveys, the total number of Americans using any CAM therapy remained fairly stable at 72 million. However, there were changes in the choice of CAM therapies used.
The largest change was a 50 percent jump in the use of herbal supplements, growing over the five years from 12.1 percent of adults reporting usage in 1997 to 18.6 percent -- or 38 million adults -- in 2002. The practice of yoga increased 40 percent over the same period, growing from 3.7 percent in 1997 to 5.1 percent-- over 10 million adults-- in 2002.
Use of CAM therapies such as acupuncture, biofeedback, energy healing, and hypnosis remained essentially unchanged between 1997 and 2002, while the use of homeopathy, high-dose vitamins, chiropractic, and massage therapy declined slightly. Since many CAM therapies are paid out-of-pocket by consumers, the authors suggest that some of these declines may be due, at least in part, to a downturn in the U.S. economy from 1997 to 2002.
The ways in which several CAM therapies are used also appear to have changed. For example, only 5 percent of people who used herbs saw a practitioner of herbal medicine in 2002, compared to 15 percent in 1997. "Such changes are important considering that other research has shown that 60 to 70 percent of patients who use CAM therapies do not disclose it to their physician," says lead author Dr. Tindle. "This is especially critical as more becomes known about the adverse effects associated with individual dietary supplements as well as their interactions with prescription drugs".
Despite variability seen in previously published reports about overall CAM use, the authors conclude the use of CAM by one third of U.S. adults from 1997 to 2002 appears to have been steady, reconfirming results from the first national survey in 1990.
This work was made possible in part by grants from the National Center for Complementary and Alternative Medicine and by private foundation grants: Horton Family Fund; Seattle Foundation; John E. Fetzer Institute; American Society of Actuaries; Friends of Beth Israel Deaconess Medical Center; Kenneth J. Germeshausen Foundation; and the J.E. and Z.B. Butler Foundation.
ALTERNATIVE THERAPIES IN HEALTH & MEDICINE: http://www.alternative-therapies.com
The largest peer-reviewed medical research journal in the field of complementary and alternative medicine. Published since 1995, it has a circulation of approximately 15,000 healthcare professionals. Alternative Therapies is published by InnoVision Communications, a division of InnerDoorway, Inc. InnoVision also publishes the peer-reviewed journals Integrative Medicine: a Clinician's Journal and Advances in Mind-Body Medicine and is accredited to grant credits for continuing medical education.
HARVARD MEDICAL SCHOOL: http://hms.harvard.edu
Harvard Medical School has more than 5,000 full-time faculty working in eight academic departments based at the School's Boston quadrangle or in one of 47 academic departments at 18 Harvard teaching hospitals and research institutes. Those Harvard hospitals and research institutions include Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge Health Alliance, The CBR Institute for Biomedical Research, Children's Hospital Boston, Dana-Farber Cancer Institute, Forsyth Institute, Harvard Pilgrim Health Care, Joslin Diabetes Center, Judge Baker Children's Center, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Massachusetts Mental Health Center, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, VA Boston Healthcare System.