Complementary and Alternative Medicine Use in the 21st Century

Data on the U.S. population's use of CAM was collected in 2002 and 2007. Considered the most comprehensive and reliable findings on American's use of CAM, these studies were conducted by the NCCAM and the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC). For the first time, detailed questions regarding CAM were added into the 2002 edition of the NCHS National Health Interview Survey (NHIS), an annual study interviewing tens of thousands of Americans about their health- and illness-related experiences. The

2002 and 2007 studies were completed by ~30,000 families through adults 18 years or older who spoke English or Spanish. The study reflected CAM use during the 12 months before the survey. The 2007 survey included expanded questions on 36 types of CAM therapies commonly used in the United States—10 practitioner-based therapies, such as acupuncture, and 26 other, self-care therapies not requiring a practitioner. CAM therapies included in the surveys are listed in Table 11-3, and the terms are defined in eAppendix 11-1.

As shown in Figure 11-2, CAM use increased from 36% of U.S. adults in 2002 to 38% in 2007, or almost 4 of 10 adults (Barnes et al., 2004, 2008). For the first time, the 2007 survey collected data on CAM use in children (<18 years), showing 12% use, or 1 in 9 children. The top 10 CAM therapies for both adults and children are shown in Figure 11-3. Significant increases in adults' use of deep breathing, meditation, massage, and yoga occurred over the 5 years of the study. Another notable NCCAM/AARP study focused on CAM use in adults older than 50 years. Approximately two-thirds (63%) had used one or more CAM therapies (AARP, 2007). The most common reasons cited for not discussing CAM included: the physician never asked (42%), the patient did not know they should ask (30%), and there was not enough time during the office visit (19%). Of those using CAM, 66% did so to treat a specific condition and 65% for overall wellness. For details on CAM costs in the U.S., see eFigures 11-1 to 11-3 online at www.expertconsult.com.

Table 11-2 Guidelines for Advising Patients Who Seek Alternative Therapies

Be willing to listen and learn. Communicate and collaborate. Diagnose.

Explain and explore options and preferences.

Table 11-3 Complementary and Alternative Medicine (CAM) Therapies Included in 2002 and 2007 National Health Interview Surveys

Acupuncture"

Natural nonvitamin and

Ayurveda"

nonmineral products (e.g., herbs,

Alternative practitioner^

other products from plants,

Biofeedback"

enzymes)

Chelation therapy"

Naturopathy*

Chiropractic care"

Osteopathic manipulation*t

CAM+

Prayer for health reasons

Deep breathing exercises

Prayed for own health

Diet-based therapies

Others ever prayed for your health

Vegetarian diet

Participate in prayer group

Macrobiotic diet

Healing ritual for self

Atkins diet

Progressive relaxation

Pritikin diet

Qi gong

Ornish diet

Reiki*

Zone diet

Tai chi

Energy healing therapy"

Traditional healers*t

Folk medicine

Bontanica

Guided imagery

Curandero

Homeopathic treatment

Espiritista

Hypnosis

Hierbero

Massage"

Native American

Meditation

Shaman

Megavitamin therapy

Subador

Movement therapy+

Yoga

Alexander

Feldenkreis

Pilates

Trager

Definitions of these therapies are provided in the glossary of eAppendix 11-1. Indicates a practitioner-based therapy. indicates addition to 2007 survey.

Definitions of these therapies are provided in the glossary of eAppendix 11-1. Indicates a practitioner-based therapy. indicates addition to 2007 survey.

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