Use and expenditure on complementary medicine in England: a population based survey. Complement Ther Med

Medical Centre Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Complementary Therapies in Medicine (Impact Factor: 1.55). 04/2001; 9(1):2-11. DOI: 10.1054/ctim.2000.0407
Source: PubMed


Many claims are made that complementary medicine use is a substantial and growing part of health-care behaviour. Estimates of practitioner visits in the USA and Australia indicate high levels of use and expenditure. No reliable population-based estimates of practitioner use are available for the UK.
In 1998, a previously piloted postal questionnaire was sent to a geographically stratified, random sample of 5010 adults in England. The questionnaire focuses on practitioner contacts, but also asked about the purchase of over-the-counter remedies. Additional information was requested on socio-demographic characteristics, perceived health, and recent NHS resource use. Information on use included reason for encounter, expenditure, insurance, and location of visit.
Population estimates (by age group and sex) of lifetime use and use in the past 12 months for acupuncture, chiropractic, homoeopathy, hypnotherapy, medical herbalism, osteopathy. Estimates for two additional therapies (reflexology and aromatherapy), and homoeopathic or herbal remedies purchased over-the-counter. Estimates of annual out-of-pocket expenditure on practitioner visits in 1998.
A crude response rate of 60% was achieved (adjusted response rate 59%). Responders were older and more likely to be female than non-responders. Usable responses (n = 2669) were weighted using the age/sex profile of the sample frame. From these adjusted data we estimate that 10.6% (95% CI 9.4 to 11.7) of the adult population of England had visited at least one therapist providing any one of the six more established therapies in the past 12 months (13.6% for use of any of the eight named therapies, 95% CI 12.3 to 14.9). If all eight therapies, and self-care using remedies purchased over the counter are included, the estimated proportion rises to 28.3% (95% CI 26.6 to 30.0) for use in the past 12 months, and 46.6% (95% CI 44.6 to 48.5) for lifetime use. All types of use declined in older age groups, and were more commonly reported by women than men (P < 0.01 for all comparisons). An estimated 22 million visits were made to practitioners of one of the six established therapies in 1998. The NHS provided an estimated 10% of these contacts. The majority of non-NHS visits were financed through direct out-of-pocket expenditure. Annual out-of-pocket expenditure on any of the six more established therapies was estimated at pound 450 million (95% CI 357 to 543).
This survey has demonstrated substantial use of practitioner-provided complementary therapies in England in 1998. The findings suggest that CAM is making a measurable contribution to first-contact primary care. However, we have shown that 90% of this provision is purchased privately. Further research into the cost-effectiveness of different CAM therapies for particular patient groups is now urgently needed to facilitate equal and appropriate access via the NHS.

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    • "The acceptance and use of complementary alternative medicine (CAM) in general populations has been increasing in both Asian and Western countries [1] [2] [3] [4] [5]. A populationbased survey in the United Kingdom showed that use of one or more CAM therapies during the life course was 46% [3]. A high prevalence of CAM use has also been noted in the United States among patients with breast cancer [5]. "
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    ABSTRACT: Background. This study investigates the prevalence of and factors associated with users of folk therapy in Taiwan. Methods. Using data from the 2005 National Health Interview Survey and the National Health Insurance Research Database, we identified 16,750 adults aged 20 years and older. Sociodemographic factors, lifestyle, medical utilization, and health behaviors were compared between people using and not using folk therapy. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of factors associated with folk therapy were analyzed. Results. The one-month prevalence of folk therapy use was 6.8%, which was significantly associated with ages of 30-59 years (OR = 1.98, 95% CI = 1.49-2.63), women (OR = 1.63, 95% CI = 1.40-1.90), nonindigenous population (OR = 1.90, 95% CI = 1.14-3.17), having two or more unhealthy lifestyle habits (OR = 1.51, 95% CI = 1.26-1.81), high density of traditional Chinese medicine (TCM) physicians (OR = 1.40, 95% CI = 1.20-1.62), and being ill without receiving medical care in past six months (OR = 2.11, 95% CI = 1.76-2.53). Medical care utilization of TCM and Western medicine were also associated factors for folk therapy. Conclusions. The use of folk therapy is correlated with sociodemographics, lifestyle and health behaviors.
    Evidence-based Complementary and Alternative Medicine 07/2015; 2015:1-9. DOI:10.1155/2015/649265 · 1.88 Impact Factor
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    • "In the UK, healthcare is provided by the National Health Service (NHS). Integration within the NHS is unusual although many patients choose to use CAM privately alongside their conventional NHS care [11] [12]. For example, in the primary care setting there are three forms of IM: referral between the primary health care team and local CAM practitioners; CAM practitioners working directly within the same setting as the primary health care team; or a primary health care team member with training in CAM, such as acupuncture [13] [14]. "
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    ABSTRACT: The term, integrative medicine (IM), has evolved over time to describe treatment which uses both CAM (complementary and alternative medicine) and conventional approaches. Drawing from the experience of experts in different geographical areas, including USA, UK, Australia, and China, this review aimed to identify key elements which could be used to define IM and to develop a checklist for reporting IM in clinical trials. Method A total of 54 sources were searched (including websites of governments, key authorities, representative clinical sites, academic journals, relevant textbooks) to identify definitions of IM from the four countries from 1990 - 2014. Key elements characterizing IM were extracted and categorized in a thematic approach in order to identify items to consider when reporting IM in research studies. Results Seventeen definitions were identified and extracted from 17 sources. The remaining thirty seven sources did not provide a definition of IM. The most common key elements which defined IM were: practitioner-patient relationship; using aspects of both CAM and conventional medicine; goals of health and healing; holistic approach; and optimum treatment. Integration was also defined at three levels: theoretical, diagnostic and therapeutic. A potential check list of items is proposed for reporting IM in clinical studies. Conclusion This paper identifies the key elements which define IM and provides a potential reporting guide for developing IM clinical trials which could be used in narrative/systematic reviews. Further debate, discussion and input is now needed from the research and clinical IM communities to further advance this agenda.
    European Journal of Integrative Medicine 01/2015; DOI:10.1016/j.eujim.2014.11.006 · 0.78 Impact Factor
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    • "Therapies to strengthen the motor function and relieve low back pain are the most commonly recommended treatment for lumbar disc herniation (LDH), such as acupuncture and moxibustion [1]. They have the advantage better than other therapies (especially surgery) that they have no physical side-effects or adverse reactions [2, 3]. Moxibustion is a traditional oriental therapy that treats diseases through thermal stimulation of burning herbs, primarily Artemisia vulgaris, at specific acupuncture and moxibustion point on the skin [4]. "
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    ABSTRACT: Systematic reviews of moxibustion for LDH have identified ponderable evidence, especially for heat-sensitive moxibustion (HSM). Therefore, we designed and carried out the large sample trial to evaluate it. 456 patients were recruited from 4 centers in China and were randomly divided into three groups by the ratio of 1 : 1 : 1 to HSM (152) group, conventional moxibustion (152) group, and conventional drug plus acupuncture (152) group. Compared with usual care, there was a statistically significant reduction in mean M-JOA score at 2 weeks and 6 months for HSM (3.8 ± 2.6 versus 8.5 ± 2.9; 3.7 ± 2.2 versus 10.1 ± 2.9) and conventional moxibustion (7.9 ± 3.0 versus 8.5 ± 2.9; 8.9 ± 3.1 versus 10.1 ± 2.9). Compared with conventional moxibustion group, HSM group showed greater improvement in all the outcomes. The mean dose of moxibustion was 41.13 ± 5.26 (range 21-60) minutes in the HSM group. We found that HSM was more effective in treating patients with LDH, compared with conventional moxibustion and conventional drug plus acupuncture. This finding indicated that the application of moxibustion on the heat-sensitive points is a good moxibustion technique in treating disease.
    Evidence-based Complementary and Alternative Medicine 07/2014; 2014:154941. DOI:10.1155/2014/154941 · 1.88 Impact Factor
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