Alternative Medicine in the U.S.

1. Alternative Medicine in the U.S. James G. Anderson, Ph.D. Purdue University

2. Objective • To document trends in alternative medicine use in the U.S. between 1990 and 1997.

3. Design • Nationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively. • A total of 1539 adults in 1991 and 2055 in 1997. • Prevalence, estimated costs and disclosure of alternative therapies to physicians were measured.

4. Other countries% of population who used alternative medicine during the past 12 months • 10% Denmark • 15% Canada • 33% Finland • 49% Australia

5. Types of Alternative Therapies • Relaxation techniques • Herbal medicine • Massage • Chiropractic • Spiritual healing • Megavitamins • Self-help group • Imagery

6. Types of Alternative Therapies • Commercial diet • Folk remedies • Lifestyle diet • Energy healing • Homeopathy • Hypnosis • Biofeedback • Acupuncture

7. Results • Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997. • The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3%.

8. Results • Therapies increasing the most included: herbal medicine massage megavitamins self-help groups folk remedies energy healing homeopathy

9. ResultsAlternative therapies used most frequently for: • Back problems • Anxiety • Depression • Headaches

10. Disclosure of Alternative Therapies to Physicians • 1990: 38.5% • 1997: 38.5%

11. Percentage of Users paying Entirely Out-of-Pocket for Alternative Therapies • 1990: 64% • 1997: 68.3%

12. Alternative Practitioners 1990: 427 million 1997: 629 million Primary Care Physicians 1990: 387 million 1997: 385 million Total Visits to Alternative Medicine Practitioners in the U.S.

13. Estimated Total Expenditures for Alternative Medicine Services • 1990: $14.6 billion • 1997: $21.2 billion

14. Why Patients use Alternative Medicine • National study of why people in the U.S. use alternative medicine. • Objective – to investigate predictors of alternative health care use.

15. HypothesesPeople seek alternative medicine because: • (1). they are dissatisfied with conventional treatment. • (2). they see alternative medicine as offering more personal autonomy and control over health care decisions. • (3). the alternatives are seen as more compatible with their beliefs, values, and world view.

16. Design • Written survey examining use of alternative health care and attitudes toward conventional medicine. • 1035 individuals were randomly selected who lived throughout the United States.

17. Results Predictors of use of alternative medicine: • More education • Poorer health status • Chronic health problems • Holistic orientation to health • Experience that changed their world view • Membership in cultural groups such as environmentalism, feminism, spiritualism • Believing in the importance of body, mind, and spirit in treating health problems • Perceived efficacy (relief of symptoms)

18. Results Predictors of use by those who primarily use alternative medicine: • Distrust of conventional physicians and hospitals • Desire for control over health decisions • Dissatisfaction with conventional practitioners • Belief in importance ofn one’s inner life