23 Mar Many Patients Do Not Tell Their Primary Care Physician About Alternative Medicine Use
MedicalResearch.com Interview with:
Judy Jou, MA PhD Candidate
PhD Candidate in Health Services Research, Policy, & Administration
Division of Health Policy and Management
University of Minnesota, Twin Cities
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Use of complementary and alternative medicine (CAM) is rising among U.S. adults, but CAM is often poorly integrated into patients’ treatment and self-care routines. We analyzed nearly 7,500 responses from the 2012 National Health Interview Survey (NHIS) and found that over two-fifths of U.S. adults who used CAM during the past year did not disclose their complementary and alternative medicine use to their primary health care providers, with rates of disclosure varying by the type of CAM used. We also examined reasons for non-disclosure and found that, in contrast to prior studies, lack of provider-initiated conversation about complementary and alternative medicine was the most commonly cited reason, rather than patients’ concerns about negative reactions from their providers regarding their complementary and alternative medicine use.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Failure to disclose complementary and alternative medicine use to primary care providers can potentially lead to medical complications, especially if the type of CAM being used interacts adversely with any conventional treatments that patients may be receiving concurrently. Examples of this might include use of herbs and supplements that interfere with prescription drugs or movement-based CAM therapies that counteract prescribed physical therapy treatments. Encouraging more candid discussion of CAM use in the clinical setting can help prevent these types of situations from arising, as well as improving communication and trust between patients and providers. Physicians may consider integrating questions about CAM into standard clinical practice guidelines, while patients might benefit from education and outreach efforts that lead them to feel more comfortable discussing complementary and alternative medicine with their providers. Changes in health care financing and organization—for instance, providing health insurance coverage for more types of CAM or including CAM practitioners into accountable care organizations (ACOs) and other types of provider networks—can also help improve coordination between CAM and conventional medicine.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We recommend further research exploring the role of patient-provider communication in health care quality and safety. To better understand how communication about CAM use might contribute to patients’ health and treatment outcomes, we hope to look at whether these outcomes differ significantly between patients who do and do not discuss CAM with their primary care providers, and whether these patterns hold for individuals using CAM for general health and wellbeing versus treating a specific condition. We are also interested in exploring systematic factors contributing to non-disclosure, e.g., socio-demographic characteristics of both patients and providers, which may help facilitate the design of targeted initiatives aimed at promoting discussion of CAM use and improving patient-provider communication overall.
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Dr. Judy Jou (2016). Many Patients Do Not Tell Their Primary Care Physician About Alternative Medicine Use MedicalResearch.com