This study was performed to assess the relationship among factors such as socioeconomic status, age, sex, education and medical condition, and the use of complementary and alternative medicine (also known as CAM). The study involved around 5,750 patients with chronic pain; the alternative medical therapies that were used were acupuncture, relaxation/biofeedback therapy and manipulation therapy, such as chiropractic work. It was found that at least 35 percent of the patients used alternative therapies. Educational status, severity of pain and duration of pain played a part in the choice of CAM.
Complementary and alternative medicine (CAM) consists of medical therapeutics other than traditional medication. There is an increasing demand for CAM today. Selection of CAM has been related to health of patients and factors such as the philosophy and ideology on which the conventional medicine is based. It has also been noted that most studies related to CAM do not assess the physical, psychosocial and medical reasons for patients seeking these therapies. Various factors such as age, race, gender, education, marital status and ability to tolerate pain determine initiation of CAM therapeutics. This study was done to ascertain the above factors and their relationship with the initiation of CAM.
* The study was performed by assessing the database of 5,750 Caucasian and African-American adult patients who had had chronic pain and were admitted to a pain center between 1994 and 2000.
* From the database, each patient had to choose the best type of CAM that he had experienced.
* Factors such as age, martial status, disability, mental status, income and the characteristics of the pain that the participants experienced were also analyzed.
* About 8.3 percent of the patients had used acupuncture, 13.0 percent had used relaxation training, and 24.9 percent of them had used manipulation therapy prior admission at the pain center.
* The use of CAM increased with higher educational status and improper pain care in conventional medicine. African-Americans used comparatively less manipulation and biofeedback/relaxation services than Caucasians.
* CAM users were found to have poorer physical and mental health when compared with those who didn’t use CAM.
In this study, the databases were mostly collected for clinical use and not for the actual study. There were limitations on the choice of CAM modalities. The difference in the knowledge of various CAM terminologies among the patients could have been misleading. Personal beliefs such as spirituality could have altered the study and led to a bias. Thus, the authors suggest that further studies be done with regard to CAM.
CAM therapies are gaining popularity as an option for the treatment of chronic pain. This study has reported a high CAM service utilization over a span of six years. Most people using CAM were younger, educated and dissatisfied with prior treatment modalities for pain. The decision to opt for CAM was highly dependent on the educational status of people and insurance coverage. African-Americans were found to use CAM less. This study has identified the need for insurance coverage on a few CAM services for those living with chronic pain. As these patients have a substantial loss of income, it is necessary that out-of-pocket expenses be kept minimal. Future CAM studies need to be done, looking for markers to delayed access to pain care.
For More Information:
Predictors of Complementary and Alternative Medicine Use in Chronic Pain Patients
Publication Journal: The Journal of Pain Medicine, 2010
By S Khady Ndao-Brumblay; Carmen R Green, MD; University of Michigan, Ann Arbor
*FYI Living Lab Reports Are Summaries of the Original Research.