Patterns of user disclosure of complementary and alternative medicine (CAM) use.

OBJECTIVE: To investigate patterns of complementary and alternative medicine (CAM) use disclosure across medical and sociobehavioral factors and to provide a model that takes into account factors in explaining those patterns. SUBJECTS: A total of 21,849 CAM use episodes from 7347 respondents in the 2007 US National Health Interview Survey which involves the latest survey on CAM use. RESEARCH DESIGN: Respondents were a representative sample of US national population. Logistic hierarchical linear models specify how characteristics of users and their CAM use episodes influence user disclosure behaviors. RESULTS: At the individual level, users were more likely to disclose CAM use to health care professionals when they had health problems and when they were insured. At the episode level, CAM use episodes were more likely to be disclosed when they were intended to treat a specific medical condition and recommended by a health professional. Disclosure rates were high among most susceptible users (ie, sick people intending to treat specific conditions with CAM) and among the biologically based CAM modalities (eg, herbal supplements) that are most likely to produce adverse interactions with conventional biomedical treatments. CONCLUSIONS: User disclosure was affected not only by users' demographic and socioeconomic characteristics but also by episode-specific factors. Efforts to improve provider-user communication of CAM use should consider the varying effects of these factors.

Duke Scholars

Author Farr A Curlin Medicine, General Internal Medicine