Complementary and Alternative Medicine Services in the Military Health System

Objectives: Surveys of military personnel indicate substantial use of complementary and alternative medicine (CAM) that possibly exceeds use in the general U.S. population. Although military treatment facilities (MTFs) are known to offer CAM, surveys do not indicate where service members receive this care. This study offers a comprehensive system-wide accounting of the types of CAM offered across the military health system (MHS), the conditions for which it is used, and its level of use. These data will help MHS policymakers better support their population's healthcare needs. Design: A census survey of MTFs across the MHS on all CAM use, supplemented where possible by MHS utilization data. Outcome measures: Types of CAM offered by each MTF, reasons given for offering CAM, health conditions for which CAM is used, and number of patient visits for each CAM type. Results: Of the 142 MTFs in the MHS, 133 (94%) responded. Of these, 110 (83%) offer at least one type of CAM and 5 more plan to offer CAM services in the future. Larger MTFs (those reporting 25,000 beneficiaries enrolled) are both more likely to offer CAM services (p<0.001) and a larger number (>10) of different types of CAM (p=0.010) than smaller MTFs. Three-fourths of MTFs offering CAM provide stress management/relaxation therapy, two-thirds provide acupuncture, and at least half provide progressive muscle relaxation, guided imagery, chiropractic, and mindfulness meditation. MTFs most commonly report CAM use for pain and mental health conditions. Acupuncture and chiropractic are most commonly used for pain, and stress management/relaxation therapy and mind-body medicine combinations are most often used for mental health-related conditions. We estimate 76,000 CAM patient encounters per month across the MHS. Conclusions: The availability of CAM services in the MHS is widespread and is being used to address a range of challenging pain and mental health conditions.