Use of complementary and alternative medicines by ambulatory patients

Background: Complementary and alternative medicines (CAM) include a number of different modalities to improve health. The popularity of such healing methods has increased, although reports of problems and adverse effects have also increased. Difficulties have also been identified in communication between patients and their providers. Previous reports concerning CAM may have undersampled lower socioeconomic groups as a result of the telephone survey techniques used. Methods: All patients with valid appointments for internal medicine resident teaching clinics at 2 publicly supported centers were considered for eligibility. Patients were surveyed about current medications and a variety of CAM modalities. Medical records were reviewed for demographic information and to confirm diagnoses, allergies, medications, and any documented adverse effects. Results: Use of CAM was common by 85.4% of patients, including those using some form of diet, exercise, and prayer. A smaller number (32.3%) were currently using alternate health care providers and products. About 5% of the population used 6 products or more. Use by this primarily poor urban population appeared similar to that in previous reports, with some exceptions. Expensive modalities were less frequently used, whereas use of prayer appears more prevalent. Conclusions: Complementary and alternate medical modalities are as commonly used by poor urban populations as by the general population. Quantification of use depends on the types of CAM used and the time frame asked. Although much of the use does not appear to be maladaptive, a small percentage of individuals have enthusiastically adapted CAM in ways that would not be endorsed by most allopathic physicians.