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Gallego G, Gugnani S, Armour M, Smith CA, Chang E. Attitudes and factors involved in decision-making around complementary and alternative medicines (CAMs) by older Australians: A qualitative study. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Aboyade OM, Beauclair R, Mbamalu ON, Puoane TR, Hughes GD. Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:410. [PMID: 27776505 PMCID: PMC5078908 DOI: 10.1186/s12906-016-1378-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 10/06/2016] [Indexed: 12/25/2022]
Abstract
Background Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE). Method A homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250). Descriptive statistics were used to examine the number of NCDs reported by the study sample, health seeking behaviour and practices as well as THM use. Logistic regression was also employed to investigate possible associations between reported conditions and THM use or medical pluralism. Results Within the study sample, 72 % self-reported an NCD. Of those with self-reported NCDs, 46 % had one, and 54 % had two or more NCDs. Those with NCDs usually visited public clinics (80 %), relied on doctors (90 %) and nurses (85 %) for health information, and mostly used conventional medicine (CM) to manage high blood pressure (81 %). About 30 % of those with NCDs indicated using THM, of whom 29 (53 %) reported practicing medical pluralism. Participants with dental problems (OR: 3.24, 95 % CI: 1.30–8.20), headaches (OR: 2.42, 95 % CI: 1.24–4.94), heart burn (OR: 2.30, 95 % CI: 1.18–4.48) and severe tiredness (OR: 2.05, 95 % CI: 1.08–3.99) were more likely to use THM. Anxiety and allergies increased the likelihood to practise medical pluralism by five and 20 times, respectively. Conclusion Self-reported NCD with co-morbidities was prevalent among the participants in the study. Most of the study participants utilized state-owned clinics and hospitals for the management of their chronic conditions. THM use was not very common. However, among those who used THM, medical pluralism was prevalent. Family history was the most common reason for THM use, with many THM patrons utilizing these for treatment of a health condition. Older black women with anxiety and allergies were more likely to practise medical pluralism.
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Fisher C, Sibbritt D, Hickman L, Adams J. A critical review of complementary and alternative medicine use by women with cyclic perimenstrual pain and discomfort: a focus upon prevalence, patterns and applications of use and users' motivations, information seeking and self-perceived efficacy. Acta Obstet Gynecol Scand 2016; 95:861-71. [PMID: 27185060 DOI: 10.1111/aogs.12921] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 05/09/2016] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Complementary and alternative medicine (CAM) is used for treating cyclic perimenstrual pain and discomfort. This critical review examines women's reported CAM use, its perceived effectiveness and information relating to women's attitudes, behaviors, motivations and patterns of CAM use in its treatment. MATERIAL AND METHODS An extensive search of the main medical databases EBSCO, CINAHL, Medline, AMED and SCOPUS, as well as additional hand searches, was conducted. Papers included were confined to those that had been peer-reviewed, written in English and that contained original research into CAM use for cyclic perimenstrual pain and discomfort among adult women. RESULTS CAM, particularly herbal medicine, nutritional supplements and massage, is widely used for a range of cyclic perimenstrual pain and discomfort symptoms. A large number of CAM modalities are adopted, often simultaneously and with little professional oversight. Women's assessment of efficacy of different CAM modalities is positive, though the majority of users are self-prescribing apparently without professional guidance. Although the uptake of CAM for cyclic perimenstrual pain and discomfort is widespread, few empirical data are available regarding which women are using CAM, their motivations for doing so and, importantly, the sources through which women receive information about CAM. CONCLUSIONS This review highlights the extensive use of (often self-prescribed) CAM in a number of countries to alleviate the widespread symptoms of cyclic perimenstrual pain and discomfort. An understanding of all health care use by women with perimenstrual pain and discomfort is vital to help ensure safe, effective and coordinated health care that can lead to optimal patient outcomes.
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Affiliation(s)
- Carole Fisher
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - David Sibbritt
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Louise Hickman
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jon Adams
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Rayner JA, Bauer M. “I Wouldn’t Mind Trying It. I’m in Pain the Whole Time”: Barriers to the Use of Complementary Medicines by Older Australians in Residential Aged-Care Facilities. J Appl Gerontol 2016; 36:1070-1090. [DOI: 10.1177/0733464816629852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Older people living in the community use complementary medicine (CM) to manage the symptoms of chronic illness; however, little is known about CM use by older people living in care settings. Using focus groups and individual interviews, this study explored the use of CM from the perspective of 71 residents, families, and health professionals from six residential aged-care facilities in Victoria, Australia. Residents used CM to manage pain and improve mobility, often covertly, and only with the financial assistance of their families. Facility policies and funding restrictions constrained CM use at the individual and facility level. An absence of evidence to support safety and efficacy coupled with the risk of interactions made doctors wary of CM use in older people. These findings have relevance for the large number of CM using “baby-boomers” as they move into residential aged-care.
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Lo TKT, Parkinson L, Cunich M, Byles J. Factors associated with the health care cost in older Australian women with arthritis: an application of the Andersen's Behavioural Model of Health Services Use. Public Health 2016; 134:64-71. [PMID: 26791096 DOI: 10.1016/j.puhe.2015.11.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/27/2015] [Accepted: 11/27/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Factors associated with the utilisation of health care have not been rigorously examined in people with arthritis. The objective of this study was to examine the determinants of health care utilisation and costs in older women with arthritis using the Andersen's behavioural model as a framework. STUDY DESIGN Longitudinal cohort study. METHODS Participants of Surveys 3 to 5 of the Australian Longitudinal Study on Women's Health who reported arthritis were included in the study. Information about health care utilisation and unit prices were based on linked Medicare Australia data, which included prescription medicines and health services. Total health care costs of participants with arthritis were measured for the years 2002 to 2003, 2005 to 2006, and 2008 to 2009, which corresponded to the survey years. Potential explanatory variables of the health care cost and other characteristics of the participants were collected from the health surveys. Explanatory variables were grouped into predisposing characteristics, enabling factors and need variables conforming to the Andersen's Behavioural Model of Health Services Use. Longitudinal data analysis was conducted using generalized estimating equations. RESULTS A total of 5834 observations were included for the three periods. Regression analysis results show that higher health care cost in older Australian women with arthritis was significantly associated with residing in an urban area, having supplementary health insurance coverage, more comorbid conditions, using complementary and alternative medicine, and worse physical functioning. It was also found that predisposing characteristics (such as the area of residence) and enabling factors (such as health insurance coverage) accounted for more variance in the health care cost than need variables (such as comorbid conditions). CONCLUSION These results may indicate an inefficient and unfair allocation of subsidised health care among older Australian women with arthritis, where individuals with less enabling resources and more socio-economic disadvantages have a lower level of health care utilisation. Future research may focus on evaluating the effectiveness of policies designed to reduce excessive out-of-pocket costs and to improve equity in health care access in the older population.
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Affiliation(s)
- T K T Lo
- Research Centre for Gender, Health and Ageing, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - L Parkinson
- Central Queensland University, School of Human Health and Social Sciences, Rockhampton, QLD 4701, Australia
| | - M Cunich
- Faculty of Pharmacy, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia; School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - J Byles
- Research Centre for Gender, Health and Ageing, The University of Newcastle, Callaghan, NSW 2308, Australia
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Lin V, Canaway R, Carter B, Manderson L. Room for improvement: complementary therapy users and the Australian health system. Health Expect 2015; 18:1451-62. [PMID: 23992199 PMCID: PMC5060902 DOI: 10.1111/hex.12125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2013] [Indexed: 11/30/2022] Open
Abstract
CONTEXT People with chronic conditions who are often in contact with the health-care system are well placed to reflect on how services meet their needs. Some research characterizes people who use complementary and alternative medicines (CAMs) as a distinct group who opt out of the mainstream health system. However, many CAM users are people with chronic or terminal health conditions who concurrently use mainstream health-care services. The difference in perspectives between people with chronic conditions who do or do not use CAM has received little attention by researchers. OBJECTIVE To explore the views of CAM users with chronic conditions and identify their perspectives on the health system. DESIGN AND SETTING In-depth interviews and a self-administered questionnaire were used to collect data on care-seeking, self-management and CAM use among people with type 2 diabetes and/or cardiovascular disease living in Victoria, Australia. RESULTS One in four CAM practitioner users was partly motivated to use CAM as a result of their dissatisfaction with the mainstream health system. In general, their dissatisfaction mirrored the concerns of the general population. This included the perceived lack of a humanistic or person-centred approach, which was central to problems relating to individuals' clinical encounters as well as to health system design. DISCUSSION AND CONCLUSION Participants' concerns suggest room for improvement in the Australian health system to better reflect patients' needs. A systems approach is needed to reorient health-care practitioners to modify the organization of care because of the incentives embedded in the structure of the health-care system.
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Affiliation(s)
- Vivian Lin
- CAMELOT ProjectSchool of Public HealthLa Trobe UniversityBundooraVic.Australia
| | - Rachel Canaway
- CAMELOT ProjectSchool of Psychology and PsychiatryMonash UniversityCaulfieldVic.Australia
| | - Bronwyn Carter
- CAMELOT ProjectSchool of Public HealthLa Trobe UniversityBundooraVic.Australia
| | - Lenore Manderson
- CAMELOT ProjectSchool of Psychology and PsychiatryMonash UniversityCaulfieldVic.Australia
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Murthy V, Sibbritt D, Broom A, Kirby E, Frawley J, Refshauge KM, Adams J. Back pain sufferers' attitudes toward consultations with CAM practitioners and self- prescribed CAM products: A study of a nationally representative sample of 1310 Australian women aged 60-65 years. Complement Ther Med 2015; 23:782-8. [PMID: 26645516 DOI: 10.1016/j.ctim.2015.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 07/22/2015] [Accepted: 09/07/2015] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To analyze back pain sufferers' attitudes toward consultations with complementary and alternative medicine (CAM) practitioners and self-prescribed CAM products. METHODS A cross-sectional survey of a nationally representative sample of Australian women aged 60-65 years. RESULTS A significant number of women with back pain consulted a massage therapist (41.4%, n=578), a chiropractor (37.3%, n=488), an acupuncturist (13.3%, n=174), used self-prescribed supplements (59.2%, n=776), vitamins/minerals (45.2%, n=592) and/or herbal medicines (13.1%, n=172). Women who perceived CAM as providing greater control over their body/health were more likely to have consulted a chiropractor (OR=4.21; 95% CI; 2.16, 8.19) and/or self- prescribed supplements (OR=2.38; 95% CI: 1.05, 3.49) than those who did not perceive CAM as providing greater control over their body/health. Women who perceived CAM as natural (OR=1.56; 95% CI: 1.02, 2.37) or promoting a holistic approach to health (OR=2.73; 95% CI: 1.60, 4.64) were more likely to have self-prescribed vitamins/minerals than those who did not perceive CAM as natural and promoting a holistic approach to health. Women who expressed that knowledge about evidence of CAM as important to them were more likely to have self-prescribed herbal medicines (OR=7.15; 95% CI: 1.72, 29.64) than those who did not express an interest in knowledge about evidence of CAM. CONCLUSION Certain key attitudes toward CAM influence back pain sufferers' choice of CAM use, highlighting the need for back pain care providers to ensure appropriate enquiry and discussion with their patients regarding consulting CAM practitioners and/or self-prescribing CAM products for back pain.
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Affiliation(s)
- Vijayendra Murthy
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia
| | - Alex Broom
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia
| | - Emma Kirby
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia
| | - Kathryn M Refshauge
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, UTS, Level 7, Building 10, 235-253 Jones Street, Ultimo, NSW 2006, Australia.
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Gyasi RM, Asante F, Segbefia AY, Abass K, Mensah CM, Siaw LP, Eshun G, Adjei POW. Does spatial location matter? Traditional therapy utilisation among the general population in a Ghanaian rural and urban setting. Complement Ther Med 2015; 23:439-50. [DOI: 10.1016/j.ctim.2015.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/15/2015] [Accepted: 04/04/2015] [Indexed: 10/23/2022] Open
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Lo TKT, Parkinson L, Cunich M, Byles J. Factors associated with higher healthcare costs in individuals living with arthritis: evidence from the quantile regression approach. Expert Rev Pharmacoecon Outcomes Res 2015; 15:833-41. [PMID: 25896664 DOI: 10.1586/14737167.2015.1037833] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To examine the factors associated with higher healthcare cost in women with arthritis, using generalized linear models (GLMs) and quantile regression (QR). METHODS This is a cross-sectional healthcare cost study of individuals with arthritis that focused on older Australian women. Cost data were drawn from the Medicare Australia datasets. RESULTS GLM results show that healthcare cost was significantly associated with various socio-demographic and health factors. Although QR analysis results show the same direction of association between these factors and healthcare cost as in the GLMs, they indicate progressively increased effect sizes at the 50th, 75th, 90th and 95th percentiles. CONCLUSION Findings suggest traditional regression models such as GLMs that assume a single rate of change to accurately describe the relationships between explanatory variables and healthcare costs across the entire distribution of cost can produce biased results. QR should be considered in future healthcare cost research.
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Affiliation(s)
- T K T Lo
- a 1 Research Centre for Gender, Health & Ageing, The University of Newcastle, HMRI Building, C/- University Drive, Callaghan, NSW 2308, Australia
| | - Lynne Parkinson
- b 2 Human Health and Social Sciences/Higher Education Division, Central Queensland University, Bruce Highway, Rockhampton Qld 4702, Australia
| | - Michelle Cunich
- c 3 The University of Sydney, Charles Perkins Centre, Research and Education Hub, The University of Sydney, NSW 2006, Australia
| | - Julie Byles
- a 1 Research Centre for Gender, Health & Ageing, The University of Newcastle, HMRI Building, C/- University Drive, Callaghan, NSW 2308, Australia
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Hsu YC, Chiu CJ, Wray LA, Beverly EA, Tseng SP. Impact of traditional Chinese medicine on age trajectories of health: evidence from the Taiwan Longitudinal Study on Aging. J Am Geriatr Soc 2015; 63:351-7. [PMID: 25688607 DOI: 10.1111/jgs.13247] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Although traditional Chinese medicine (TCM) is widely used, its effect on health outcomes is not well understood. This study employed a cohort sequential design to investigate levels and rates of change in health from midlife to older adulthood in TCM users and nonusers. A sample of 1,302 community-dwelling adults aged 53 to 80 was selected from individuals interviewed in the 1999 Taiwan Longitudinal Study on Aging (TLSA) and reinterviewed in 2003 and 2007. TCM users were identified as participants who reported visiting a Chinese medicine clinic in the year before each of the three interviews. Health outcomes included physical function, self-rated health, cognitive function, and depressive symptoms. Approximately one in five adults reported that they used TCM in at least one wave of the 3 interview years, but less than one in twenty across all waves. Controlling for time-varying sociodemographic and health conditions, levels and rates of change in physical and cognitive function did not differ according to TCM use. Although adults who reported using TCM had higher depressive symptoms (βTCM = 0.979, 95% confidence interval (CI) = 0.200-1.758) and poorer self-rated health (βTCM = -0.267, 95% CI = -0.267 to -0.081) at baseline, their rates of change in these outcomes did not differ from those who did not use TCM. Subgroup analyses revealed that TCM use benefited adults with higher depressive symptoms by attenuating worsening depressive symptoms (βTCM ×Age = -0.221, 95% CI = -0.434 to -0.007). Further research aimed at understanding the specific mechanisms by which TCM affects health outcomes is warranted.
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Affiliation(s)
- Yu-Ching Hsu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Chinese Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
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Kirby ER, Broom AF, Adams J, Sibbritt DW, Refshauge KM. A qualitative study of influences on older women's practitioner choices for back pain care. BMC Health Serv Res 2014; 14:131. [PMID: 24655816 PMCID: PMC3998023 DOI: 10.1186/1472-6963-14-131] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Back pain is an increasingly prevalent health concern amongst Australian women for which a wide range of treatment options are available, offered by biomedical, allied health and complementary and alternative medicine (CAM) providers. Although there is an emerging literature on patterns of provider utilisation, less is known about the reasons why women with back pain select their chosen practitioner. In this paper we explore the influences on back pain sufferers' decision-making about treatment seeking with practitioners for their most recent episode of back pain. METHODS Drawing on 50 semi-structured interviews with women aged 60-65 years from the Australian Longitudinal Study on Women's Health (ALSWH) who have chronic back pain, we focus on the factors which influence their choice of practitioner. Analysis followed a framework approach to qualitative content analysis, augmented by NVivo 9 qualitative data analysis software. Key themes were identified and tested for rigour through inter-rater reliability and constant comparison. RESULTS The women identified four predominant influences on their choice of practitioner for back pain: familiarity with treatment or experiences with individual practitioners; recommendations from social networks; geographical proximity of practitioners; and, qualifications and credentials of practitioners. The therapeutic approach or evidence-base of the practices being utilised was not reported by the women as central to their back pain treatment decision making. CONCLUSIONS Choice of practitioner appears to be unrelated to the therapeutic approaches, treatment practices or the scientific basis of therapeutic practices. Moreover, anecdotal lay reports of effectiveness and the 'treatment experience' may be more influential than formal qualifications in guiding women's choice of practitioner for their back pain. Further work is needed on the interpersonal, collective and subjective underpinnings of practitioner choice, particularly over time, in order to better understand why women utilise certain practitioners for back pain.
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Affiliation(s)
- Emma R Kirby
- School of Social Science, University of Queensland, St Lucia, QLD 4072, Australia
| | - Alex F Broom
- School of Social Science, University of Queensland, St Lucia, QLD 4072, Australia
| | - Jon Adams
- School of Social Science, University of Queensland, St Lucia, QLD 4072, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - David W Sibbritt
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
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Prevalence, Purposes, and Perceived Effectiveness of Complementary and Alternative Medicine Use in a Hypertension Population: A Questionnaire Survey. ACTA ACUST UNITED AC 2013. [DOI: 10.1155/2013/137472] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Complementary and alternative medicine (CAM) is widely used among patients with hypertension. This study aimed to determine the use of CAM in community-dwelling individuals with hypertension. A cross-sectional questionnaire survey was administered to 318 hypertension patients to examine prevalence and patterns of CAM use; the use of CAM, specifically for treatment of hypertension or other conditions, and perceived effectiveness of CAM were examined. CAM use in the last 12 months was reported by 236 (74.2%) participants. Only 13.1% of these CAM users reported using CAM to treat hypertension. CAM users did not differ statistically from non-CAM users by age, marital status, health status, duration of hypertension, income, or education. Females showed a significantly higher prevalence of CAM use than that of males (OR 1.82, 95% CI 1.09, 3.11). Family/relatives, doctors, and patients themselves were the three main sources of information about CAM. More than 70% of responses were able to perceive the effectiveness of alternative medical systems, mind-body medicine, and manipulative/body-based therapies. There was a high prevalence of CAM use among hypertension patients, although the majority of CAM use was not specifically for hypertension. Further research is needed to assess the safety and efficacy of diverse CAM.
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Complementary and Alternative Medicine Consultations in Urban and Nonurban Areas: A National Survey of 1427 Australian Women. J Manipulative Physiol Ther 2013; 36:12-9. [DOI: 10.1016/j.jmpt.2012.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 11/01/2012] [Accepted: 11/02/2012] [Indexed: 10/27/2022]
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Bauer M, Rayner JA. Use of complementary and alternative medicine in residential aged care. J Altern Complement Med 2012; 18:989-93. [PMID: 22909299 DOI: 10.1089/acm.2011.0582] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES There is increasing evidence of the use of complementary and alternative medicine (CAM) by older people living in the community; however, little is known about the use of CAM in residential aged-care facilities (RACF). This review examined the literature on the use of CAM in RACF, focusing on prevalence, motivations, and support for use. METHODS A search of multiple databases between 2000 and 2010 was conducted. Articles were analyzed under five key themes: prevalence of CAM use, CAM user profile, motivations for use, expectations for and satisfaction with CAM use, and institutional and/or staff support for CAM use. RESULTS Only five articles were found that met the inclusion criteria. The review highlights the absence of evidence regarding the use of CAM by older people in RACF. CONCLUSIONS To inform policy and improve clinical practice in line with the aging of the population, nationally representative, population-based studies are required.
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Affiliation(s)
- Michael Bauer
- Australian Institute for Primary Care and Ageing, La Trobe University, Bundoora, Victoria, Australia.
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Spinks J, Hollingsworth B. Policy implications of complementary and alternative medicine use in Australia: data from the National Health Survey. J Altern Complement Med 2012; 18:371-8. [PMID: 22515796 DOI: 10.1089/acm.2010.0817] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES The objective of this study was to investigate the drivers of complementary and alternative medicine (CAM) use in the general population in Australia and to identify key policy implications. DATA AND METHODS The National Health Survey 2007/2008, a representative survey of the Australian population, provides information on CAM use (practitioners and products) in the last 12 months. All adult respondents (N=15,779) aged 18 years or older are included in this study. Logistic regression is employed to determine the effect of socio-economic, condition-specific, health behavior variables, and private health insurance status on CAM use. RESULTS In addition to socio-economic variables known to affect CAM use, individuals who have a chronic condition, particularly a mental health condition, are more likely to use CAM. There does not appear to be a correlation between CAM use and more frequent General Practitioner use; however, ancillary private health insurance is correlated with a greater likelihood of CAM use, as expected. CONCLUSIONS The Australian government does not currently intervene in the CAM market in a systematic way. CAM is clearly considered to be a legitimate and important component of health care for many Australians, despite the limited availability of clinical evidence for its efficacy and safety. Policy interventions may include the regulation of CAM products, practitioners, and information as well as providing subsidies for cost-effective modalities.
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Affiliation(s)
- Jean Spinks
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia.
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Lorenc A, Clow A, Forte D, Robinson N. “It keeps me going” – older people's perception of well‐being and use of complementary and alternative medicine (CAM). QUALITY IN AGEING AND OLDER ADULTS 2012. [DOI: 10.1108/14717791211231210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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McLaughlin D, Lui CW, Adams J. Complementary and alternative medicine use among older Australian women--a qualitative analysis. Altern Ther Health Med 2012; 12:34. [PMID: 22471758 PMCID: PMC3342907 DOI: 10.1186/1472-6882-12-34] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 04/04/2012] [Indexed: 12/05/2022]
Abstract
Background The use of complementary and alternative medicines (CAM) among older adults is an emerging health issue, however little is known about older people's experiences of using CAM and the cultural, geographical and other determinants of CAM use in this population. This study used qualitative methods to explore older women's views of CAM and reasons for their use of CAM. Participants for the project were drawn from the Australian Longitudinal Study on Women's Health (ALSWH) 1921-1926 birth cohort. Women who responded positively to a question about CAM use in Survey 5 (2008) of the ALSWH were invited to participate in the study. A total of 13 rural and 12 urban women aged between 83 and 88 years agreed to be interviewed. Results The women expressed a range of views on CAM which fell into three broad themes: "push" factors such as dissatisfaction with conventional health services, "pull" factors which emphasised the positive aspects of choice and self-care in health matters, and barriers to CAM use. Overall, the "push' factors did not play a major role in the decision to use CAM, rather this was driven by "pull" factors related to health care self-responsibility and being able to source positive information about types of CAM. A number of barriers were identified such as access difficulties associated with increased age, limited mobility and restricted transport options, as well as financial constraints. Conclusions CAM use among older women was unlikely to be influenced by aspects of conventional health care ("push factors"), but rather was reflective of the personal beliefs of the women and members of their close social networks ("pull factors"). While it was also apparent that there were differences between the rural and urban women in their use of CAM, the reasons for this were mainly due to the difficulties inherent in accessing certain types of CAM in rural areas.
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Pit SW, Byles J. The association of health and employment in mature women: a longitudinal study. J Womens Health (Larchmt) 2011; 21:273-80. [PMID: 22060315 DOI: 10.1089/jwh.2011.2872] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite a reduction in income inequalities between men and women, there is still a large gap between income and retirement savings of Australian men and women. This is especially true for women who have health or disability problems. Mature age women are closest to retirement and, therefore, have less chance than younger women to build up enough retirement savings and may need to continue working to fund their older age. Continued workforce participation may be particularly difficult for women who are less healthy. Understanding which health problems lead to a decrease in workforce participation among mature age women is crucial. Therefore, this longitudinal study sought to identify which health problems are associated with employment among midage women over time. METHODS Data were analyzed from the midage cohort of the Australian Longitudinal Study on Women's Health (ALSWH), which involved 14,200 midage women (aged 45-50 years in 1996). The women have been surveyed four additional times, in 1998, 2001, 2004, and 2007. Generalized estimating equations (GEE) were used to conduct nested multivariate longitudinal analyses. RESULTS The percentages of women who were employed in the years 2001, 2004, and 2007 were 77%, 72%, and 68%, respectively. Results were adjusted for sociodemographic variables. Being employed decreased as physical and mental health deteriorated and with self-reported conditions: diabetes, high blood pressure, depression, anxiety, and other psychiatric conditions. Back pain, arthritis, cancer, obesity, and being a current smoker are associated with employment but not when quality of life is added to the model. CONCLUSIONS There were significant associations between health and employment. Understanding these relationships could inform policies and guidelines for preventing declines in employment in mature age women.
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Affiliation(s)
- Sabrina W Pit
- University Centre for Rural Health, Northern Rivers School of Public Health, University of Sydney, Lismore, Australia.
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Adams J, Sibbritt D, Broom A, Loxton D, Pirotta M, Humphreys J, Lui CW. A comparison of complementary and alternative medicine users and use across geographical areas: a national survey of 1,427 women. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 11:85. [PMID: 21981986 PMCID: PMC3198987 DOI: 10.1186/1472-6882-11-85] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 10/07/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors. METHODS A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009. RESULTS The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas. CONCLUSION It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.
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Affiliation(s)
- Jon Adams
- Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
| | - David Sibbritt
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
| | - Alex Broom
- School of Social Science, University of Queensland, Brisbane, Queensland, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
| | - Deborah Loxton
- Priority Research Centre for Gender, Health and Ageing, University of Newcastle, New South Wales, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Victoria, Australia
| | - John Humphreys
- School of Rural Health, Monash University, Bendigo, Victoria, Australia
| | - Chi-Wai Lui
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
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McLaughlin D, Adams J, Sibbritt D, Lui CW. Sex differences in the use of complementary and alternative medicine in older men and women. Australas J Ageing 2011; 31:78-82. [DOI: 10.1111/j.1741-6612.2011.00554.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sibbritt D, Adams J. Developing and promoting public health methods for integrative medicine: examples from the field in Australia. ACTA ACUST UNITED AC 2011; 9:233-6. [PMID: 21419073 DOI: 10.3736/jcim20110301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Integrative medicine (IM) research in China has largely focused on clinical and experimental research, which is critical to determining the efficacy of treatments and enhancing the standing of IM. Nevertheless, there is also a need to extend research activities to include methods and research perspectives from public health, which will provide a greater understanding of clinical practice and assist government and professional organizations to shape policies and directives in IM. In this article we outline the public health research methods we have used in relation to our program of research on complementary and alternative medicine use and area of residence/geography, to highlight the usefulness of these methods in IM.
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Affiliation(s)
- David Sibbritt
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia.
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Team V, Canaway R, Manderson L. Integration of complementary and alternative medicine information and advice in chronic disease management guidelines. Aust J Prim Health 2011; 17:142-9. [DOI: 10.1071/py10013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 12/09/2010] [Indexed: 11/23/2022]
Abstract
The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) – particularly for chronic or recurrent conditions – means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions – cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) – to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor–client discussion about CAM.
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Abstract
SummaryThe increasing prevalence of complementary and alternative medicine (CAM) use is a significant health care issue in contemporary societies and researchers have identified CAM as holding potential for treating and coping with chronic illness and other conditions experienced in later life. This paper focuses upon contemporary research literature to provide a critical review of the prevalence, correlates, conditions, perceptions and communication of CAM use in later life. Evidence from recent research illustrates the substantial prevalence and complexity of CAM use amongst older people and such ‘community’ use requires all providers, regardless of their experience or perception of the worth of CAM, to at least acknowledge and enquire with their older patients about the potential use of these other medicines.
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