Older Americans Not Discussing Complementary and Alternative

In spite of the high use of complementary and alternative medicine (CAM) among people age 50 or older, 69 percent of those who use CAM do not talk to their doctors about it, according to a new survey conducted by AARP and the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health. The survey examined conversations between patients and their physicians regarding complementary and alternative medicine use.

Complementary and alternative medicine is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. It includes such products and practices as herbal supplements, meditation, homeopathy, and acupuncture.

"We know that people 50 and older tend to be high users of complementary and alternative medicine, but this study was the first to explore gaps in communications regarding the use of CAM between patients and their physicians," said Cheryl Matheis, AARP Director of Health Strategies. "Communication is important to ensure the wise use of all conventional and CAM therapies."

Differences in communication practices across demographic groups were also found. Women were more likely than men to have discussed complementary and alternative medicine use (26 percent versus 16 percent) and what types of therapies to use (70 percent versus 51 percent). In addition, people with incomes of $75,000 or more (31 percent) or $25,000 to $49,999 (25 percent) frequently discussed CAM use with doctors.

"An open dialogue between consumers and their physicians is critical to ensuring safe and appropriate integrated care," said Margaret A. Chesney, Ph.D., NCCAM's Deputy Director. "As the Federal Government's lead agency for scientific research on CAM, NCCAM is especially committed to educating both consumers and health care providers about the importance of discussing the use of CAM and providing evidence-based information to help with health care decision-making."

Tips for Discussing Complementary and Alternative Medicine with Your Doctor:

• If you are considering a CAM therapy, ask your physician about its safety, effectiveness, and possible interactions with medications (prescription and non-prescription).

• Tell your doctor about all therapies or treatments including over-the-counter and prescription medicines as well as herbal and dietary supplements.

• When completing patient history forms, be sure to include all therapies and treatments you use. Make a list in advance.

This telephone survey, administered to a nationally representative group of 1,559 people age 50 or older, revealed some reasons why doctor-patient dialogue is lacking. Respondents most often did not discuss their complementary and alternative medicine use with doctors because the physicians never asked (42 percent); they did not know that they should (30 percent); or there was not enough time during the office visit (19 percent). Interestingly, men who had seen a doctor were more likely than women not to have discussed CAM because their doctors never asked (46 percent versus 38 percent).

Dialogue Topics

• The topics most often discussed with doctors were the effectiveness of a CAM therapy (67 percent); what to use (64 percent); how a complementary and alternative medicine therapy might interact with other medications or treatments received (60 percent); advice on whether to pursue a CAM therapy (60 percent); and safety of a CAM therapy (57 percent).

Prescription and Over-the-Counter Medication Use

• Nearly three-fourths of respondents said they take one or more prescription medications; in addition, 59 percent of respondents said they take one or more over-the-counter medications. Twenty percent of respondents reported taking more than five prescription medications.

• The high number of prescription and over-the-counter medications used by this group underscores the need for consumers and physicians to discuss all therapies, including CAM, to ensure safe, integrated care.