Who uses complementary and alternative therapies in regional South Australia? Evidence from the Whyalla Intergenerational Study of Health
Katina D’Onise A C , Matthew T. Haren A , Gary M.H. Misan B and Robyn A. McDermott AA City East Campus, Sansom Institute, University of South Australia, GPO Box 2471, Adelaide, SA 5000, Australia.
B Centre for Rural Health and Community Development, Centre for Regional Engagement, University of South Australia, 111 Nicholson Ave, Whyalla Norrie, SA 5608, Australia.
C Spencer Gulf Rural Health School, University of Adelaide, 111 Nicholson Ave, Whyalla Norrie, SA 5608, Australia.
D Corresponding author. Email: katina.d’onise@unisa.edu.au
Australian Health Review 37(1) 104-111 https://doi.org/10.1071/AH11130
Submitted: 19 December 2011 Accepted: 22 May 2012 Published: 19 November 2012
Abstract
Objective. To assess the prevalence of complementary and alternative medicine (CAM) and service use for people with a chronic disease in rural and regional Australia, where reported prevalence of CAM use is higher.
Methods. Data were from the Whyalla Intergenerational Study of Health, a population representative cross sectional study of 1146 people recruited in 2008–2009. Self-reported chronic disease diagnosis and health service use including CAM use were collected. Complementary and other medicines were recorded at a clinic visit in a reduced sample (n = 722) and SF36 data were collected by questionnaire.
Results. Around 32% of respondents reported complementary medicine use and 27% CAM service use. There was no difference in the overall prevalence of CAM use among those with and without a chronic disease (OR 0.9, 95% CI 0.7–1.3). Greater age- and sex-adjusted use of complementary medicines was associated with the ability to save money (OR 1.75, 95% CI 1.17–2.63), but not with any other socioeconomic position indicator. Those who reported using prescribed medication were more likely to report using complementary medicines (OR 2.09, 95% CI 1.35–3.24).
Conclusions. The prevalence of CAM use in this regional community appeared lower than reported in similar communities outside of South Australia. Mainstream medicine use was associated with complementary medicine use, increasing the risk of an adverse drug interaction. This suggests that doctors and pharmacists should be aware of the possibility that their clients may be using complementary medicines, and the need for vigilance regarding potential side effects and interactions between complementary and mainstream therapies.
What is known about this topic? The prevalence of complementary and alternative therapy use in Australian rural and regional communities is high relative to urban communities.
What does this paper add? The prevalence of complementary and alternative therapy use in a regional South Australian community is lower than reported elsewhere. In this community, mainstream medicine use was associated with an increased chance of complementary medicine use.
What are the implications for practitioners? Doctors and pharmacists should be aware of the possibility that their clients may be using complementary medicines, and the need for vigilance regarding potential side effects and interactions between complementary and mainstream therapies.
References
[1] World Health Organization. Traditional medicines: definition. 2011. Available at http://www.who.int/medicines/areas/traditional/definitions/en/. [Verified 22 August 2011][2] Ernst E. Prevalence of use of complementary/alternative medicine: a systematic review. Bull World Health Organ 2000; 78 252–7.
| 1:STN:280:DC%2BD3c3gslOjsw%3D%3D&md5=5acaf53d1c882e57f4d58425dd0713bdCAS | 10743298PubMed |
[3] Adams J, Sibbritt D, Easthope G, Young A. The profile of women who consult alternative health practitioners in Australia. Med J Aust 2003; 179 297–300.
| 12964912PubMed |
[4] MacLennan A, Myers S, Taylor A. The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004. Med J Aust 2006; 184 27–31.
| 16398628PubMed |
[5] Wilkinson J, Simpson M. High use of complementary therapies in a New South Wales rural community. Aust J Rural Health 2001; 9 166–71.
| High use of complementary therapies in a New South Wales rural community.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvktlSqsw%3D%3D&md5=a037bd6df51fbe123d118bcbc66858eaCAS | 11488700PubMed |
[6] Australian Institute of Health and Welfare. Rural, regional and remote health: indicators of health system performance. Rural Health Series no. 10. Canberra: AIHW, 2008.
[7] Ernst E. The role of complementary and alternative medicine. BMJ 2000; 321 1133–1135.
| The role of complementary and alternative medicine.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M%2Fjs1CmtQ%3D%3D&md5=dfb24ad90ffea0b0974a1e2d60bbe66fCAS | 11061738PubMed |
[8] Angell M, Kassirer JP. Alternative medicine and the risks of untested and unregulated remedies. N Engl J Med 1998; 339 839–41.
| Alternative medicine and the risks of untested and unregulated remedies.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1cvgtVKmsQ%3D%3D&md5=3de2b09829c323afd5970c558f1c240aCAS | 9738094PubMed |
[9] Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, Melchart D. St John’s wort for depression – an overview and meta-analysis of randomised clinical trials. BMJ 1996; 313 253–8.
| St John’s wort for depression – an overview and meta-analysis of randomised clinical trials.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28zit1Klug%3D%3D&md5=7f339a5c2367d463b7b8cd68bf80044fCAS | 8704532PubMed |
[10] Werneke U, Earl J, Seydel C, Horn O, Chricton P, Fannon D. Potential health risks of complementary and alternative medicines in cancer patients. Br J Cancer 2004; 90 408–13.
| Potential health risks of complementary and alternative medicines in cancer patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c%2FjsVSisw%3D%3D&md5=bffec9439de53a6ab0f423c104761189CAS | 14735185PubMed |
[11] Tachjian A, Maria V, Jahangir A. Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol 2010; 55 515–25.
| Use of herbal products and potential interactions in patients with cardiovascular diseases.Crossref | GoogleScholarGoogle Scholar | 20152556PubMed |
[12] Hu Z, Yang X, Paul Chi Lui H, Sui Yung C, Paul Wan Sia H, Chan E, et al Herb-drug interactions: A literature review. Drugs 2005; 65 1239–82.
| Herb-drug interactions: A literature review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2MXhtVekurfL&md5=41f6976b68398d518a6ced3326cd3a15CAS | 15916450PubMed |
[13] Pirotta M, Kotsirilos V, Brown J, Adams J, Morgan T, Williamson M. Complementary medicine in general practice: a national survey of GP attitudes and knowledge. Aust Fam Physician 2010; 39 946–50.
| 21301677PubMed |
[14] Metcalfe A, Williams J, McChesney J, Patten S, Jette N. Use of complementary and alternative medicine by those with a chronic disease and the general population – results of a national population based survey. BMC Complement Altern Med 2010; 10 58
| Use of complementary and alternative medicine by those with a chronic disease and the general population – results of a national population based survey.Crossref | GoogleScholarGoogle Scholar | 20955609PubMed |
[15] Saydah SH, Eberhardt MS. Use of complementary and alternative medicine among adults with chronic diseases: United States 2002. J Altern Complement Med 2006; 12 805–12.
| Use of complementary and alternative medicine among adults with chronic diseases: United States 2002.Crossref | GoogleScholarGoogle Scholar | 17034287PubMed |
[16] Seeff LB, Lindsay KL, Bacon BR, Kresina TF, Hoofnagle JH. Complementary and alternative medicine in chronic liver disease. Hepatology 2001; 34 595–603.
| Complementary and alternative medicine in chronic liver disease.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3MXmvV2kt7c%3D&md5=b5d6c1eeccb9155e234c7efaef0eac11CAS | 11526548PubMed |
[17] Chang H, Wallis M, Tiralongo E. Use of complementary and alternative medicine among people living with diabetes: literature review. J Adv Nurs 2007; 58 307–19.
| Use of complementary and alternative medicine among people living with diabetes: literature review.Crossref | GoogleScholarGoogle Scholar | 17442034PubMed |
[18] Australian Bureau of Statistics (ABS). National regional profile: Whyalla. Canberra: Australian Bureau of Statistics, 2010.
[19] Dillman DA. Mail and telephone surveys: the total design method. New York: Wiley–Interscience (Wiley & Sons), 1978.
[20] Grant JF, Chittleborough CR, Taylor AW, Dal Grande E, Wilson DH, Phillips PJ, et al The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases. Epidemiol Perspect Innov 2006; 3 4
| The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases.Crossref | GoogleScholarGoogle Scholar | 16608529PubMed |
[21] Haren M, Misan G, Grant J, Buckley J, Howe P, Taylor A, et al Proximal correlates of metabolic phenotypes during ‘at-risk’ and ‘case’ stages of the metabolic disease continuum. Nutr Diabetes 2012; 2 e24
| Proximal correlates of metabolic phenotypes during ‘at-risk’ and ‘case’ stages of the metabolic disease continuum.Crossref | GoogleScholarGoogle Scholar | 23154680PubMed |
[22] National Heart Foundation of Australia and the Cardiac Society of Australian and New Zealand. Reducing risk in heart disease 2007: National Heart Foundation, 2008.
[23] The Royal Australasian College of General Practitioners. Clinical guideline for the diagnosis and management of early rheumatoid arthritis. South Melbourne: RACGP, 2009.
[24] The Royal Australasian College of General Practitioners. Guidelines for the non-surgical management of hip and knee osteoarthritis. South Melbourne: RACGP, 2009.
[25] StataCorp. Stata statistical software: Release 10. College Station, TX: StataCorp LP, 2007.
[26] Morgan T, Williamson M, Pirotta M, Stewart K, Myers S, Barnes J. A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. Med J Aust 2012; 196 50–3.
| A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older.Crossref | GoogleScholarGoogle Scholar | 22256935PubMed |
[27] Xue CCL, Zhang AL, Lin V, Da Costa C, Story DF. Complementary and alternative medicine use in Australia: a national population-based survey. J Altern Complement Med 2007; 13 643–50.
| Complementary and alternative medicine use in Australia: a national population-based survey.Crossref | GoogleScholarGoogle Scholar |
[28] Sirois F, Gick M. An investigation of the health beliefs and motivations of complementarymedicine clients. Soc Sci Med 2002; 55 1025–37.
| An investigation of the health beliefs and motivations of complementarymedicine clients.Crossref | GoogleScholarGoogle Scholar | 12220087PubMed |
[29] Yeh G, Eisenberg D, Davis R, Phillips R. Use of complementary and alternative medicine among persons with diabetes mellitus: results of a national survey. Am J Public Health 2002; 92 1648–52.
| Use of complementary and alternative medicine among persons with diabetes mellitus: results of a national survey.Crossref | GoogleScholarGoogle Scholar | 12356615PubMed |
[30] Nilsson M, Trehn G, Asplund K. Use of complementary and alternative medicine remedies in Sweden. A population-based longitudinal study within the northern Sweden MONICA Project. J Intern Med 2001; 250 225–33.
| Use of complementary and alternative medicine remedies in Sweden. A population-based longitudinal study within the northern Sweden MONICA Project.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mrgs1GrtQ%3D%3D&md5=0003e31f7782f3bd536c389081700d5bCAS | 11555127PubMed |
[31] Australian Government. Eligibility criteria for allied health professionals providing chronic disease allied health (individual and group) Medicare services. 2010. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/A30767354D10ACF0CA256F19003CB4F5/$File/Eligibility%20Criteria%20for%20AHPs%20with%20NRAS%20changes.pdf. [Verified 13 September 2011].
[32] Australian Institute of Health and Welfare. Health expenditure Australia 2008–09. Health and welfare expenditure series no.42. Cat. no. HWE 51. Canberra: AIHW, 2010.
[33] Australian Bureau of Statistics. Australian social trends 2008: complementary therapies. Canberra: Australian Bureau of Statistics, 2008.
