Understanding alternative medicine use

Saadia Ali
Saadia Ali, pharmacy student. 

College of Pharmacy student Saadia Ali is one of 97 students and faculty members presenting research April 12 at the 7th annual Louis C. Littlefield Celebrating Pharmacy Research Excellence Day.

Ali's research topic is "Factors That Influence Adults' Decisions to Use Complementary and Alternative Medicine (CAM)." She is a student of Dr. Carolyn Brown, professor of pharmacy. In this Q-and-A, Ali answers questions about the research she's done on CAM, products and practices not usually considered part of conventional medicine.

What are a few examples of Complementary Alternative Medicine (CAM) and the diseases people are trying to treat with their use?
People use fish oil (omega 3 fatty acids) for various medical conditions like heart disease, high blood pressure and even depression. Some people use glucosamine for joint pain. St. John's wort is used to treat depression/anxiety and chamomile for upset stomach or insomnia. Other diseases people treat with CAM include arthritis, back pain and high cholesterol.

You've said before that an estimated one-third of adults in the United States use CAM. Is it still heavily influenced by culture and ethnic background?
According to the National Center for Complementary and Alternative Medicine (NCCAM), four in 10 U.S. adults use CAM. In general, the race/ethnicity with the most CAM users is the American Indians/Alaska Natives with 50.3 percent of this population using CAM.
Some types of CAM are heavily influenced by culture such as Ayurvedic medicine in South Asia or traditional Chinese medicine. In the past few decades, modernized forms of Ayurvedic medicine and Chinese medicine have become more popular in the western world and people of all cultures and ethnicities utilize these therapies. Some CAMs like herbals (ginseng or St. John's wort) and other dietary supplements also are used by an array of cultures.

Have we seen a big increase in CAM use and, if so, is it partly because of the financial downturn?
CAM use increased only 2 percent from 2002 to 2007. CAM use was probably not influenced by the financial downturn because many types of CAM are costly and not accepted by insurance. Also, CAM use is greater among those with higher levels of education and higher incomes. Specific types of CAM use did increase from 2002 to 2007 such as deep breathing, meditation, massage and yoga. Interestingly enough, these are the types of CAM that may not cost anything at all.

Why is it so important for us to understand CAM use? Why hasn't there been more research on the patterns of CAM use?
Healthcare providers like doctors and pharmacists need to understand patterns of CAM use so that they can personalize patient care based on whether a specific patient is likely to use CAM. By understanding CAM use, healthcare providers can spend more time talking about CAM with particular patients and educate them on side effects and drug interactions.

Fish oil caps
Fish oil capsulesImage: Stephen Cummings on Flickr/CC

Why are patients hesitant to inform their healthcare providers about CAM use?
Patients are hesitant to inform their healthcare providers about CAM use because they are fearful of criticism. Another primary reason patients don't tell is because the provider never asks. However, it is very important for patients to inform their doctors and pharmacists about CAM use and/or for providers to proactively inquire about CAM use, especially products taken by mouth (like herbals) because many conventional drug therapies have the potential to interact with CAM therapies.

Why is it important for healthcare providers (including pharmacists) to learn about their patients' beliefs regarding CAM use and their history and likelihood of future CAM use?
It is important for healthcare providers such as doctors and pharmacists to learn about their patients' beliefs regarding CAM use so that they can personalize patient care. For example, if a doctor knows a patient believes herbals are an effective treatment for depression, they could be more vigilant about that specific patient's use of herbals. Also, in the research that Dr. Brown and I conducted, we found that beliefs and past CAM use are associated with people's willingness to use CAM.

More information about the 7th annual Louis C. Littlefield Celebrating Pharmacy Research Excellence Day on April 12.

All of the Pharmacy Research Excellence Day events are open to the public. The research poster presentations will take place on the main campus in a large tent between Anna Hiss Gymnasium and the Molecular Biology Building in the afternoon.