Alternative medicine in allergies - prevalence, patterns of use, and costs.
BACKGROUND
There is evidence that the use of alternative medicine (AM) for allergies has increased. However, little is known from population-based studies about what determines its use. The objective of this study was to evaluate the patterns of use of AM for allergies.


METHODS
A population-based nested case-control study was conducted in 2000-01 using computer-assisted telephone interviews. Three hundred and fifty-one adults participated (median age 46 years) with allergies including hay fever, asthma, atopic eczema, and food hypersensitivity. Information was obtained on demographics, prevalence, motivation, information, type of AM, provider, costs, willingness to pay, and subjective assessment of AM.


RESULTS
26.5% of participants used AM because of their allergies. Compared to nonusers, this group of users was significantly younger (median age 43 vs 47; p=0.004) and better educated (school education > 8 year vs<or= 8 year; odds ratio (OR) 2.17, 1.28-3.67) and was mostly motivated by the assumption of few side-effects (78.3%), by a wish to try everything (71.7%), and by unsatisfying results from conventional therapy (66.3%). Users also had more experience with conventional therapy than nonusers (94.6% vs 63.6%; OR 10.10, 4.00-25.72). Four procedures accounted for almost the entire usage: homeopathy (35.3%), autologous blood injection (28.1%), acupuncture (16.6%), and bioresonance (10.0%). The AM were mostly promoted (40.2%) and provided (60.9%) by medical doctors, and produced median costs for single and entire treatment of 4 (15-205) and 205 (15-1278) euros. Reimbursement from insurance companies was received by 52.3%, in full (37.8%) or partial (14.5%). Most subjects (55.4%) admitted that they would pay more (median 153 euros) for the achieved result. Users scored the efficacy of conventional therapy significantly lower (p<0.001) than nonusers, and assessed the results of AM as very good (28.6%) or rather good (53.8%).


CONCLUSIONS
AM is used widely for allergies by the general population and is associated with considerable costs. This has implications for the health care system and health policy.
Schäfer
T
T
Department of Social Medicine, Medical University Lübeck, Germany.
Riehle
A
A
Wichmann
H-E
HE
Ring
J
J
D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D000529:Complementary Therapies / Q000191:economics / Q000379:methods* / Q000592:standards; D005190:Family; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006967:Hypersensitivity / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012017:Referral and Consultation; D013997:Time Factors