Alternative medicine or "alternative" patients: a qualitative study of patient-oriented decision-making processes with respect to complementary and alternative medicine.
BACKGROUND
Theory and clinical practice suggest that complementary and alternative medicine (CAM) decision-making processes may differ from those used in conventional medicine. If so, understanding the differences could improve patient-provider communication around treatment options.


OBJECTIVE
To examine patient-oriented decision-making processes relative to CAM use.


METHODS
Adults with chronic rheumatological disorders who utilize allopathic medicine only, CAM only, or both.


METHODS
An exploratory, cross-sectional naturalistic design with thematic and content analyses.


RESULTS
Three distinct decision paths were developed, differing substantially on the importance of provider trust, disease severity/prognosis, willingness to experiment, intuitive/spiritual factors, and outcomes evidence.


CONCLUSIONS
These divergent decision paths indicate the possibility of "alternative patients," not just "alternative therapies." Since informed decisions, tailored to the patient, would likely lead to sustainable improvements in health care outcomes, the findings may facilitate providers' capacity to effectively advise patients about treatment alternatives and CAM use.
Caspi
Opher
O
Department of Medicine, College of Medicine, University of Arizona Health Sciences Center, PO Box 245153, Tucson, AZ 85724-5153, USA. ocaspi@ahsc.arizona.edu.
Koithan
Mary
M
Criddle
Michael W
MW
D000328:Adult; D000368:Aged; D001130:Arizona; D002908:Chronic Disease; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012216:Rheumatic Diseases / Q000628:therapy*