title: Alternative medicine use by Canadian ambulatory gastroenterology patients: secular trend or epidemic?
abstract: OBJECTIVE
  To assess the prevalence and determinants of alternative medicine (AM) use in gastroenterology outpatients and those with inflammatory bowel disease (IBD).
  
  
  METHODS
  An 80-item questionnaire, addressing symptoms, general health, quality of life, and AM use, was administered and analyzed using logistic regression.
  
  
  RESULTS
  52.5% of 341 participants used AM in the previous year. Most commonly used were herbal medicine (45.2% of users; 95% CI 35.4-52.5%), chiropractor (40.7%; 95% Cl 31.4-48.0%), and massage therapy (22.9%; 95% CI 15.9-29.1%). Reasons prompting AM use were ineffective medical therapy (39.5%; 95% CI 30.4-46.8%), a greater sense of self-control (29.1%; 95% CI 21.2-35.7%), agreement with personal beliefs (19.5%; 95% CI 13.1-25.4%), and conventional drug adverse-effects (17.3%; 95% CI 11.2-22.9%). AM use was predicted as follows: (1) higher education (odds ratio (OR) 2.10; 95% CI 1.22-3.60), (2) comorbid medical conditions (OR 1.80; 95% CI 1.08-3.00), 3) poor mental component summary score of the SF-12 health survey (OR 1.04; 95% CI 1.01-1.07), and (4) higher annual income (OR 1.17; 95% CI 1.001-1.36), but was not related to response to conventional medical therapy. AM practitioners had instructed 8.6% to change prescription medications. AM usage for gastrointestinal disease was greater in patients with IBD (44.6% vs 10.0%; p < 0.05), who were more likely to cite adverse drug effects as a reason for AM use (28.9 vs 14.4%; p = 0.03).
  
  
  CONCLUSIONS
  AM was used by 52.5% of gastroenterology outpatients and its use was greater in those with a higher level of education, comorbid conditions, poorer mental health-related quality of life, and higher income. Drug-related side effects also led to increased AM use.
authors.affiliation: St Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada.
authors.forename: Subhas C
authors.initials: SC
authors.lastname: Ganguli
authors.forename: Ruth
authors.initials: R
authors.lastname: Cawdron
authors.forename: E J
authors.initials: EJ
authors.lastname: Irvine
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D002170:Canada / Q000453:epidemiology; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D005762:Gastroenterology / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence