Complementary and alternative medicine in multiple sclerosis: survey of licensed naturopaths.
OBJECTIVE
This paper describes the treatments and treatment outcome measures used by licensed naturopathic physicians in the United States who treat people with multiple sclerosis (MS).


METHODS
A cross-sectional mail survey was used.


METHODS
The participants were licensed naturopaths who were members of the American Association of Naturopathic Physicians.


METHODS
Outcome measures included practitioner demographics; patient demographics by practitioner report; recommended therapies; perceived effectiveness of treatments for MS; methods for measuring treatment effectiveness.


RESULTS
Forty three percent (43%) of the respondents (166/385) had treated at least one patient with MS while 56.9% (291/385) had never treated MS. 63.3% had treated 1-10 patients with MS, 19.9% had treated 11-20 patients with MS, and 16.8% had treated > or =20 patients with MS. Among the naturopaths, 68.1% communicated with an M.D. about their patient(s)' care and the majority of patients with MS were diagnosed by an M.D. (mean % = 96.3). The mean number of therapies recommended for M.S. was 3.91 (standard deviation [SD] =2.01, range 1-10). The most frequently recommended therapies included, diet (52.4%), essential fatty acid supplementation (44.6%), vitamin/mineral supplementation (33.7%), homeopathy (30.7%), botanicals (22.3%), and antioxidants (18.1%). Respondents perceived their treatments as "very effective" for the following stages of MS: early stage (57.2%); middle stage (25.3%); and late stage (3.0%). Respondents perceived their treatments as "very effective" for the following disease-related outcomes: improved quality of life (59.0%); decrease relapse rates (48.2%); decreased symptom severity (45.8%); prevention of disease progression (41.6%). The methods used "most often" for measuring treatment effectiveness included, patient report (88.0%); physical examination (27.1%); medical records/laboratory testing (13.3%). The mean estimated percentage of patients not taking conventional disease-modifying medication was 51.2% (SD = 42.7%).


CONCLUSIONS
Naturopaths use both a broad range and multiple complementary and alternative medicine CAM therapies for treating MS and report treatment effectiveness on the following outcomes: quality of life; symptom severity; relapse rates; and disease progression. Further research on single CAM therapies and holistic CAM systems is warranted in MS.
Shinto
Lynne
L
Department of Neurology, Oregon Health & Science University, Portland, OR 97239-3098, USA. shintol@ohsu.edu
Calabrese
Carlo
C
Morris
Cynthia
C
Sinsheimer
Shannon
S
Bourdette
Dennis
D
D000529:Complementary Therapies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006306:Health Surveys; D006801:Humans; D008004:Licensure; D009103:Multiple Sclerosis / Q000628:therapy*; D009324:Naturopathy; D009922:Oregon; D010043:Outcome and Process Assessment, Health Care; D016896:Treatment Outcome