[Use of complementary and alternative medicine among the patients in primary health care].
OBJECTIVE
Use of complementary and alternative medicine (CAM) is widespread in western countries despite its unconfirmed effectiveness. The aim of the study was to show the use of CAM by patients in primary health care.


METHODS
Cross-sectional method was used in a sample of 941 patients attending fourteen primary care practices from six Croatian cities who visited their family physician for whatever reason and filled in an anonymous questionnaire. On data analysis, distribution of frequencies and chi2-test were used. A probability value of p (two-tailed) indicated a statistically significant difference.


RESULTS
The response rate was 70%. At least once in their lifetime CAM was utilized by 46% and in previous year by 32% of patients. Most frequent users were persons in the 46-55 age group years and those with higher education. A statistically significant difference was established between CAM utilization and age, education, employment and relaxation/stress reducing techniques. The most frequently used methods were herbalism (38%), homeopathy (15.6%) and acupuncture (13.1%). In 53.5% of subjects CAM was used together with conventional medicine. CAM was most often used for musculoskeletal diseases, gastrointestinal diseases, and for prevention. Chiropractic was most commonly used for musculoskeletal disorders, and herbalism and homeopathy for respiratory disorders. Supplements, natural healing products and homeopathic medicines were used by 80.1% of study subjects. Patients decide on the use of CAM because they believe it will help them (27%), conventional medicine failed to alleviate their complaints (19.7%) and they were afraid of side effects of drugs (13.3%). Satisfaction with CAM treatment was reported by 45.5% of study subjects. More than half of the patients notified their physician on the use of CAM (59.6%) and the majority (81.7%) of all subjects would like to discuss the use of CAM in their treatment with their family physician.


CONCLUSIONS
In this study, the use of CAM was consistent with literature data. Frequent use of herbal method may lead to potential risks due to possible herb-drug interactions. The reason for the use of CAM is rarely dissatisfaction with their physician but often dissatisfaction with the results and side effects of conventional treatment. Doctors will require additional education on CAM methods, their effectiveness, safety, indications and contraindications in order to be well informed and able to discuss CAM use with their patients.


CONCLUSIONS
The use of CAM is common among patients attending primary health care. Sociodemographic factors are important predictors of its use. Doctors should openly ask their patients about the use of CAM and receive proper education to be able to discuss the potential benefits versus possible risks of its use in individual cases.
Cizmesija
Tomislav
T
National Railroad Health Center, University of Zagreb, Zagreb, Croatia. tcizmes@inet.hr
Bergman-Marković
Biserka
B
D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care