title: Use of complementary and alternative medicine and self-tests by coronary heart disease patients.
abstract: BACKGROUND
  Coronary heart disease patients have to learn to manage their condition to maximise quality of life and prevent recurrence or deterioration. They may develop their own informal methods of self-management in addition to the advice they receive as part of formal cardiac rehabilitation programmes. This study aimed to explore the use of complementary and alternative medicines and therapies (CAM), self-test kits and attitudes towards health of UK patients one year after referral to cardiac rehabilitation.
  
  
  METHODS
  Questionnaire given to 463 patients attending an assessment clinic for 12 month follow up in four West Midlands hospitals.
  
  
  RESULTS
  91.1% completed a questionnaire. 29.1% of patients used CAM and/or self-test kits for self-management but few (8.9%) used both methods. CAM was more often used for treating other illnesses than for CHD management. Self-test kit use (77.2%,) was more common than CAM (31.7%,) with BP monitors being the most prevalent (80.0%). Patients obtained self-test kits from a wide range of sources, for the most part (89.5%) purchased entirely on their own initiative. Predictors of self-management were post revascularisation status and higher scores on 'holism', 'rejection of authority' and 'individual responsibility'. Predictors of self-test kit use were higher 'holism' and 'individual responsibility' scores.
  
  
  CONCLUSIONS
  Patients are independently using new technologies to monitor their cardiovascular health, a role formerly carried out only by healthcare practitioners. Post-rehabilitation patients reported using CAM for self-management less frequently than they reported using self-test kits. Reports of CAM use were less frequent than in previous surveys of similar patient groups. Automatic assumptions cannot be made by clinicians about which CHD patients are most likely to self-manage. In order to increase trust and compliance it is important for doctors to encourage all CHD patients to disclose their self-management practices and to continue to address this in follow up consultations.
authors.affiliation: Department of Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. s.m.greenfield@bham.ac.uk
authors.forename: Sheila
authors.initials: S
authors.lastname: Greenfield
authors.forename: Helen
authors.initials: H
authors.lastname: Pattison
authors.forename: Kate
authors.initials: K
authors.lastname: Jolly
mesh_terms: D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015995:Prevalence; D011369:Professional-Patient Relations; D011788:Quality of Life; D012648:Self Care / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology