title: Integrated medicine in the management of chronic illness: a qualitative study.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) is popular with patients, yet how patients use CAM in relation to orthodox medicine (OM) is poorly understood.
  
  
  OBJECTIVE
  To explore how patients integrate CAM and OM when self-managing chronic illness.
  
  
  METHODS
  Qualitative analysis of interviews.
  
  
  METHODS
  Semi-structured interviews were conducted with individuals attending private CAM practices in the UK, who had had a chronic benign condition for 12 months and were using CAM alongside OM for more than 3 months. Patients were selected to create a maximum variation sample. The interviews were analysed using framework analysis.
  
  
  RESULTS
  Thirty five patient interviews were conducted and seven categories of use were identified: using CAM to facilitate OM use; using OM to support long-term CAM use; using CAM to reduce OM; using CAM to avoid OM; using CAM to replace OM; maximising relief using both CAM and OM; and returning to OM. Participants described initiating CAM use following a perceived lack of suitable orthodox treatment. Participants rejecting OM for a specific condition never totally rejected OM in favour of CAM.
  
  
  CONCLUSIONS
  Patients utilise CAM and OM in identifiably different ways, individualising and integrating both approaches to manage their chronic conditions. To support patients and prevent potential adverse interactions, open dialogue between patients, OM practitioners, and CAM practitioners must be improved.
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK. s.brien@southampton.ac.uk
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Brien
authors.forename: Felicity L
authors.initials: FL
authors.lastname: Bishop
authors.forename: Kirsty
authors.initials: K
authors.lastname: Riggs
authors.forename: David
authors.initials: D
authors.lastname: Stevenson
authors.forename: Victoria
authors.initials: V
authors.lastname: Freire
authors.forename: George
authors.initials: G
authors.lastname: Lewith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult