title: Complementary and alternative medicine consultations in urban and nonurban areas: a national survey of 1427 Australian women.
abstract: OBJECTIVE
  The purpose of this study was to evaluate survey data from a national cross-sectional sample of 1427 urban and nonurban Australian women focusing on the relationship between the use of specific complementary and alternative medicine (CAM) practitioner types and the levels of CAM use across urban and nonurban areas.
  
  
  METHODS
  A cross-sectional survey of 1427 middle-aged participants from the Australian Longitudinal Study on Women's Health conducted in 2009 was performed. The survey was designed to investigate multiple factors affecting the health and well-being of a cohort of women, with a particular emphasis on urban and nonurban residence. Women in 3 age groups ("young" 18-23 years, "mid-age" 45-50 years, and "older" 70-75 years) were randomly selected from the national Medicare database. The survey covered place of residence, measures of health status, rating of health care providers/services, and consultation with CAM practitioners.
  
  
  RESULTS
  The most commonly consulted CAM practitioners for this sample were massage therapists (n = 912; 63.9%), doctors of chiropractic/chiropractors (n = 614; 43.0%), and naturopaths/herbal therapists (n = 327; 22.9%). Statistically significant differences between the areas of residence were found for women who used chiropractors (P = .0165), yoga practitioners (P = .0087), and osteopaths (P < .0001). Women residing in nonurban areas were more likely to consult with a chiropractor compared with women residing in major cities. Women in major cities were more likely to consult with a yoga practitioner or osteopath than women from nonurban areas. Women from nonurban areas who consulted a chiropractor were significantly less satisfied with their access to a medical specialist (P < .0001), access to a female general practitioner (P = .043), the number of general practitioners they have to choose from (P = .001), how long they have to wait for an appointment (0.0146), and the amount of information sharing by their general practitioner (P = .003), compared with urban women.
  
  
  CONCLUSIONS
  For the population sample studied, the higher overall consultation rates with CAM therapists by Australian nonurban women were caused by consultations for chiropractic care.
authors: Faculty of Health, University of Technology Sydney, Sydney, Australia. jon.adams@uts.edu.au
authors: Jon
authors: J
authors: Adams
authors: David
authors: D
authors: Sibbritt
authors: Alex
authors: A
authors: Broom
authors: Deborah
authors: D
authors: Loxton
authors: Jon
authors: J
authors: Wardle
authors: Marie
authors: M
authors: Pirotta
authors: Chi-Wai
authors: CW
authors: Lui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012424:Rural Population; D013383:Suburban Population; D014505:Urban Population; D055815:Young Adult