title: Room for improvement: complementary therapy users and the Australian health system.
abstract: BACKGROUND
  People with chronic conditions who are often in contact with the health-care system are well placed to reflect on how services meet their needs. Some research characterizes people who use complementary and alternative medicines (CAMs) as a distinct group who opt out of the mainstream health system. However, many CAM users are people with chronic or terminal health conditions who concurrently use mainstream health-care services. The difference in perspectives between people with chronic conditions who do or do not use CAM has received little attention by researchers.
  
  
  OBJECTIVE
  To explore the views of CAM users with chronic conditions and identify their perspectives on the health system.
  
  
  METHODS
  In-depth interviews and a self-administered questionnaire were used to collect data on care-seeking, self-management and CAM use among people with type 2 diabetes and/or cardiovascular disease living in Victoria, Australia.
  
  
  RESULTS
  One in four CAM practitioner users was partly motivated to use CAM as a result of their dissatisfaction with the mainstream health system. In general, their dissatisfaction mirrored the concerns of the general population. This included the perceived lack of a humanistic or person-centred approach, which was central to problems relating to individuals' clinical encounters as well as to health system design.
  
  
  CONCLUSIONS
  Participants' concerns suggest room for improvement in the Australian health system to better reflect patients' needs. A systems approach is needed to reorient health-care practitioners to modify the organization of care because of the incentives embedded in the structure of the health-care system.
authors.affiliation: CAMELOT Project, School of Public Health, La Trobe University, Bundoora, Vic., Australia.
authors.forename: Vivian
authors.initials: V
authors.lastname: Lin
authors.affiliation: CAMELOT Project, School of Psychology and Psychiatry, Monash University, Caulfield, Vic., Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Canaway
authors.affiliation: CAMELOT Project, School of Public Health, La Trobe University, Bundoora, Vic., Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Carter
authors.affiliation: CAMELOT Project, School of Psychology and Psychiatry, Monash University, Caulfield, Vic., Australia.
authors.forename: Lenore
authors.initials: L
authors.lastname: Manderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001315:Australia; D002318:Cardiovascular Diseases / Q000628:therapy; D002908:Chronic Disease / Q000628:therapy; D000529:Complementary Therapies; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy; D005260:Female; D006296:Health Services; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: chronic disease; complementary therapy users; consumer perspectives; health systems; mixed-methods research