title: Examination of the use of complementary and alternative medicine in Central Appalachia, USA.
abstract: BACKGROUND
  A growing number of people in the USA and worldwide use complementary and alternative medicine (CAM). CAM usage has been reported to differ by region. Little is known about the usage of CAM, especially among the Appalachian region population. The aim of this study is to evaluate the usage of CAM among adults in Central Appalachia.
  
  
  METHODS
  A 23-question survey was distributed to 250 participants seeking free medical care at remote area medical events held in Wise County, Virginia in July 2012 and in Buchanan County, Virginia in October 2012. The questions on the survey addressed various aspects concerning CAM: forms of treatment used, frequency of use, main reasons for using CAM, and where they obtained their CAM therapies. The survey also collected demographic characteristics of the respondents. Subjects were asked to complete a two-page survey while waiting for service.
  
  
  RESULTS
  A total of 192 (76.8%) responses were useful and complete. About 56% of the CAM users were female and 55% had an annual gross income of less than $20,000. About 49% had used CAM therapies in the past, of which 58% used CAM therapies at least once a month. Respondents used CAM because it worked well (n=52; 27%), had less side effects (n=45; 23%), and was affordable (n=43; 22%). CAM therapies were used mainly to address back pain (n=23; 15.6%), general health and wellbeing (n=22; 14.9%), depression and anxiety (n=11; 7.5%), and general pain (n=11; 7.5%), among others. Having a primary care provider, current level of education, and gross annual income were significantly associated with CAM use (p<0.001). Most respondents (n=94; 85%) were comfortable telling their doctor or other medical personnel about their use of CAM therapies.
  
  
  CONCLUSIONS
  The prevalence of CAM usage among people in the Central Appalachia region was high, and higher than the national average. Most respondents were comfortable sharing their CAM usage information with their healthcare providers. More research is needed to further understand the factors underpinning CAM usage by the Central Appalachia population.
authors.affiliation: Appalachian College of Pharmacy, Oakwood, Virginia, USA. dnguyen@students.acpharm.org.
authors.forename: Duc
authors.initials: D
authors.lastname: Nguyen
authors.affiliation: Appalachian College of Pharmacy, Oakwood, Virginia, USA. pgavaza@acp.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Gavaza
authors.affiliation: Appalachian College of Pharmacy, Oakwood, Virginia, USA. lhollon@acp.edu.
authors.forename: Leah
authors.initials: L
authors.lastname: Hollon
authors.affiliation: Appalachian College of Pharmacy, Oakwood, Virginia, USA. rnicholas@acp.edu.
authors.forename: Richard
authors.initials: R
authors.lastname: Nicholas
mesh_terms: D001061:Appalachian Region; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data*; D030881:Disclosure; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires