title: Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease.
abstract: OBJECTIVE
  To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts.
  
  
  METHODS
  A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis.
  
  
  RESULTS
  In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001).
  
  
  CONCLUSIONS
  In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.
authors.affiliation: Réme Mountifield, Peter Bampton, Department of Gastroenterology and Hepatology, Flinders Medical Centre, South Australia 5042, Australia.
authors.forename: Réme
authors.initials: R
authors.lastname: Mountifield
authors.affiliation: Réme Mountifield, Peter Bampton, Department of Gastroenterology and Hepatology, Flinders Medical Centre, South Australia 5042, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Andrews
authors.affiliation: Réme Mountifield, Peter Bampton, Department of Gastroenterology and Hepatology, Flinders Medical Centre, South Australia 5042, Australia.
authors.forename: Antonina
authors.initials: A
authors.lastname: Mikocka-Walus
authors.affiliation: Réme Mountifield, Peter Bampton, Department of Gastroenterology and Hepatology, Flinders Medical Centre, South Australia 5042, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Bampton
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003142:Communication; D000529:Complementary Therapies; D003430:Cross-Sectional Studies; D005260:Female; D033062:Friends; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D012919:Social Behavior; D013021:South Australia; D011795:Surveys and Questionnaires
keywords: Alternative therapy; Complementary medicine; Inflammatory bowel disease; Medication adherence; Patient-Doctor Communication; Therapy
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