NHS patients’ perspective on complementary medicine: a survey

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Abstract

Objectives: To examine patients’ reasons for seeking complementary and alternative medicine (CAM) in the National Health Service, including the nature and duration of the patient’s main health problem, the impact of CAM on this, satisfaction with clinical care, and usage of conventional prescription medication. Design: Survey (n=499). Setting: Out-patient Department, The Royal London Homoeopathic Hospital, a National Health Service facility dedicated to CAM. Results: Five hundred and six questionnaires were returned, 499 were analysed. Patients’ most frequent reasons for seeking CAM were that other treatment had not helped, and concerns about or experience of adverse treatment reactions. Two hundred and ninety-seven patients (63%) had had their main problem for more than 5 years. Musculoskeletal system problems were the most frequent diagnostic group (n=151, 32%). Satisfaction with clinical care was high (443/490: 90%). Three hundred and eighty patients (81%) indicated their main problem had improved very much, moderately or slightly. Of the 262 patients who had been taking prescription medicines when they first attended, 76 (29%) had stopped, and 84 (32%) had reduced their intake. Conclusions: The results suggest that orthodox medicine is not meeting the needs of some patients and that CAM may wholly or partly substitute for conventional medicines. Most patients indicated their problem had improved with CAM. Implications for future research are discussed.

Section snippets

INTRODUCTION

Complementary medicine is used by 20–28% of the UK population.1., 2. Use by the US population rose from 34 to 42% between 1991 and 1997.3 Provision of complementary and alternative medicine (CAM) in the National Health Service (NHS) is growing, and 40% of NHS GPs now refer patients for treatment.4 Patients’ motives for seeking CAM include dissatisfaction with and concern about potential side effects of orthodox medicine.5., 6., 7., 8., 9., 10. A study by Astin11 into reasons for the use of CAM

METHODS

Out-patients attending the RLHH during a 3-week period in September 1997 were identified from the Patient Administration System. Inclusion criteria were: at least three consultations with a doctor at the RLHH, the minimum number required for clinical improvement to be realistically expected and assessed; over 18 years of age. Patients attending the Children’s or Assessment Clinics were excluded. The following clinics were included: acupuncture, allergy, nutritional medicine and enzyme

RESULTS

There were 786 patients identified as eligible; 245 did not participate for the following reasons: did not attend (128), did not wish to complete questionnaire (54), missed by data collectors (54), attended less than three times (9). Five hundred and forty-one patients agreed to participate, 506 (93% response rate) questionnaires were returned, and 499 were analysed as 7 subsequently met the study’s exclusion criteria. A representative sample of patients attending the hospital for 8 out of 10

DISCUSSION

Patients’ views and preferences in the provision and evaluation of healthcare are increasingly important.19 The results of our survey show a fairly even age distribution of patients receiving CAM treatment at a dedicated NHS secondary care centre (but note that children were excluded). A wide range of clinical conditions was treated. Patients were predominantly female and referral was usually initiated by the patient. Patients from ethnic minorities appear over-represented, although to what

Acknowledgements

Wolfgang Weinert and Jan Shafer, ‘Health Data Administrator’ students from the University of Ulm, Germany, and all the staff at the Royal London Homoeopathic Hospital who have helped with this project.

Fiona M.C. Sharples MSc, RGN, Clinical Governance Manager, Academic Unit, The Royal London Homoeopathic Hospital, UCL Hospitals NHS Trust, Greenwell Street, London W1W 5BP, UK. Tel.: 44 (0) 20 7391 8895; Fax: +44 (0) 20 7391 8812

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    Fiona M.C. Sharples MSc, RGN, Clinical Governance Manager, Academic Unit, The Royal London Homoeopathic Hospital, UCL Hospitals NHS Trust, Greenwell Street, London W1W 5BP, UK. Tel.: 44 (0) 20 7391 8895; Fax: +44 (0) 20 7391 8812

    Funding There was no support in the form of grants for this project.

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