Assessing complementary and alternative medicine usage in disease specific minority patients

Purpose: While data from the 2007 National Health Interview Survey (NHIS) indicate that almost 4 out of 10 adults across the US used complementary and alternative medicine (CAM) within the past 12 months, there is currently no consensus on how to assess disease specific CAM usage during clinical encounters. Results from a bilingual CAM survey of minority patients with rheumatic diseases were compared to the NHIS to validate findings and highlight differences among patients attending an urban clinic in northwest Washington, D.C. Methods: This mixed method study examined participants (n=109) enrolled in the Natural History of Rheumatic Disease in Minority Communities study. Pre-testing using cognitive interviews suggested modifying the Inventory of Complementary and Alternative Medicine Practices (ICAMP) to a yes/no format, covering only “current” CAM use. Face-to-face questionnaires were completed in Spanish and English to quantify CAM usage among this population. Results: Study participants were predominantly African-American (n=40) and Hispanic (n=46). As shown in the NHIS, this population tends to have the highest use of biologically-based and mind-body therapies. CAM usage was reported by 71% of participants, 25% used >5 different modalities. Acupuncture, meditation, deep breathing, guided imagery, and diet based therapies, were used more often by study participants than the general US adult population. Conclusions: Because CAM usage may differ by disease process and cultural background additional research is needed to develop and validate culturally appropriate, disease specific assessment tools. This analysis was undertaken to open a dialogue around the methods to capture the diverse use of CAM among complex, multiracial/ethnic patient populations.