Online Program

Patient non-disclosure of CAM use to usual care providers: Trends by modality and reasons for CAM use

Tuesday, November 3, 2015

Judy Jou, MA, School of Public Health, Division of Health Policy and Management, University of Minnesota, Twin Cities, Minneapolis, MN
Pamela Jo Johnson, MPH, PhD, Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN
Background. Although 40% of U.S. adults used complementary and alternative medicine (CAM) within the past year, CAM is not yet integrated into conventional care delivery systems, contributing to poor patient-provider communication and care coordination. This study examines trends in non-disclosure of CAM use to patients’ usual care providers.

Methods. Data from the 2012 National Health Interview Survey (NHIS) were used to identify respondents who used CAM during the past year (N=7,493) and have personal care providers. One- and two-way tabulation were used to describe sample characteristics and reasons for CAM use by modality. Logistic regression was used to predict odds of and reasons for non-disclosure by CAM modality and reasons for CAM use.

Results. Overall, 42.3% of respondents did not disclose CAM use to their providers. Non-disclosure was 2-3 times more likely for mind-body therapies (AORs 2.09-2.67, p<0.001) and half as likely for herbs/supplements (AOR 0.57, p<0.001) compared to chiropractic/osteopathic manipulation. Older respondents were more likely to disclose CAM use than those ages 18-30 (AOR 0.39, p<0.001) but 2.6 times more likely to non-disclose due to negative provider reactions (p=0.012). Respondents using CAM to treat specific conditions were half as likely to non-disclose (AOR 0.52, p<0.001), but were 2.6 times more likely to non-disclose due to negative provider reactions (p<0.001).

Conclusions. Non-disclosure of CAM use is common, especially among younger patients and those using mind-body therapies. Provider-initiated discussion of CAM use and reforms to care delivery and payment systems may facilitate better integration of CAM into conventional medical care.

Learning Areas:

Advocacy for health and health education
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe trends in patient non-disclosure of the use of complementary and alternative medicine to their usual care providers. Identify systematic differences in non-disclosure by socio-demographic characteristics and types of CAM modality used. Evaluate reasons for non-disclosure and potential approaches to improving patient-provider communication regarding CAM use.

Keyword(s): Alternative and Complementary Health, Patient-Centered Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral candidate in Health Services Research, Policy, and Administration at the University of Minnesota School of Public Health with an interest and previous publications in the area of patient-provider communication, perceptions of care quality, and healthcare utilization. Dr. Johnson, my co-author, has extensive experience working with NHIS data and in the area of integrative, complementary, and traditional health practices.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.