Patientsx perspective in chronic pain management using Complementary and Alternative Medicine (CAM) in a primary care setting, a pilot CAM-integration project in Bogota D.C

Tunjuelito Hospital participated of a pilot project to integrate Complementary and Alternative Medicine (CAM) services into the Health Department´s public healthcare network in Bogota, Colombia. Along with the implementation of the CAM service, the Health Department required that participant institutions develop a research project.  Tunjuelito Hospital prioritized patients with chronic pain. The aim of the study was to understand the participants’ perceptions of their experience at the newly-established CAM service. Participants were referred to the CAM service by their primary care physicians or the nurse in charge of the hospital´s chronic diseases´ program.  Twenty-one patients, randomly selected, were interviewed. After consenting, interviews were audiotaped and transcribed. Data was analyzed using NVivo.  Participants’ ages ranged between 36 and 85 years old and lived in neighborhoods classified on the lowest two (out of six) socio-economic status categories, as defined by the city. Only a third of them had some education higher than sixth grade. Chronic pain duration ranged between 3 months and several years; patients often had other concurrent chronic illnesses.  Analysis of interviews showed the social, cultural and clinical importance of non-conventional health practices in the local context, particularly, in the treatment of patients with chronic pain. The data showed that boundaries between conventional and non-conventional health practices are blurry, often overlap, and represent a continuum of care in the local context. Nevertheless, participants also pointed to differences among the two and discussed specific characteristics of the CAM service they valued.  Access to CAM services, safety, and clinical effectiveness were examined.