The use of complementary and alternative therapies in people with chronic diseases is an under-researched area, despite the fact that these therapies can interact with mainstream health treatment, such as prescription medicines. The latest column from PHCRIS (the Primary Health Care Research and Information Service) outlines the findings of a new study into complementary and alternative medicine use among people in a regional South Australian community.

Jodie Oliver-Baxter writes: 
Lessening the burden of chronic disease is a growing concern at individual, community, national and global levels.

There is some evidence that Complementary and alternative medicine (CAM) use is higher for people with a chronic disease.

CAM is commonly divided into two categories based on the modalities employed – medication-based (e.g., multivitamins) or procedure-based (e.g., massage,) manual therapies. In addition the scientific evidence for most CAM use is limited.

The authors of this study acknowledge that understanding the prevalence of CAM use in this regional population is vital because people managing chronic disease are more likely to require multiple prescription medications, thus increasing the potential for adverse drug-herbal medicine interactions.

There was also concern that studies conducted elsewhere may not be generalisable to the Australian rural/regional context.

This project sought to explore biological, psychosocial and environmental determinants of chronic health conditions (N = 1138). Participants were based in regional South Australia.

Findings indicate the prevalence of CAM use in this regional community was slightly lower (~30%) than in other rural communities outside of South Australia. CAM service users had a higher socioeconomic status than non-users, but CAM supplement users were not different socioeconomically from their counterparts.

Similar to previous research, multivitamin supplements, fish oil and glucosamine were the most frequently reported CAM consumed.

Critically, this study limited CAM services to the three categories – chiropractors, alternative therapists, and massage therapists.

In addition there may have been misclassification of CAM medicine use as this relied on the participants determining their reason for taking the medication. For example CAM can be taken to treat a disease, to treat symptoms or side-effects of treatment and for prevention.

This study identified that although participants who used CAM were no more likely to have a chronic disease, they were more likely to be higher users of the mainstream health system, and taking prescription medications.

This finding has particular relevance for consumers and practitioners, as authors reiterate, there are risks associated with combined mainstream and CAM use.


This article was originally published in the Australian Health Review.

Who uses complementary and alternative therapies in regional South Australia? Evidence from the Whyalla Intergenerational Study of Health

Katina D’Onise, Matthew T. Haren, Gary M. H. Misan and Robyn A. McDermott. (2013).

Australian Health Review, 37(1), 104-111.

It can be read in conjunction with the latest RESEARCH ROUNDup: ‘Complementary medicine use in chronic disease: What is the evidence?’  featured in the 4th July 2013 edition of PHC RIS eBulletin.

The eBulletin is designed to inform readers of recently published articles and reports, news items, media releases, upcoming conferences and courses, research grants, scholarships and fellowships, PHCRIS products and services and relevant websites in the primary health care field.

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Previous PHCRIS columns at Croakey

• Some advice for researchers and services wanting to improve Aboriginal health

• Reduced access to GPs for low SES consumers: Canadian study 

• The uncertain merits of pay for performance funding systems

• The impact of dementia on couples and a plan for more equitable healthcare

•  Could this approach help make integrated care a reality?

• From nurse prescribing to an Australian experiment

 Some Canadian lessons on primary health care reform and facing up to dilemmas of public health advocacy

• Patients with chronic conditions value the sense of control they gain from using complementary and alternative medicines; and five suggestions for how primary health care researchers can boost global health

• Wrapping three articles on: improving organisation of services, caution on smartphone use, nurse practitioners in primary care

• How best to improve management of childhood obesity and related health problems

Sustaining small rural primary health care services

• What is the evidence on knowledge translation strategies?

• Should your doctor be asking after your pet too?

• Nurses add value to chronic disease management

• For patients to play a more active role in managing chronic health conditions, some changes are needed

• Some useful tips for finding health policy information on the web

• Pros and cons of telehealth for people in rural areas

• What helps GPs provide better mental healthcare (and what doesn’t)

• Improving collaboration in diabetes care

• Improving dementia management in general practice

• Improving the diagnosis of ovarian cancer

• Chronic health problems and depression

• Helping older patients with chronic diseases to navigate the health system

• Tackling overuse of antibiotics

• When doctors prescribe exercise, does it make any difference?

• Caring for country is also good for Aboriginal people

• The perils of surrogate markers

• Are Australians willing to pay more for better oral health?

• What helps encourage self-care for those with chronic illness?

• More effort needed to strengthen shared care for people with serious mental illness

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