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      Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use

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          Abstract

          Background

          There is increasing evidence that complementary medicine (CM) services are being used by a substantial proportion of the Australian population and this topic has attracted keen interest from primary health care providers and policy makers. This article outlines the first summative critical review of the predictors of CM use in Australia as well as the characteristics and perceptions of Australian CM users over the last 14 years.

          Methods

          A literature search was conducted to ascertain original research from 2000 to 2014 in the AMED; CINAHL; and PubMed databases. Selected articles were subject to a critical appraisal analysis to identify the quality of the article. The search was confined to peer reviewed original articles published in English which identified the nature of CM services use in Australia.

          Results

          The findings indicate a correlation between CM users and gender, with reports of a higher rate of use from females compared to males. Female CM users are more likely to be middle-aged with a higher education and higher annual income in comparison to female non-CM users. An association between resident location and use of CM disciplines was also identified with reports of rural residents utilising manual therapies more frequently compared to urban residents. CM users are more likely to seek CM services for a range of chronic conditions including diseases identified as National Health Priority Areas by the Australian Government.

          Conclusions

          This article provides the first comprehensive review examining the nature of CM use in Australia. The review findings offer important insights into the characteristics and features of CM use in Australia and provide insights for national and regional primary health care initiatives and of interest to medical doctors, allied health professionals, CM practitioners, researchers and policy makers.

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          Most cited references83

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          Complementary and alternative medicine use in Australia: a national population-based survey.

          To investigate the use of and expenditure on 17 of the most popular forms of complementary and alternative medicine (CAM) by adult Australians, sociodemographic characteristics of CAM users, and communication between CAM users and their doctors. In May-June 2005, a sample of 1067 adults, 18 years and older, from all Australian states and territories, was recruited by random-digit telephone dialing and interviewed about their CAM use in the previous 12 months. In the 12-month period, 68.9% (95% CI: 66.1%-71.7%) of those interviewed used at least one of the 17 forms of CAM and 44.1% (95% confidence interval: 41.1%-47.1%) visited a CAM practitioner. The estimated number of visits to CAM practitioners by adult Australians in the 12-month period (69.2 million) was almost identical to the estimated number of visits to medical practitioners (69.3 million). The annual "out of pocket" expenditure on CAM, nationally, was estimated as 4.13 billion Australian dollars (US $3.12 billion). Less than half of the users always informed their medical practitioners about their use of CAM. The most common characteristics of CAM users were: age, 18-34; female; employed; well-educated; private health insurance coverage; and higher-than-average incomes. CAM use nationally in Australia appears to be considerably higher than estimated from previous Australian studies. This may reflect an increasing popularity of CAM; however, regional variations in CAM use and the broader range of CAM included in the current study may contribute to the difference. Most frequently, doctors would not appear to be aware of their patient use of CAM.
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            Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use

            Complementary and Alternative Medicines (CAM) are used by an extensive number of patients in the UK and elsewhere. In order to understand this pattern of behavior, it is helpful to examine the characteristics of people who use CAM. This narrative review collates and evaluates the evidence concerning the demographic characteristics and health status factors associated with CAM use in community-based non-clinical populations. A systematic literature search of computerized databases was conducted, and published research papers which present evidence concerning associations between CAM use and demographic and health characteristics are discussed and evaluated. The evidence suggests that people who use CAM tend to be female, of middle age and have more education. In terms of their health, CAM users tend to have more than one medical condition, but might not be more likely than non-users to have specific conditions such as cancer or to rate their own general health as poor. The multivariate studies that have been conducted suggest that both demographic and health characteristics contribute independently to CAM use. In conclusion, demographic characteristics and factors related to an individual's health status are associated with CAM use. Future research is needed to address methodological limitations in existing studies.
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              Use of complementary or alternative medicine in a general population in Great Britain. Results from the National Omnibus survey.

              A representative sample of the adults in England, Scotland and Wales was interviewed to estimate levels of use of complementary or alternative medicines (CAMs) and their socio-economic correlates. The Omnibus survey is a multi-purpose survey carried out in the United Kingdom by the Office for National Statistics on behalf of non-profit making organizations. The survey is carried out in 2 out of 3 months each quarter using a stratified random, probability sample of households. An eight-question module was added to the interview schedule of the survey in March 2001. Topics included practitioner-based use of 23 named CAM therapies in the past 12 months. The resulting data were analysed in conjunction with socio-economic and demographic variables. A response rate of 65 per cent (1794/2761) was achieved. An estimated 10.0 per cent of the population [95 per cent confidence interval (CI) 8.7-11.5 per cent] had received any CAM therapy from a practitioner in the past year. No individual therapy was used by more than 2 per cent of the sample. An estimated 6.5 per cent (95 per cent CI 5.4-7.6) had used one of the five main therapies: acupuncture, homeopathy, chiropractic, osteopathy or herbal medicine. Estimates of CAM use were similar in England, Scotland and Wales. There was a significant positive association between CAM use and non-manual social class (p < 0.002), age left full-time education (p < 0.001), and gross income over pounds sterling 15,600 (p < 0.001). More than half (52 per cent) of the respondents that had used CAM in the past year had not told their general practitioner. Strong correlations between the use of CAM and gross socio-economic indicators are demonstrated in the survey. Repeated national surveys of this type could provide a useful vehicle for collecting information about changing patterns of CAM use on a routine basis.
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                Author and article information

                Contributors
                Amie.Steel@uts.edu.au
                Journal
                BMC Complement Altern Med
                BMC Complement Altern Med
                BMC Complementary and Alternative Medicine
                BioMed Central (London )
                1472-6882
                11 June 2016
                11 June 2016
                2016
                : 16
                : 176
                Affiliations
                [ ]Australian Research Centre in Complementary and Integrative Medicine, University of Technology, Sydney, Ultimo, NSW 2007 Australia
                [ ]Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, QLD 4006 Australia
                Article
                1143
                10.1186/s12906-016-1143-8
                4902999
                27289517
                178c2281-cd6b-48c4-a45b-17addacffb7a
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 December 2015
                : 25 May 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Complementary & Alternative medicine
                complementary medicine,health services use,chronic disease,sociodemographics,sociological factors

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