ABSTRACT
More than half of all Canadians use some form of complementary and alternative medicine (CAM) every year. The way CAM is being used, the magnitude of its use and the lack of clarity on standards of evidence make CAM a rising healthcare issue. A recent research priority-setting exercise by the Canadian Interdisciplinary Network for CAM Research (IN-CAM) identified three research priority areas: (1) healthcare delivery and policy research, including (a) exploring if and how CAM should be regulated, (b) defining what constitutes acceptable evidence of safety and efficacy, (c) investigating the organization and delivery of integrative healthcare; (2) methodological research, including exploring how best to assess whole systems of care and how to choose patient-, practitioner- and policy-relevant outcome measures; and (3) knowledge transfer, including formal education strategies, the provision of information and dialogue with those who use information in decision-making. The high use of CAM products and therapies leads to many questions from patients, practitioners and policy makers. The research agenda presented here provides a guide to begin programs of research that will answer these questions.
ABSTRACT
PURPOSE: The purpose of this study was to explore prostate cancer patients 'perceptions, feelings, ideas, and experiences regarding making decisions to use (or not use) complementary/alternative medicine (CAM). METHODS: Five focus groups were conducted with 29 men diagnosed with prostate cancer. Content analysis of the verbatim transcripts was used to identify key themes in the data. FINDINGS: Decision making about CAM treatments appears to depend on both fixed (e.g., disease characteristics, demographic characteristics, and medical history) and flexible (e.g., perceptions of CAM and conventional medicine, experiences with the health care system and health care practitioners, and perceptions about the need for control or action) decision factors. CONCLUSIONS: The participants in this study appeared more likely to be "pushed" toward using CAM by negative experiences with the health care system than to be "pulled" toward CAM by perceptions about its safety or congruence with their beliefs about health and illness.
Subject(s)
Choice Behavior , Complementary Therapies/statistics & numerical data , Patient Acceptance of Health Care/psychology , Prostatic Neoplasms/therapy , Aged , Aged, 80 and over , Complementary Therapies/psychology , Conflict, Psychological , Focus Groups , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Neoplasm Staging , Ontario , Physician-Patient Relations , Prostatic Neoplasms/psychology , Socioeconomic FactorsABSTRACT
OBJECTIVES: To ascertain the prevalence of the use of complementary/alternative medicine (CAM) among a random sample of Ontario (Canadian) men diagnosed with prostate cancer and to explore in what way users of CAM differ from nonusers. METHODS: A questionnaire was mailed to a random sample of 696 men diagnosed with prostate cancer. RESULTS: The final response rate was 78.8%. Almost one third (29.8%) reported using CAM for their prostate cancer care. Natural health products (most commonly vitamin E, saw palmetto, and selenium) were used by 26.5% of the respondents. CAM therapies were used by 17.0% of the men (most commonly dietary changes), and only 9.1% visited CAM practitioners. Three characteristics appear to differentiate CAM users from nonusers. Men who had attended support groups were much more likely to use CAM. Men who had more advanced disease, and those who believed in the efficacy of CAM, but were not concerned about potential adverse effects of CAM, were also more likely to use CAM. CAM use was not related to education, income, or geographic location. CONCLUSIONS: The data suggest that CAM use is no longer a phenomenon restricted to a unique segment of the population that is highly educated and enjoys a high family income. CAM use appears to be more related to other factors such as support group attendance, disease characteristics, and beliefs about CAM. Our findings highlight the need for urologists to ask all their patients about their use of CAM.
