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Physicians should inquire about patients’ complementary and alternative medicine use

More than 40% of patients who used complementary and alternative medicine did not disclose that use to their primary care physicians, according to research recently published in JAMA Internal Medicine.

Judy Jou, MA, division of health policy and management, University of Minnesota, and Pamela Jo Johnson, MPH, PhD, center for spirituality and healing, University of Minnesota, encouraged physicians to ask patients about complementary and alternative medicine to improve outcomes.

"Although one-third of U.S. adults report using complementary and alternative medication (CAM), integration of CAM into the conventional medical system is inconsistent," they reported. "Patients have shown a desire for their primary care physicians to inquire about CAM and refer to CAM practitioners (acupuncturist, massage therapists, etc), but primary care physicians rarely initiate conversations with patients about their use of CAM. Patients have also expressed concerns about discussing the use of CAM with their physicians, fearing disapproval."

Jou and Johnson analyzed CAM patterns in the 2012 National Health Interview Survey (NHIS) from January through December 2012.

They found that among the 34,525 adults who completed the CAM supplement of the 2012 NHIS, 10,158 reported using CAM in the last year, 22,765 reported having a primary care physician and 7,493 reported both using CAM and having a primary care physician. Of those who use both, 42.3% did not disclose the use of their most-used CAM modality to their primary care physicians.

Jou and Johnson also found that nondisclosure was more common among participants who were doing yoga (64.7%) and meditation (64%) and less common among participants among participants who used herbs and/or supplements (24.9%) and acupuncture (35.5%). Participants reported that nondisclosure was most likely due to physicians not asking about CAM use (57%) and not thinking that physicians needed to know about CAM use (46.2%).

"Physicians should consider more actively inquiring about patients’ use of CAM, especially for modalities likely to be medically relevant," Jou and Johnson concluded. "Incorporating more education about CAM into medical curricula can better equip physicians to initiate conversations with patients relating to their use. In addition, including CAM physicians in groups such as accountable care organizations can improve communication between physicians and streamline patient records. Clinical and organizational incentives that encourage patient disclosure of CAM use may facilitate better coordination of care, reduce the risk of adverse interactions between conventional medications and CAM products, and lead to better patient outcomes." – by Chelsea Frajerman Pardes

Disclosures: The researchers report no relevant financial disclosures.