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DOI: 10.1055/s-2008-1081505
© Georg Thieme Verlag KG Stuttgart · New York
The Use of Complementary Alternative Medicine (CAM) in 1 001 German Adults: Results of a Population-Based Telephone Survey
Inanspruchnahme von Alternativverfahren bei 1 001 deutschen Erwachsenen: Ergebnisse eines bervölkerungsbezogenen TelephonsurveysPublikationsverlauf
Publikationsdatum:
10. September 2008 (online)
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Abstract
Aim of the Study: The objective of this study was to evaluate the patterns of use of complementary alternative medicine (CAM) in a representative adult population in Germany.
Methods: A population-based telephone survey was conducted in Lübeck, Germany. We performed computer-assisted telephone interviews (CATI) in order to obtain information on demographics, health status, prevalence of CAM usage, motivation for using CAM, type of CAM and health problems for which CAM were used.
Results: 1 001 adults (median age 48 years) participated in the study (response 46.8%). 79.6% of the interviewed subjects reported health problems. The most frequently named problems were chronic pain (45.3%), circulation problems (32.9%) and colds with fever (27.8%). Non-users of CAM had a lower incidence (76.6%) of overall illness than users (83.5%) (OR 0.65, 0.47–0.89). 42.3% of the participants had used CAM. The CAM user group consisted of significantly more females (72.8 vs. 55.5%) (OR 2.32, 1.74–3.08) and involved better educated subjects (school education >12 years, 36.6 vs. 27.9%, OR 3.25, 1.35–7.81) than the non-user group. The main health problems for which CAM was used were chronic pain (36.3%), some cases of uncomplicated colds (16.9%) and for improving general health (14.7%). Three procedures accounted for the majority of usage: Acupuncture (34.5%), homeopathy (27.3%) and herbal medicine (9.7%). A large number of participants reported as the main reason for using CAM the wish to avoid drugs as much as possible (31.7%). 26.7% reported opting for CAM due to the recommendation of their physician. 23.9% gave unsatisfactory results of conventional medicine as reason for CAM usage.
Conclusions: CAM is used widely for different complaints by the general population. This frequent use of CAM has implications for the health-care system and health policy.
Zusammenfassung
Ziel der Studie: Ziel der Studie war es, die Determinanten der Inanspruchnahme so genannter Alternativverfahren in einer repräsentativen Erwachsenenpopulation Deutschlands zu bestimmen.
Methodik: Es wurden computerunterstützte und populationsbasierte Telefoninterviews in Lübeck, Deutschland, durchgeführt. Dabei wurden Informationen zur Demografie, dem Gesundheitszustand, der Häufigkeit, der Inanspruchnahme und der Art des Alternativverfahrens sowie zur Motivation und zur behandelten Gesundheitsstörung erfasst.
Ergebnisse: Insgesamt nahmen 1 001 Erwachsene mit einem Altersmedian von 48 Jahren an der Studie teil (Teilnahmequote 46,8%). Von den interviewten Personen berichteten 79,6% Gesundheitsprobleme. Dabei wurden chronische Schmerzen (45,3%), Kreislaufstörungen (32,9%) und Erkältungskrankheiten ohne Fieber (27,8%) am häufigsten genannt. Nicht-Nutzer von Alternativverfahren gaben insgesamt seltener (76,6%) Gesundheitsstörungen an, als Nutzer (83,5%) (OR 0,65, 0,47–0,89). Von den Teilnehmern hatten 42,3% jemals Alternativverfahren angewandt. Die Anwender waren signifikant häufiger weiblichen Geschlechts (72,8 vs. 55,5%) (OR 2,32, 1,74–3,08) und besser ausgebildet (Schulbildung >12 Jahre, 36,6 vs. 27,9%, OR 3,25, 1,35–7,81) als die Nichtanwender. Am häufigsten wurden Alternativverfahren zur Behandlung chronischer Schmerzen (36,3%), unkomplizierter Erkältungskrankheiten (16,9%) oder zur allgemeinen Gesundheitsstärkung (14,7%) eingesetzt. Drei Verfahren deckten die Mehrheit der Anwendungen ab. Akupunktur (34,5%), Homöopathie (27,3%) und Phytotherapie (9,7%). Die Hauptmotivation für die Anwendung von Alternativverfahren lag in dem Wunsch, auf Arzneimittel so weit wie möglich verzichten zu wollen (31,7%) und 23,9% gaben unbefriedigende Ergebnisse mit der herkömmlichen medizinischen Behandlung als Hauptmotivation an. 26,7% wandten die Verfahren auf Empfehlung ihres Arztes an.
Schlussfolgerungen: So genannte Alternativverfahren werden von der Allgemeinbevölkerung häufig und für verschiedene Gesundheitsstörungen angewandt. Dieser häufige Gebrauch hat Auswirkungen auf das Gesundheitssystem und die Gesundheitspolitik.
Key words
adults - complementary alternative medicine - determinants - Germany - telephone survey
Schlüsselwörter
Alternativmedizin - Determinanten - Deutschland - Erwachsene - Telefoninterviews
References
- 1 Al-Windi A. Determinants of complementary alternative medicine (CAM) use. Complement Ther Med. 2004; 12 99-111
- 2 Sommer J, Bürgi M, Theiss R. Verbreitungsmuster alternativer Heilmethoden in der Schweiz – Eine empirische Untersuchung. Forsch Komplementarmed. 1996; 3 289-299
- 3 Barnes PM, Powell-Griner E, MacFann K, Nahin RL. Complementary and alternative medicine use among adults: United States 2002. Adv Data. 2004; 343 1-19
- 4 MacLennan A, Wilson D, Taylor A. Prevalence and cost of alternative medicine in Australia. Lancet. 1996; 347 569-573
- 5 Ernst E, White A. The BBC survey of complementary medicine use in the UK. Complement Ther Med. 2000; 8 32-36
- 6 Eisenberg D, Davis R, Ettner S, Appel S, Wilkey S, Rompay M Van, Kessler R. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA. 1998; 280 1569-1575
- 7 Burge S, Albright T. Use of Complementary and Alternative Medicine among Family Practice Patients in South Texas. Am J Public Health. 2002; 92 1614-1616
- 8 Härtel U, Volger E. Inanspruchnahme und Akzeptanz klassischer Naturheilverfahren und alternativer Heilmethoden – Ergebnisse einer repräsentativen Bevölkerungsstudie. Forsch Komplementarmed Klass Naturheilkd. 2004; 11 327-334
- 9 Ernst E, Resch K, Mills S. Complementary medicine – a definition. Br J Gen Pract. 1995; 45 506
- 10 Eisenberg D, Kessler R, Foster C, Norlock F, Calkins D, Delbanco T. Unconventional medicine in the United States. Prevalence, costs and pattern of use. N Engl J Med. 1993; 328 246-252
- 11 Yamashita H, Tsukayama H, Sugishita C. Popularity of complementary and alternative medicine in Japan: a telephone survey. Complement Ther Med. 2002; 10 84-93
- 12 Fischer R, Meyer N, Weikunat R, Crispin A, Schotten K, berla K. Bevölkerungsbezogenes Gesundheitsmonitoring in Bayern mit computerassistierten Telefoninterviews. Gesundheitswesen. 2002; 63 123-129
- 13 Lampert T, Burger M. Rauchgewohnheiten in Deutschland – Ergebnisse des telefonischen Bundes- Gesundheitssurveys 2003. Gesundheitswesen. 2002; 66 511-517
- 14 Koch A. Wenn „mehr” nicht gleichbedeutend mit „besser” ist: Ausschöpfungsquoten und Stichprobenverzerrungen in allgemeinen Bevölkerungsumfragen. ZUMA- Nachrichten. 1998; 42 66-90
- 15 Rafferty A, MacGee H, Miller C, Reyes M. Prevalence of Complementary and Alternative Medicine Use: State-specific Estimates from the 2001 Behavioral Risk Factor Surveillance System. Am J Public Health. 2002; 92 1598-1600
- 16 Lee G, Charn T, Chew Z, Ng T. Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs. Fam Pract. 2002; 21 654-660
- 17 Oldendick R, Coker A, Wieland D, Raymond J, Probst J, Schell B, Stoskopf C. Population-based survey of complementary and alternative medicine usage, patient satisfaction, and physician involvement. South Med J. 2000; 93 375-381
- 18 Ong C, Peterson S, Bodeker G, Stewart-Brown S. Health Status of People Using Complementary and Alternative Medical Practitioner Services in 4 English Counties. Am J Public Heath. 2002; 92 1653-1656
- 19 Menniti-Ippolito F, Gargiulo L, Bologna E, Forcella E, Raschetti R. Use of unconventional medicine in Italy: a nation-wide survey. Eur J Clin Pharmacol. 2002; 58 61-64
- 20 Astin J. Why patients use alternative medicine. Results of a national study. JAMA. 1998; 279 1548-1553
- 21 Bullock M, Pheley A, Kiresuck T, Lenz S, Culliton P. Characteristics and complaints of patients seeking therapy at a hospital-based alternative medicine clinic. J Altern Complement Med. 1997; 3 23-27
- 22 Bernstein J, Shuval J. Nonconventional medicine in Israel: consultation patterns of the Israeli population and attitudes of primary care physicians. Soc Sci Med. 1997; 44 1341-1348
- 23 Abbot N, Ernst E. Patients opinions about complementray medicine. Forsch Komplementarmed. 1997; 4 164-168
- 24 Ernst E, Fugh-Berman A. Complementary and alternative medicine: what is it all about?. Occup Environ Med. 2002; 59 140-144
- 25 Schneider B, Hanisch J, Weiser M. Complementary medicine prescription patterns in Germany. Ann Pharmacother. 2004; 38 502-507
- 26 Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997–2002. Altern Ther Health Med. 2005; 11 42-49
- 27 Huber R, Koch D, Beiser I, Zschocke I, Luedtke R. Experience and attitudes towards CAM – a survey of internal and psychosomatic patients in a German university hospital. Altern Ther Health Med. 2002; 10 32-36
- 28 Ernst E. Complementary therapies for asthma: what patients use. J Asthma. 1998; 35 ((8)) 667-671
- 29 Druss B, Rosenheck R. Association between use of unconventional therapies and conventional medical services. JAMA. 1999; 282 651-656
- 30 Happle R. The essence of alternative medicine. A dermatologistŽs view from Germany. Arch Dermatol. 1998; 134 1455-1460
- 31 Melchart D, Linde K, Fischer P, Berman B, White A, Vickers A, Allais G. Acupuncture for idiopathic headache. Cochrane Database Syst Rev. 2005; CD001218
- 32 Furlan A, Tulder M van, Cherkin D, Tsukayama H, Lao L, Koes B, Berman B. Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev. 2001; CD001351
- 33 Trampisch HJ. Akupunktur sticht Standardtherapie aus. Nadeln wirken gegen Kreuz- und Knieschmerz. Erste Ergebnisse der gerac- Studien. Presse- Info. 2004; 308 http://www.gerac.de
- 34 Becker-Witt C, Brinkhaus B, Jena S, Weber K, Linde K, Streng A, Wagenpfeil S, Melchart D, Willich S. Efficacy of acupuncture in patients with pain due to osteoarthritis of the knee – the Acupuncture Randomised Trials (ART). Biom J. 2004; 46 34
- 35 Brinkhaus B, Becker- Witt C, Jena S, Weber K, Linde K, Streng A, Wagenpfeil S, Melchart D, Willich S. Efficacy of acupuncture in patients with chronic low back pain – the Acupuncture Randomised Trials (ART). Biom J. 2004; 46 113
- 36 Linde K, Streng A, Reitmayr S, Hoppe A, Brinkhaus B, Becker-Witt C, Wagenpfeil S, Weidenhammer W, Willich S, Melchart D. Efficacy of acupuncture in patients with migraine – the Acupuncture Randomised Trials (ART). Biom J. 2004; 46 34
- 37 Melchart D, Streng A, Hoppe A, Brinkhaus B, Witt C, Wagenpfeil S, Pfaffenrath V, Hammes M, Hummelsberger J, Irnich D, Weidenhammer W, Willich SN, Linde K. Acupuncture in patients with tension-type headache: randomised controlled trial. BMJ. 2005; 331 376-382
- 38 Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S, Hummelsberger J, Walther HU, Melchart D, Willich SN. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet. 2005; 366 136-143
- 39 Rabe A, Weiser M, Klein P. Effectiveness and tolerability of a homoeopathic remedy compared with conventional therapy for mild viral infections. Int J Clin Pract. 2004; 58 827-832
- 40 Taylor M, Reilly D, Llewellyn-Jones R, MacSharry C, Aitchison T. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. BMJ. 2000; 321 471-476
- 41 Ernst E. A systematic review of systematic reviews of homeopathy. Br J Clin Pharmacol. 2002; 54 577-582
- 42 Almeida R. A critical review of the possible benefits associated with homeopathic medicine. Rev Hosp Clin Fac Med Sao Paulo. 2003; 58 324-331
- 43 Ernst E, Pittler M, Stevinson C. Complementary/alternative medicine in dermatology: evidence-assessed efficacy of two diseases and two treatments. Am J Clin Dermatol. 2002; 3 341-348
- 44 Ernst E. The role of complementary and alternative medicine. BMJ. 2000; 321 1133-1135
- 45 Long L, Soeken K, Ernst E. Herbal medicines for the treatment of osteoarthritis: a systematic review. Rheumatology (Oxford). 2001; 40 779-793
- 46 Zhang W, Leonard T, Bath-Hextall F, Chambers C, Lee C, Humphreys R, Williams H. Chinese herbal medicine for atopic eczema. Cochrane Database Syst Rev. 2004; 18
- 47 Zhu X, Proctor M, Bensoussan A, Smith CA, Wu E. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev. 2007; ((4)) CD005288
- 48 Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. 2006; ((4)) CD003521
- 49 Coulter MK, Dean ME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database Syst Rev. 2007; ((4)) CD005648
- 50 Lim B, Manheimer E, Lao L, Ziea E, Wisniewski J, Liu J, Berman B. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2006; ((4)) CD005111
- 51 Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J. ARIA update: I-Systematic review of complementary and alternative medicine for rhinitis and asthma. J Allergy Clin Immunol. 2006; 117 ((5)) 1054-1062
Correspondence
Prof. Dr. med. T. SchäferMPH
Scharbeutzer Str. 23
23684 Scharbeutz
eMail: torsten.schaefer4@gmx.de