Alternative Therapies and Quality of Life
Nearly half of adults in the United States use complementary and alternative medicine (CAM) every year, and Americans are visiting CAM practitioners more frequently than primary care physicians. Worldwide, the prevalence rates of CAM use in adults ranged
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Springer Science+Business Media LLC 2010 (USA)
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Alternative Therapies and Quality of Life
Abstract: Nearly half of adults in the United States use > complementary and alternative medicine (CAM) every year, and Americans are visiting CAM practitioners more frequently than primary care physicians. Worldwide, the prevalence rates of CAM use in adults ranged from 9 to 76%. Despite the significant growth in CAM use in the past decade, there exists a lack of consistency in the body of CAM literature as to precisely what CAM is. There is also a paucity of evidence on the efficacy of CAM. The research on the efficacy of CAM use is faced with many challenges that are different from those associated with conventional medicine. Historically, the common drawbacks in CAM research include poor study design, small sample size, and inadequate controls. In recent years, high-quality research articles have begun to emerge in leading medical journals. However, the evidence on the efficacy of CAM use on quality of life (QOL) is not convincing. Even for those areas of CAM which have been studied with several relatively large trials, it is unclear whether the observed effect is due to true CAM intervention or placebo effect. List of Abbreviations: CAM, complementary and alternative medicine; CES-D, Center for Epidemiologic Depression Scale; CHF, congestive heart failure; HADS, Hospital Anxiety and Depression Scale; IBS, irritable bowel syndrome; NCCAM, National Center for Complementary and Alternative Medicine; OA, osteoarthritis; PSS, perceived stress scale; PST, periosteal stimulation therapy; RCTs, randomized controlled trials; SF-36, 36-item short-form health survey; SPPB, short physical performance battery; TCA, traditional Chinese acupuncture; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index
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Introduction
The proportion of the general population in the United States that reports using complementary and alternative medicine (CAM) has increased from 33.8% in 1990 to 42.1% by 1997 (Eisenberg et al., 1998), and the National Health Interview Survey indicated a continued growth of CAM use to 62.1% in 2002 (Barnes et al., 2004). The increased use of CAM was the result of a secular trend across all major socio-demographic sectors in the general population (Kessler et al., 2001). Corroborating evidence also suggested that nearly half of adults in the United States use CAM every year, and that Americans are visiting CAM practitioners more frequently than primary care physicians (Kelly et al., 2005; Nahin et al., 2005; Ruggie, 2005; Kelly et al., 2005, and Scharf et al., 2006). The growth in CAM use has been significant in the US in the past decade. Worldwide, a systematic review found that the prevalence rates of CAM use in general population ranged from 9 to 65% in developed economies with German having the highest prevalence rate, based upon various definitions of CAM (Ernst, 2000). A more recent study in Singapore, a city-state in south-eastern Asia, reported an even higher 76% prevalence rate (Li
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