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Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States.

Jones JF, Maloney EM, Boneva RS, Jones AB, Reeves WC. Complementary and alternative medical therapy utilization by perople with chronic fatiguing illnesses in the United States. BMC Complementary and Alternative Medicine 2007;7:12

The complete electronic version of this article is available at http://www.biomedcentral.com/1472-6882/7/12

Summary

Treatment of persons with CFS is a difficult issue both for those suffering the illness and for health care providers. This becomes more complicated because many patients become frustrated when they do not improve as rapidly as they had hoped and turn to complementary and alternative therapy modalities ( CAM). However, we were aware of no rigorous peer-reviewed population based studies that evaluated how frequently persons with unexplained fatiguing illnesses utilized CAM therapy. In this pilot study, we examined the use of CAM and conventional medical therapy in a cross-sectional population survey of fatiguing illnesses in the United States. We conducted standardized detail telephone interviews with members of randomly selected households from 8 metropolitan and rural areas of the US. The detailed interviews included 440 fatigued (49 had CFS-like illness, 338 were chronically fatigued not CFS and 53 had been fatigued < 6 months) and 444 non-fatigued respondents. Seventy-seven percent of all participants had used some for of a CAM during the year. Women (57%) were significantly more likely to use CAM than were men (44%) and those with higher educational levels were also more likely to have used CAM. Although the combined groups of fatigued subjects were more likely to have used CAM than the non fatigued (82 and 73%, respectively), there were no differences in CAM use between CFS-like, chronically fatigued, and persons fatigued <6 months. However, poorer physical and mental health and the presence of other medical and psychiatric conditions appeared to account for this greater utilization of CAM.

Abstract

Background : Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS), pose a diagnostic and therapeutic challenge. Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM) therapies used. This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population.

Methods : During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically based, and energy modalities.

Results : Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening. Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue, and 49 with CFS-like illness. Mind-body therapy (primarily personal prayer and prayer by others) was the most frequently used CAM across all groups. Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003). All categories of CAM use were associated with significantly poorer physical health scores, and all but one (alternative medicine systems) were associated with significantly poorer mental health scores. People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage) than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82). Use of body-based therapies increased significantly in a linear trend across subgroups of nonfatigued, prolonged fatigued, chronic fatigued, and CFS-like subjects (p-trend = 0.002). People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1.07, 2.16) and mind body (excluding prayer) therapy than non-fatigued participants (OR = 1.73, CI = 1.20 – 2.48).

Conclusion : Utilization of CAM was common in fatiguing illnesses, and was largely accounted for by the presence of underlying conditions and poor physical and mental health. Compared to non-fatigued persons, those with CFS-like illness or chronic fatigue were most likely to use body-based and mind-body therapies. These observations have important implications for provider education programs and development of intervention strategies for CFS.

Page last modified on October 24, 2007

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