More adults use complementary and alternative medicine, but access is unequal, British survey says

Use of complementary and alternative medicine (CAM) services, such as acupuncture, massage, osteopathy, and chiropractic treatment, rose from 12 percent of England’s population in 2005 to 16 percent of the population in 2015, according to a survey led by researchers at the University of Bristol's Centre for Academic Primary Care. However, access to these treatments was unequal, with women, those who are financially better off, and those in the south of England more likely to use CAM therapies.

The survey, funded by the National Institute for Health Research and published earlier today in the BJGP Open online journal, asked adults in England about their CAM use in the last 12 months. Out of a representative sample of 4,862 respondents aged 15 and over, 766 (16 percent) said they had seen a CAM practitioner.

More women than men and more people in higher socioeconomic groups than in lower socioeconomic groups used CAM. Additionally, CAM use was almost twice as high in the south of England compared with the North and Midlands.

Nearly 67 percent of CAM users either paid for treatment themselves or had it paid for by friends or family. About 70 percent of CAM users self-referred, and either found the practitioners themselves or through a recommendation from a friend or family. Around 17 percent were referred by their primary care provider or other health professional (4 percent).

The main reasons for CAM use were for musculoskeletal problems, particularly back pain (38 percent), and other musculoskeletal pain such as neck pain, shoulder pain, and knee pain (22 percent). Mental health accounted for 12 percent of CAM use, including for minor depression, anxiety, and stress (seven percent) and sleep problems, tiredness and fatigue (four percent).

CAM use was evenly spread across all age groups, researchers said.

Debbie Sharp, PhD, from the Centre for Academic Primary Care and lead author of the study, said the survey shows that CAM is widely used by the general population, especially for musculoskeletal and mental health problems, with a slight increase in use since 2005. Access, however, is unequal and most people who see a CAM practitioner are better off and pay for it themselves.

“We also asked about people's willingness to pay for CAM and found, unsurprisingly, that it seemed to be based on ability to pay,” said Sharp. “However, 13 percent of non-CAM users said they would be willing to part-pay if the NHS or other organizations paid the rest."

Current United Kingdom health policy advocates patient-centered care and has a focus on prevention and patient self-management, said study co-author Ava Lorenc, PhD. Greater integration of CAM services into NHS primary care could address the inequality in access that we found, for example, through social prescribing.

“This survey was part of a wider scoping study for a trial to test the effectiveness of CAM for people with both musculoskeletal and mental health problems, she said, “which we hope will add to the evidence-base for CAM."