Medical skepticism and the use of complementary and alternative health care providers by patients followed by rheumatologists

Leigh F Callahan, Janet K Freburger, Thelma J Mielenz, Elizabeth K Wiley-Exley
Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases 2008, 14 (3): 143-7

BACKGROUND: Our understanding of the determinants of use of complementary and alternative (CAM) providers is limited, especially in regard to medical skepticism (ie, doubt in the ability of conventional medical care to appreciably alter health status).

OBJECTIVES: To determine whether medical skepticism was associated with CAM provider use in patients with arthritis and to explore the association between medical skepticism and demographic and health-related characteristics of persons with arthritis.

METHODS: A cross-sectional analysis of data from patients (N = 721) with osteoarthritis, rheumatoid arthritis, or fibromyalgia who completed a questionnaire about their health, health care use, and health-related attitudes/behaviors, including medical skepticism. Patients were recruited from 14 rheumatology practices in North Carolina. A multiple logistic regression analysis was conducted to examine the relationship between medical skepticism and the use of any CAM providers. Multiple linear regression analysis was conducted to examine relationships between medical skepticism and demographic and health-related measures.

RESULTS: Fifteen percent of the sample used one or more CAM providers. Medical skepticism was positively associated with CAM provider use. A one point increase in skepticism increased the probability of CAM provider use by approximately 70% (odds ratios =1.70; 95% confidence intervals [1.13-2.56]). Individuals, who were younger, had better perceived health, and had a diagnosis of osteoarthritis or fibromyalgia had greater skepticism.

CONCLUSIONS: By knowing more about medical skepticism and other determinants of CAM provider use, conventional practitioners can target patients to improve their uptake of appropriate conventional care, while also monitoring patients alternative therapy use.

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