Integrative medicine research at an academic medical center: patient characteristics and health-related quality-of-life outcomes.

OBJECTIVE: To characterize patients seeking care at a university-based integrative medicine practice, and to assess short-term changes in health-related quality of life (HRQoL) associated with integrative medical treatment.

DESIGN: Prospective, observational study.

SETTING: This study was conducted at a large U.S. academic medical center affiliated with the Consortium of Academic Health Centers for Integrative Medicine.

PARTICIPANTS: Seven hundred and sixty-three (763) new patients with diverse medical conditions participated in the study. Mean age was 49 years (standard deviation = 16, range = 14-93). Two thirds of patients were women and three quarters were white. The most common International Classification of Diseases 9th Revision medical diagnoses were malaise and fatigue, myalgia and myositis, allergy, anxiety or depression, hypertension, malignant neoplasm of the breast, lumbago, and irritable bowel disease. Over half the sample had two or more comorbid medical conditions.

OUTCOME MEASURE: The Medical Outcomes Study 36-item Short-Form (SF-36) health survey was used to measure HRQoL at initial assessment and 3-months following integrative medicine consultation.

RESULTS: Baseline SF-36 scores fell below the 25th percentile, indicating substantially compromised HRQoL. Physician-prescribed treatment modalities included anthroposophical medicine, nutritional medicine, Western herbs, homeopathy, nutritional counseling, and acupuncture. Three (3) month follow-up assessment revealed statistically significant improvements on all eight SF-36 subscales among survey respondents. HRQoL effect sizes ranged from 0.17 (Physical Functioning) to 0.41 (Social Functioning), with a mean of 0.30. HRQoL effects were consistent among demographic subgroups.

CONCLUSIONS: Integrative medical treatment at a university-based center is associated with significant increases in HRQoL for a medically diverse population with substantial comorbidity and functional limitations. Controlled studies that measure HRQoL and additional outcomes related to whole person health--physical, mental, social, and spiritual--are needed to determine the full therapeutic potential of integrative medicine, and to determine efficacy and cost-effectiveness relative to conventional medical care.