Presented at the 2013 AAPM Annual Meeting « Back

Complementary and Alternative Medicine Use, Effectiveness, Interest, and Barriers to Use at a Tertiary-Care Pain Medicine Center

Mehul J. Desai, MD MPH, mdesai@mfa.gwu.edu¹, Audrey Spelde, BA², Sasha E. Knowlton, MD³, Andrew Nava, MD², (1) GW Spine & Pain Center, Washington, D.C., (2) George Washington University, Washington, D.C., (3) Lahey Clinic, Burlington, Massachusetts

Introduction: The popularity of complementary and alternative medicine (CAM) increased significantly in the U.S. over the last decade, particularly in patients with chronic pain (1). Despite this increase, chronic pain patients continue to experience barriers to CAM access while their physicians remain unaware of their use (2, 3). We attempted to quantify the extent of CAM use by patients with painful conditions and to characterize their interactions with pain physicians regarding CAM use. Methods: Following Institutional Review Board approval, we performed an anonymous, prospective survey of patients at a tertiary-care spine & pain center. Data collected included patient demographics, pain characteristics, experiences with and perceived barriers to utilizing CAM, and communication with pain physicians regarding CAM. Results: 65% of respondents indicated prior CAM use. Pain physicians were least likely to ask about CAM use to those in the 31-50 year age range (51.7%), of female gender (55.8%), of Asian/Indian ethnicity (25%), who completed some graduate school (45%), and with a yearly income between $50-100,000 (52.5%). Of the 35.7% indicating perceived barriers to CAM use, the most common barriers were expense (28.7%), lack of providers (14%), and lack of insurance coverage (11.6%). Conclusion: Despite interest, barriers to CAM use remain. Disparities exist regarding patient-physician discussion of CAM use. This group utilized CAM at a higher rate than previous reports (65% vs. 38%), which might reflect an improvement in communication and access. There remain groups with whom discussion is limited. Improved access to and physician-patient discussion of CAM use are ongoing issues.

Funding: None.