TitleComplementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO.
Publication TypeJournal Article
Year of Publication2008
Authorsvan Tilburg MAL, Palsson OS, Levy RL, Feld AD, Turner MJ, Drossman DA, Whitehead WE
JournalBMC Complement Altern Med
Volume8
Pagination46
Date Published2008
ISSN1472-6882
KeywordsAbdominal Pain, Adult, Complementary Therapies, Constipation, Cost-Benefit Analysis, Delivery of Health Care, Integrated, Diarrhea, Female, Ginger, Health Maintenance Organizations, Humans, Irritable Bowel Syndrome, Male, Massage, Middle Aged, Patient Satisfaction, Phytotherapy, Professional-Patient Relations, Prospective Studies, Surveys and Questionnaires, United States, Yoga
Abstract

BACKGROUND: Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain.

METHODS: 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims.

RESULTS: CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice.

CONCLUSION: CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

DOI10.1186/1472-6882-8-46
Alternate JournalBMC Complement Altern Med
PubMed ID18652682
PubMed Central IDPMC2499988
Grant List3R24DK067674-03 / DK / NIDDK NIH HHS / United States
R01 DK31369 / DK / NIDDK NIH HHS / United States
R24 DK067674 / DK / NIDDK NIH HHS / United States