To what extent is CAM used and who uses it?
A South Australian research team conducted population surveys
to determine the prevalence and cost of CAM in Australia in 1993,
2000 and 2004 (Maclennan, Wilson et al. 1996; Maclennan, Wilson
et al. 2002; Maclennan, Myers et al. 2006). In 1993, 48.5% of
the survey population used at least one non-medically prescribed
alternative or complementary medicine. This percentage increased
to 52.1% in 2000 and 52.2% in 2004. In 1993, just over 20% of
respondents had visited at least one alternative practitioner
while in 2000 and 2004, 23.3% and 26.5%, respectively, had visited
a CAM therapist. The most frequently visited CAM therapists are
chiropractors (16.7%) and naturopaths (5.7%). Over the years,
there has been a marked increase in the use of herbal medicines,
particularly among women.
Based on these surveys, the estimated cost of CAM for the Australian
population rose from $930 million in 1993 to $2.3 billion in 2000
and fell slightly in 2004 to $1.8 billion. In 2000, the expenditure
on CAM was about four times as much as the public contribution
for the Pharmaceutical Benefit Scheme. The total government expenditure
on the Pharmaceutical Benefits Scheme, including the public contribution,
was $3.45 billion at the end of 2001 (Maclennan, Wilson et al.
1996; Maclennan, Wilson et al. 2002; Maclennan, Myers et al. 2006).
These surveys have found that CAM users are more likely to be
females with a better education and higher income than non-CAM
users. In the 2004 survey, it was found that CAM users tended
to have lower quality of life scores than non-users. Nearly half
the respondents used conventional medicines on the same day. Adams
et al (2003) examined the profile of women who consulted CAM therapists.
They found that middle-aged women are more likely than other age
groups to consult CAM therapists but that the consultations are
not restricted to any particular age group. They also found the
highest rate of consultation is among women living in non-urban
areas, those who report poorer health, and those who are higher
users of conventional health services (Adams, Sibbritt et al.
2003).
Of concern is that nearly 60% of respondents did not tell their
medical practitioner that they were using CAM yet most were concurrently
taking CAM and conventional medicines. Also of concern is that
nearly half the respondents believed that CAMs are independently
tested by a government agency before being sold. Three-quarters
of these respondents believed that that the government agency
tested the products for quality, safety and side effects. Less
than a quarter believed that the products were tested for what
they claimed to do or their efficacy (Maclennan, Wilson et al.
1996; Maclennan, Wilson et al. 2002; Maclennan, Myers et al. 2006)
A survey of 518 students at Newcastle University found that 81%
of the students used some form of CAM with the majority using
practices such as relaxation techniques, massage therapy, and
art therapy to reduce stress or psychosomatic issues. More than
one-third used herbal medicine (Feldman and Laura 2004).
