Underserved Use Alternative Therapies at Same Rate as General Population, Depend More on Prayer, UB Study Finds

BUFFALO, N.Y. -- Medically underserved individuals use complementary and alternative medicines at the same rate as the population at large, but they rely more heavily on prayer and low-cost therapies, a study by University at Buffalo researchers has shown.

In-person interviews of randomized patients at two inner-city Buffalo clinics indicated that 85.4 percent of those interviewed commonly used complementary and alternative medicines and therapies, which in this study included diet and exercise. About 5 percent used six products or more.

Results of the study appear in the May 10 issue of Archives of Internal Medicine.

Senior author Charles O. Hershey, M.D., professor of medicine in the UB School of Medicine and Biomedical Sciences, said the results hold two primary messages: that many patients are using alternative therapies, but aren't telling their physicians or their physicians aren't asking; and that, for the most part, using such therapies is harmless.

Physicians are becoming more comfortable with some alternative therapies, Hershey said. "If it's not harmful and it helps, patients should feel free to use them. If you have a cold, chicken soup is probably a much better approach than running to a doctor for antibiotics. Smoking cessation is difficult, and if a patient finds a bracelet helps, we should not argue with it.

"Sometimes comfort remedies do the most good," he said. "On the other hand, patients can and should be able to discern what they are purchasing and accept responsibility for their actions."

Because previous reports concerning the use of complementary and alternative therapies relied on data collected by telephone surveys, Hershey and colleagues felt lower socioeconomic groups may have been under-sampled. To remedy this situation, the researchers interviewed 371 patients at two public clinics over an 8-week period. Two-thirds of the patients were women, 59 percent were white, 37.3 percent were African-American, and the remainder was Asian, Hispanic or "other."

The researchers were interested in determining if an underserved population used complementary and alternative therapies more or less frequently than the general population, if they used more folk remedies and if they used fewer of the more expensive therapies. The modalities in question covered supplements, diet, exercise, prayer and use of an alternate provider, such as a chiropractor, osteopath, massage therapist, spiritual healer, acupuncturist, hypnotist or relaxation therapist.

What they found, said Hershey, was that these underserved patients used alternative therapies at about the same rate as the population at large. However, this study group relied more on prayer and less on expensive therapies than the participants in earlier studies.

Prayer was used for health purposes by nearly 60 percent of the respondents, results showed. More women then men, and more African Americans than whites, used prayer, and usage increased with age and number of diagnosed illnesses. More than a third, about 36 percent, said they used a diet for health purposes, 75 percent of which were prescribed by their physicians. Thirty percent said they exercised to improve their health.

Although nearly a third, 29 percent, had used an alternative provider, usually a chiropractor, at some time in their lives, only 7 percent had seen such a provider during the past year.

Nearly half the participants, 48 percent, said they currently were using vitamins, herbal products or folk remedies. A breakdown of current usage showed that 47 percent were taking vitamins (some prescribed by their physician), 16.4 percent were using herbs, 7 percent were using purchased home/folk remedies, 13 percent were using homemade folk remedies, 2 percent were using homeopathic remedies and 5.4 percent were using stones, amulets or bracelets.

The researchers found only one potentially serious reaction related to alternative therapies among the 371 participants. Although this study didn't reveal problems, they can arise, said Hershey, particularly when patients forego medical treatment completely in favor of alternate therapies for serious problems, such as hypertension or cancer.

"Physicians and patients should be reassured that people generally are reasonable," said Hershey. "While the use of complementary and alternative modalities is very widespread, they do not appear to be threatening and they don't appear to be dangerous."

Additional researchers on the study were Susan M. Rhee, a third-year medical student, and Vinod K. Garg, M.D., clinical assistant professor, both from the Department of Internal Medicine in the UB School of Medicine Sciences. The study was supported by a federal training grant to Rhee.

The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York. UB's more than 27,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs.