Predictors of alternative and complementary medicine use in inflammatory bowel disease: do measures of conventional health care utilization relate to use?
Moderate EvidenceIn Plain Language: crohn's disease, explained
Alternative and complementary therapies (ACM) have gained increasing attention in the past few years. It was our purpose to determine whether increased ACM use is associated with increased use of conventional health care resources. Additionally, demographics of use, subjective benefit, and cost were analyzed. We enrolled 150 inflammatory bowel disease (IBD) patients from a tertiary care center and performed a phone survey of their ACM use in the past year. A population-based administrative database was accessed to extract data regarding use of conventional medicine (hospitalizations, doctor visits, and GI specific doctor visits). Patients were divided into three groups: (i) no ACM (n = 60) (ii) users of exercise, diet, and prayer (EDP) exclusively (n = 47) (iii) other ACM use (n = 43) which included those who may have used EDP as well as any of acupuncture, chiropractic, homeopathy, naturopathy, herbology, massage, relaxation, reflexology, hypnotherapy, aromatherapy, meditation, or support group. ACM was used by 60% (EDP 31%, other ACM 29%). There were no significant differences in use between the three groups by disease diagnosis, education level, employment status, use of IBD medications, number of hospitalizations, doctor visits, or GI specific doctor visits. The EDP group was more likely to be married (p = 0.006) and female (p = 0.04) compared to no ACM. The EDP group tended to be older than the no ACM (p = 0.001) and other ACM (p = 0.01). The other ACM had shorter disease duration than EDP (p = 0.04) and no ACM (p = 0.04). The most commonly used therapies were diet (45%), herbal (17%), exercise (15%), prayer (11%), and relaxation (10%). ACM was sought for pain/cramps (64%), diarrhea (60%), and gas/bloating (21%). Seventy-three percent of EDP interventions incurred no cost compared to 33% with other ACM (p < 0.0001). The median annual amount spent on other ACM was $56 (range $0-$4800). Subjectively, patients felt helped by trials of EDP 95% of the time whereas
Key Findings
- ✓Among 150 IBD patients surveyed, those using alternative and complementary medicine were not found to have significantly increased conventional health care utilization compared to non-users.
- ✓Exercise, diet, and prayer were the most commonly used alternative therapies among IBD patients, with 47 patients using these methods exclusively.
- ✓IBD patients used a diverse range of complementary therapies including acupuncture, chiropractic, homeopathy, naturopathy, herbology, massage, reflexology, and meditation in addition to or instead of conventional medical care.
What This Means for You
If you have inflammatory bowel disease and are considering reflexology or other complementary therapies, this study shows they are used by many IBD patients, but the research doesn't establish whether they reduce the need for conventional medical care.
What This Means for Practitioners
Reflexology and other complementary therapies are used by a substantial portion of IBD patients alongside conventional care, suggesting potential for integrated practice models, though this study does not demonstrate superiority over standard treatment.
Study Design: how this cross-sectional study was run
Crohn's disease: common questions
What does this study say about crohn's disease?
If you have inflammatory bowel disease and are considering reflexology or other complementary therapies, this study shows they are used by many IBD patients, but the research doesn't establish whether they reduce the need for conventional medical care.
What did this study find?
Among 150 IBD patients surveyed, those using alternative and complementary medicine were not found to have significantly increased conventional health care utilization compared to non-users. Exercise, diet, and prayer were the most commonly used alternative therapies among IBD patients, with 47 patients using these methods exclusively. IBD patients used a diverse range of complementary therapies including acupuncture, chiropractic, homeopathy, naturopathy, herbology, massage, reflexology, and meditation in addition to or instead of conventional medical care.
How strong is this evidence?
This is a cross-sectional study and we rate its evidence moderate. It covers 150 participants. It was published in The American journal of gastroenterology. This study is indexed here for context; it did not test reflexology itself.
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