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Military Report More Complementary and Alternative Medicine Use Than Civilians

By |November 1, 2017|Complementary and Alternative Medicine, Veterans|

Military Report More Complementary and Alternative Medicine Use Than Civilians

The Chiro.Org Blog


SOURCE:   J Altern Complement Med. 2013 (Jun); 19 (6): 509–517

Christine Goertz, DC, PhD, Bernadette P. Marriott, PhD,
Michael D. Finch, PhD, Robert M. Bray, PhD,
Thomas V. Williams, PhD, Laurel L. Hourani, PhD,
Louise S. Hadden, BA, Heather L. Colleran, PhD,
and Wayne B. Jonas, MD

Palmer College of Chiropractic,
Davenport, IA 52803, USA.


OBJECTIVES:   The study objective was to estimate complementary and alternative medicine (CAM) use among active duty military and compare data with civilian use.

DESIGN:   A global survey on CAM use in the 12 previous months was conducted. Final participants (16,146) were stratified by gender, service, region, and pay grade. Analysis included prevalence of CAM use, demographic and lifestyle characteristics.

RESULTS:   Approximately 45% of respondents reported using at least one type of CAM therapy. Most commonly used therapies were as follows: prayer for one’s own health (24.4%), massage therapy (14.1%), and relaxation techniques (10.8%). After exclusion of prayer for one’s own health, adjusting to the 2000 U.S. census, overall CAM use in the military (44.5%) was higher than that in comparable civilian surveys (36.0% and 38.3%).

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Alternative Medicine, Worker Health, and Absenteeism in the United States

By |June 25, 2017|Alternative Medicine, Complementary and Alternative Medicine|

Alternative Medicine, Worker Health,
and Absenteeism in the United States

The Chiro.Org Blog


SOURCE:   Complement Ther Med. 2017 (Jun); 32: 116–128

Kate Rybczynski

Department of Economics,
University of Waterloo,
200 University Avenue West,
Waterloo, ON N2L 3G1, Canada


Health related absenteeism costs an estimated $153 billion annually in the United States (Witters and Agrawal, 2011).   Chronic conditions (major contributors to absenteeism) are often successfully managed by Complementary and Alternative Medicine (CAM). As CAM becomes an increasingly visible component of healthcare, firms may wish to consider whether CAM therapies can help reduce illness-related absenteeism. This paper aims to extend the literature on healthcare utilization and absenteeism by exploring whether CAM treatment is associated with fewer workdays missed due to illness.

METHODS:   Using the 2007 National Health Interview Survey (NHIS) and propensity score matching (PSM), this study estimates the relationship between visits to CAM practitioners, health, and illness-related absenteeism.

RESULTS:   In a sample of 8,820 workers, the average annual number of workdays lost due to illness is 3.69. Visiting an acupuncturist correlates with lower absenteeism among men (1.182 fewer workdays missed, p<0.05), whereas visiting a naturopathic doctor correlates with 2.359 and 2.521 fewer workdays missed for women and men, respectively (both p<0.001). Active mind-body practices, massage, chiropractic and acupuncture treatments are all significantly associated with improved health.

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Provider and Patient Perspectives on Opioids and Alternative Treatments for Managing Chronic Pain

By |April 15, 2017|Acupuncture, Complementary and Alternative Medicine|

Provider and Patient Perspectives on Opioids and Alternative Treatments for Managing Chronic Pain:
A Qualitative Study

The Chiro.Org Blog


SOURCE:   BMC Fam Pract. 2017 (Mar 24); 17 (1): 164

Lauren S. Penney, Cheryl Ritenbaugh, Lynn L. DeBar,
Charles Elder and Richard A. Deyo

South Texas Veterans Health Care System,
7400 Merton Minter Blvd,
San Antonio, TX, 78229, USA


BACKGROUND:   Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues.

METHODS:   Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care (medical) providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatment. Audio recordings were transcribed and thematically coded. A summarized version of the focus group/interview guides is included in the Additional file 1.

RESULTS:   We identified four themes around opioid use:

(1)   attitudes toward use of opioids to manage chronic pain;
(2)   the limited alternative options for chronic pain management;
(3)   the potential of A/C care as a tool to help manage pain; and
(4)   the complex system around chronic pain management.

Despite widespread dissatisfaction with opioid medications for pain management, many practical barriers challenged access to other options. Most of the participants’ perceived acupuncture and chiropractic (A/C) care as helpful for short term pain relief. We identified that problems with timing, expectations, and plan coverage limited A/C care potential for pain relief treatment.

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The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

By |March 2, 2017|Chiropractic Care, Complementary and Alternative Medicine|

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

The Chiro.Org Blog


SOURCE:   Med Care. 2012 (Dec); 50 (12): 1029–1036

Brook I. Martin, PhD MPH, Mary M. Gerkovich, PhD, Richard A. Deyo, MD, MPH, Karen J. Sherman, PhD, MPH, Daniel C. Cherkin, PhD, Bonnie K. Lind, PhD, Christine M. Goertz, DC, PhD, and William E. Lafferty, MD

Department of Orthopaedics,
The Geisel School of Medicine at Dartmouth &
Dartmouth-Hitchcock Medical Center,
Lebanon, NH 03756, USA.


This first national study of CAM/chiropractic expenditures for spine conditions finds that neither adds to overall medical spending.

From Page 23:   A recent study of 12,036 records in the Medical Expenditure Panel Survey (MEPS) investigated the costs of treating patients with low back and neck pain (Martin et al., 2012). The study estimated the expenditures for care among complementary and alternative medicine (chiropractic, homeopathy, herbalism, acupuncture, and massage) users relative to non-users. This study included a chiropractic-specific analysis of expenditures for chiropractic users versus non-users, as approximately 75% of all complementary and alternative medicine services were rendered by doctors of chiropractic.

Survey data were analyzed for the years 2002–2008. The
analysis demonstrated that seeing a CAM/chiropractic provider did not add to overall medical spending. In fact,
adjusted annual healthcare costs among chiropractic users were $424 lower for spine-related costs when compared to non-CAM users.

Additionally, those who used complementary and alternative providers, including doctors of chiropractic, had significantly lower hospitalization expenditures.


BACKGROUND:   Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample.

OBJECTIVES:   To estimate the total and spine-specific medical expenditures among CAM and non-CAM users with spine problems.

RESEARCH DESIGN:   Analysis of the 2002-2008 Medical Expenditure Panel Survey.

SUBJECTS:   Adults (above 17 y) with self-reported neck and back problems who did or did not use CAM services.

MEASURES:   Survey-weighted generalized linear regression and propensity matching to examine expenditure differences between CAM users and non-CAM users while controlling for patient, socioeconomic, and health characteristics.

RESULTS:   A total of 12,036 respondents with spine problems were included, including 4,306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users. Adjusted annual medical costs among CAM users was $424 lower (95% confidence interval: $240, $609; P<0.001) for spine-related costs, and $796 lower (95% confidence interval: $121, $1,470; P = 0.021) for total health care cost than among non-CAM users. Average expenditure for CAM users, based on propensity matching, was $526 lower for spine-specific costs (P<0.001) and $298 lower for total health costs (P = 0.403). Expenditure differences were primarily due to lower inpatient expenditures among CAM users.

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Cost-Effectiveness of Chiropractic Page

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Chronic Neck Pain and Chiropractic Page

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Results of a National Survey and Examination of Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis

By |September 4, 2016|Complementary and Alternative Medicine|

Results of a National Survey and Examination of Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2016 (Aug 14) [Epub]

Patricia M. Herman, ND, PhD, Ian D. Coulter, PhD

RAND Health,
Santa Monica, CA.
pherman@rand.org


OBJECTIVES:   The purpose of this project was to examine the policy implications of politically defining complementary and alternative medicine (CAM) professions by their treatment modalities rather than by their full professional scope.

METHODS:   This study used a 2-stage exploratory grounded approach. In stage 1, we identified how CAM is represented (if considered as professions vs modalities) across a purposely sampled diverse set of policy topic domains using exemplars to describe and summarize each. In stage 2 we convened 2 stakeholder panels (12 CAM practitioners and 9 health policymaker representatives), and using the results of stage 1 as a starting point and framing mechanism, we engaged panelists in a discussion of how they each see the dichotomy and its impacts. Our discussion focused on 4 licensed CAM professions: acupuncture and Oriental medicine, chiropractic, naturopathic medicine, and massage.

RESULTS:   Workforce policies affected where and how members of CAM professions could practice. Licensure affected whether a CAM profession was recognized in a state and which modalities were allowed. Complementary and alternative medicine research examined the effectiveness of procedures and modalities and only rarely the effectiveness of care from a particular profession. Treatment guidelines are based on research and also focus on procedures and modalities. Health plan reimbursement policies address which professions are covered and for which procedures/modalities and conditions.

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Efficacy of Selected Complementary and Alternative Medicine Interventions For Chronic Pain

By |July 5, 2016|Complementary and Alternative Medicine|

Efficacy of Selected Complementary and Alternative Medicine Interventions For Chronic Pain

The Chiro.Org Blog


SOURCE:   J Rehabil Res Dev. 2007; 44 (2): 195–222

Gabriel Tan, PhD, ABPP, Michael H. Craine, PhD,
Matthew J. Bair, MD, MS,
M. Kay Garcia, DrPH, MSN, RN, LAc,
James Giordano, PhD, Mark P. Jensen, PhD,
Shelley M. McDonald, MD

Department of Anesthesiology,
Michael E. DeBakey Department of Veterans Affairs (VA) Medical Center (VAMC),
2002 Holcombe Blvd,
Houston, TX 77030, USA


Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the classification system developed by the National Institutes of Health National Center for Complementary and Alternative Medicine (formerly Office of Alternative Medicine) and are grouped into four domains: biologically based medicine, energy medicine, manipulative and body-based medicine, and mind-body medicine. Homeopathy and acupuncture are discussed separately as “whole or professionalized CAM practices.” Based on the guidelines of the Clinical Psychology Division of the American Psychological Association, findings indicate that some CAM modalities have a solid track record of efficacy, whereas others are promising but require additional research. The article concludes with recommendations to pain practitioners.


From the FULL TEXT Article:

INTRODUCTION

      Definition of Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. They are not generally provided by U.S. hospitals and clinics or widely taught in medical schools [1].

      Prevalence and Popularity of
     Complementary and Alternative Medicine Use

CAM modalities are widely used by the U.S. public. According to the Centers for Disease Control and Prevention (CDC), 62 percent of adults used some form of CAM during the past 12 months when the definition of CAM included prayer specifically for health reasons and 36 percent when prayer was excluded [2]. The most frequent conditions associated with CAM use included back pain, neck pain, joint pain, stiffness, anxiety, and depression (the latter two are commonly associated with chronic pain). CAM use increased substantially during the 1990s. The U.S. public spent an estimated $36 to $47 billion on CAM in 1997 alone [3]; between $12.2 and $19.6 billion were paid out-of-pocket for the services of CAM providers such as chiropractors, acupuncturists, and massage therapists. These fees are more than the U.S. public paid out-of-pocket for all hospitalizations in 1997 and half the amount of all out-of-pocket physician services for traditional care [4].

      Purpose of This Article

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