Choice Increases CAM Usage by Insured Cancer Patients
New research shows that a substantial number of insured cancer patients will use alternative providers if they are given the choice.
Researchers at the University of Washington in Seattle wanted to evaluate complementary and alternative medicine (CAM) provider utilization by cancer patients in Washington. The state requires the inclusion of alternative practitioners in private, commercial insurance products.
For the study, the researchers looked at year 2000 claims data from two large Washington State insurance companies. Of 357,709 claimants, 7,915 claimants had a cancer diagnosis. Among the cancer patients, 7.1% had a claim for naturopathy, acupuncture, or massage; and 11.6% had a claim for chiropractic during the study year. The use of naturopathy and acupuncture were more common, and the use of chiropractic was less common for cancer patients compared with those without cancer.
Most of the cancer patients also had at least one conventional provider claim during the year. Factors associated with non-chiropractic alternative provider use were female gender, the presence of metastatic cancer, hematologic malignancy, and the use of chemotherapy. Increased use of naturopathic physicians accounted for much of this trend. Musculoskeletal pain was the most common diagnosis at the CAM provider visit. Billed amounts for alternative services were less than 2% of the overall medical bills for cancer patients.
Overall, the cost of the CAM treatment is modest compared with conventional care charges, the researchers say. "For individuals with cancer, CAM providers do not appear to be replacing conventional providers but instead are integrated into overall care," they conclude. Their findings were published in the April 1 print issue of the journal Cancer, but were released in late February on the journal’s web site.
Osteoarthritis Initiative Begins Participant Enrollment
A major initiative to learn about the biological markers for osteoarthritis (OA) has begun recruiting in four centers in the United States.
The Osteoarthritis Initiative (OAI) is a public-private partnership between the National Institutes of Health, including the National Center for Complementary and Alternative Medicine, and industry. Women and men at risk for developing OA and those with early disease are eligible to participate. They must be 45-79 years old, and have one or more of the following to be volunteers in the study:
- Hand osteoarthritis
- Knee pain during the past year (Note: They don’t have to have current knee pain to join.)
- Previous knee injury
This study is not for those who have rheumatoid arthritis, have joint replacements in both knees, are unable to walk without assistance, or can’t have a MRI (magnetic resonance imaging) of the knee.
After an initial screening, the four centers around the United States plan to each enroll and follow 1,250 adults for five years. Biological specimens (blood, urine, DNA), images (X-rays and magnetic resonance scans), and clinical data will be collected annually.
The four clinical centers, selected in the summer of 2002, include the University of Maryland School of Medicine/Johns Hopkins University in Baltimore, the Ohio State University Medical Center in Columbus, the University of Pittsburgh, and the Memorial Hospital of Rhode Island/Brown University in Pawtucket. A data-coordinating center at the University of California, San Francisco, oversees the study conduct and will manage the resulting data. The Ohio State University and University of Pittsburgh centers enrolled their first participants the week of Feb. 23, and centers in Maryland and Rhode Island began enrollment in late March and early April.
Participants will be asked to do the following for the study:
- Complete a telephone interview to confirm their eligibility.
- Attend two initial visits that will include a knee X-ray and knee MRI scan, knee exam, strength testing, an interview, and lab tests.
- Return to the clinic for a once-a-year follow-up visit for the next four years.
They will not be required to take medications or change their eating or exercise habits.
The OAI is a federal contract funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Complementary and Alternative Medicine, National Institute on Aging, Office of Research on Women’s Health, National Institute of Dental and Craniofacial Research, and National Center on Minority Health and Health Disparities, all part of the Department of Health and Human Services’ National Institutes of Health. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corp., and Pfizer. Private sector funding for the OAI is being managed by the Foundation for the National Institutes of Health.
For full details about the OAI, visit The OAI: A Knee Health Study at www.oai.ucsf.edu/clinics.asp. For general questions, visit www.niams.nih.gov/ne/press/2001/07_17qa.htm. The NIAMS Office of Communications and Public Liaison (301-496-8190) or the NIA Communications Office (301-496-1752) can also be contacted for information.