Harvard Survey of Alternative Medicine Use Updated

January 1999; Volume 1: 16

Source: Eisenberg DM, et al. Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. JAMA 1998; 280:1569-1575.

Objective: To document trends in alternative medicine use between 1990 and 1997.

Setting/Methods/Subjects: National random-digit dialing telephone survey of 2055 English-speaking adults over the age of 18.

Results: Between 1990-1997, women have become more common users of alternative therapies (48.9%) than men (37.8%). Patterns of use that were similar in 1990 and 1997 included: more common use in the West; in those 35-49 years old; in those with some college education; and in those with annual incomes over $50,000. In both surveys, use was less among African-Americans than other groups.

Use of at least one alternative therapy has increased from 33.8% in 1990 to 42.1% in 1997. The probability of seeing an alternative practitioner increased from 36.3% to 42.1%. The largest increases in use of specific therapies were seen in herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. The most common conditions treated were back problems, allergies, fatigue, arthritis, headaches, and neck problems. Of those taking prescription drugs, 19.4% reported concurrent use of high-dose vitamins, herbs, or both. Using conservative estimates, Americans spent an estimated $14.6 billion on visits to practitioners in 1990 and $21.2 billion in 1997. Most of this expenditure was out-of-pocket. The percentage of those using alternative therapies who discussed this use with their medical doctor did not change significantly between 1990 (38.5%) and 1997 (39.8%). A large proportion of alternative therapies for principal medical conditions is done without input from either physicians or alternative therapy practitioners.

Funding: NIH grant U24 AR43441, John E Fetzer Institutes, American Society of Actuaries, Friends of Beth Israel Deaconess Medical Center, Kenneth J. Germeshausen Foundation, JE and ZB Butler Foundation.

Comments: Extrapolating results to the general population is difficult because both surveys excluded non-English-speaking people and those without telephones. In addition, response rate was low in both surveys (60% in 1997, 67% in 1990). Despite these limitations, these survey results are important and show the growing use of alternative therapies among the American mainstream. Particularly interesting is that the number of patients who told their physicians about alternative medicine use has not changed in seven years. With almost one in five of patients on prescription medications also using herbs and/or vitamins, it is imperative that physicians ask about and document such use in order to track therapeutic effects, adverse effects, and interactions with conventional treatments.