Background
Complementary and Alternative Medicine (CAM) incorporates treatments used by cancer survivors in the attempt to improve quality of life. While population studies have identified factors associated with use, assessment of why patients use CAM or the barriers against utilization have not been examined.
Patients and Methods
We conducted a cross-sectional survey study in the thoracic, breast, and gastrointestinal medical oncology clinics at an academic cancer center. Clinical and demographic variables were collected by self-report and chart abstraction. Attitudes and beliefs were measured using the validated Attitudes and Beliefs about CAM (ABCAM) instrument. This instrument divides attitudes and beliefs into three domains: expected benefits, perceived barriers, and subjective norms.
Results
Among 969 participants (response rate 82.7%) surveyed between June 2010 and September 2011, patient age≤65, female gender and college education were associated with significantly greater expected benefit from CAM (p < 0.0001 for all). Non-white patients reported more perceived barriers to CAM use than white patients (p<0.0001), but had a similar degree of expected benefit (p=0.76). In a multivariate logistic regression analysis, all domains of the ABCAM instrument were significantly associated with CAM use (p<0.01 for all) among patients with cancer. Attitudes and beliefs about CAM explained much more variance in CAM use than clinical and demographic variables alone.
Conclusion(s)
Attitudes and beliefs varied by key clinical and demographic characteristics, and predicted CAM utilization. By developing CAM programs based upon attitudes and beliefs, we may be able to remove barriers among underserved patient populations and provide more patient centered care.