Patient Disclosure of Complementary and Integrative Health Approaches in an Academic Health Center

Abstract

Background: Effective patient-doctor communication about complementary and integrative health (CIH) is crucial to coordinate multimodal treatment for complex conditions. While rates of patient disclosure of CIH use to physicians have increased in the United States over the last 30 years, many patients still do not disclose these facts. Integrating CIH approaches within academic medical centers may enhance the communication, but this has not been explicitly studied. Objective: To examine rates of patient disclosure of CIH to physicians and reasons for nondisclosure. Methods: We surveyed 1177 patients at an academic center's CIH clinic regarding their CIH use and disclosure of CIH use to their physician. Results: Of the 1067 who responded to the disclosure questions, 80.1% had discussed their CIH use with their physician, while 19.9% did not. Of those who did not disclose, lack of physician inquiry was reported by 58% as the principal reason. Discussion: Within an academic center, there is still a need to improve communication about CIH use. Possible strategies might include continued education of both patients and physicians about CIH and communication skills and integration of CIH disclosure into routine patient health questionnaires.

Complementary and alternative medicine use in migraine patients: results from a national patient e-survey

“…This could point to poor doctor-patient relationships. A common reason for such non-disclosure might be a fear of a negative reaction or simply due to the doctor's indifference toward CAM-a phenomenon which was previously reported (29). It is important to emphasize that the lack of communication could result in CAM users switching from conventional medicine to CAM, as conventional medicine is associated with more harm, side effects and ineffectiveness, while CAM is thought to be safe and natural.…”