Prevalence

Several large surveys in the United States, Europe, and Australia have demonstrated the extent of CAM use by the public. According to the Centers for Disease Control and Prevention, in 2002 36 percent of US adults used some form of CAM therapy and if prayer was included, the number increased to 62 percent.5 Use of these therapies was most prominent for back problems, upper respiratory infections, and neck problems. In 2001, Millar6 reported that 17 percent of Canadians visited an alternative health care practitioner in 1998/1999. MacLennan etal.7 reported that approximately 49 percent of Australians used CAM in 1993. In England in 1998 the prevalence of CAM use was 28 percent.8 The prevalence in Denmark in 2003 was 20 percent.9 A survey published in Germany in 2004 found a prevalence of CAM use of 70 percent for women and 54 percent for men.10 The use of CAM is increasing at a rapid rate. In Italy the prevalence almost doubled from 1991 to 1999 to an estimated use of 15 percent.11 Estimates of prevalence may vary widely depending on the study methods used. The choice of study population and the scope of what is considered complementary or alternative medicine will greatly impact prevalence estimates. For example, the use of prayer or local heat and ice are such common practices that it would be misleading to include these in survey data.

In the United States, the high rates of CAM use crosses socioeconomic, racial, and geographic boundaries; but those who used CAM in 2002 were more likely to be white, female, college-educated, with age less than 65, living in the western US, with a higher annual household income.12 The types of therapies that patients use will depend on many factors besides patient preference, such as availability and cost. As reported in a 2002 survey by Tindle et al.,12 the most common therapies were herbal medicine (18.6 percent) and relaxation techniques (14.2 percent), chiropractic care (7.4 percent), and yoga (5 percent), while acupuncture was used by 1 percent of the population. The number of visits to a CAM practitioner varies depending on the nature of the therapy. Thus, chiropractic, acupuncture, and massage therapy will require more visits to a practitioner in a given time period than herbal medicine or homeopathy.

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