NATIONAL INSTITUTES OF HEALTH
NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE
Survey Finds That Awareness of CAM Research Varies Among Health Care Providers
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In a new survey, about 60 percent of the health-care-provider respondents were aware of the results of one out of two recent major clinical trials on CAM. Only about one-quarter were aware of both trial results. Most respondents were moderately confident in their ability to interpret clinical research findings. The importance that provider groups assigned in their own practices to clinical experience, research results, and patient preferences varied.
The report appears in the April 13 issue of Archives of Internal Medicine. Jon Tilburt, M.D., M.P.H., principal investigator, was the first CAM fellow with the NIH Clinical Center's Department of Bioethics and is now at the Mayo Clinic.
The survey focused on the 1,561 respondents' awareness of results from two NCCAM-funded trials, released in 2004 and 2006, that studied either acupuncture or glucosamine/chondroitin for osteoarthritis of the knee. The professional groups surveyed were acupuncturists, internists, naturopaths, and rheumatologists.
Fifty-nine percent of the respondents were aware of at least one of the two trials; 23 percent were aware of both. The acupuncture trial was most familiar to acupuncturists and rheumatologists, the glucosamine/chondroitin trial to internists and rheumatologists.
Those who were aware of the CAM trials were much more likely to be rheumatologists, practicing in an academic or institutional setting, having some research experience, being more confident in interpreting evidence, and/or having more favorable opinions about the role of research in their practice.
When it came to interpreting research results, most respondents said they were "moderately confident" in this ability. Few said they were "very confident."
In their clinical decisionmaking, the respondents rated the importance of three factors as follows:
- All professional groups rated clinical experience as "very important" in decisionmaking. CAM providers were more likely than conventional physicians, however, to rate it as "most important."
- Conventional physicians were much more likely than CAM providers to rate research results as "very important" or "very useful."
- CAM providers were more likely to rank patient preferences as "very important," and conventional physicians to rank them as "least important."
"These results suggest that the ultimate clinical impact of clinical research in CAM likely depends on the training, attitudes, and experiences of the clinicians who could translate research results into clinical practice…" — From the survey report
The authors conclude that CAM research has the potential to make a difference in both conventional and CAM clinical practices, as long as professionals are aware of that evidence and can apply it in the context of their specific practice. To address "significant barriers," they recommend concerted efforts to better train all clinicians in interpretation and use of evidence from research studies, and to improve the dissemination of CAM research results.
References
- Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine. 2004;141(12):901–910.
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine. 2006;354(8):795–808.
- Tilburt JC, Curlin FA, Kaptchuk TJ, et al. Alternative medicine research in clinical practice: a U.S. national survey. Archives of Internal Medicine. 2009;169(7):670–677.
