National Center for Complementary and Alternative Medicine (NCCAM)

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Time to Talk

Backgrounder

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Introduction

Patients and their health care providers need to talk openly about all of their health care practices. This includes the use of complementary health practices.

The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health has launched an educational campaign—Time to Talk—to encourage the discussion of the use of complementary health practices. NCCAM is the Federal Government’s lead agency for complementary health practices and is committed to providing evidence-based information to help health professionals and the public make health care decisions.

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Why Talk?

To ensure safe, coordinated care, it’s time to talk. Talking not only allows fully integrated care, but it also minimizes risks of interactions with a patient’s conventional treatments. When patients tell their providers about their use of complementary health practices, they can better stay in control and more effectively manage their health. When providers ask their patients about their use of these practices, they can ensure that they are fully informed and can help patients make wise health care decisions.

In a 2007 nationwide Government survey, nearly 40 percent of all adults reported using some type of complementary health practice; people age 50 to 59 were among the most likely to report use.1 According to a 2010 survey of people age 50 or older, 58 percent of those who reported ever using complementary health practices discussed them with a health care provider.2

Complementary health practices are defined as a group of diverse medical and health care systems, practices, and products whose origins come from outside of mainstream medicine. They include products and practices such as herbal supplements, meditation, chiropractic care, and acupuncture.

NCCAM and AARP Survey: In 2010, NCCAM and AARP partnered on a consumer telephone survey to measure and understand communication practices between patients age 50 or older and their health care providers; the survey built on a similar study conducted in 2006. The 2010 survey confirms that patients and providers often do not discuss the use of complementary health practices. The primary reasons are that patients do not know that they should tell their providers about their use of complementary health practices, and providers do not ask their patients about their use of complementary health practices.

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What Else Did the Survey Find?

Use of Complementary Health Practices

  • Just over half of the respondents (53%) have used complementary health practices at some point in their lives.

Communication With Providers

  • Of those who used complementary health practices in the past 12 months, 42% did not talk to a health care provider about it.
  • The most common reasons cited by patients who had not discussed complementary health practices with a health care provider were that the provider never asked (42%) or they did not know they should (30%). The same was true 4 years earlier.
  • If complementary health practices were discussed at a medical appointment, they were most likely brought up by the patient. Survey respondents were twice as likely to say they raised the topic rather than their health care provider, as was also true in 2006.

Topics Discussed With Providers

  • For respondents who talked with providers about complementary health practices, the topics most frequently discussed were interactions with other medications or treatments (44%), whether to pursue complementary health practices (41%), the effectiveness of complementary health practices (41%), what practices to use (40%), and safety (38%).

Reasons for Using Complementary Health Practices

  • Of those who have used complementary health practices, most did so to prevent illness or for overall wellness (77%) or to reduce pain or treat painful conditions (73%). Other popular uses were to treat a specific health condition (59%) or to supplement conventional medicine (53%).

Use of Conventional Medicine

  • Almost four-fifths of respondents (78%) said they take one or more prescription medicines. Almost one-fifth of respondents (19%) reported currently taking more than five prescription medicines.

Other Survey Findings

  • Herbal products or dietary supplements were the most commonly used type of complementary health practice (37%); followed by massage therapy, chiropractic manipulation, and other bodywork (22%); mind-body practices (9%); and naturopathy, acupuncture, or homeopathy (5%).
  • Women were more likely than men to discuss using complementary health practices.
  • Respondents were more likely to have discussed complementary health practices with a physician than with other types of health care providers.
  • People with a high school education or less were more likely than those who had attended or graduated from college to say that their health care provider initiated a discussion of complementary health practices (35% vs. 21%).
  • Respondents obtained their information about complementary health practices from family or friends (26%); health care providers (21%, and 13% for their physicians specifically); the Internet (14%); publications including magazines, newspapers, and books (13%); and radio and television (7%). The percentage who used the Internet as an information source had increased since the 2006 survey—from 10% to 14%.

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Tips to Start Talking

Patient Tips

  • When completing patient history forms, be sure to include all therapies and treatments you use. Make a list in advance.
  • Tell your health care providers about all therapies or treatments—including over-the-counter and prescription medicines, as well as dietary and herbal supplements.
  • Take control. Don’t wait for your providers to ask about your use of complementary health practices.
  • If you are considering a new complementary health practice, ask your health care providers about its safety, effectiveness, and possible interactions with medications (both prescription and over-the-counter).

Provider Tips

  • Include a question about use of complementary health practices on medical history forms.
  • Ask your patients to bring a list of all therapies they use, including prescription, over-the-counter, and herbal therapies, and other complementary health practices.
  • Have your medical staff initiate the conversation.

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Free Toolkit for Health Care Providers

Health care providers may order a FREE toolkit that includes posters, tip sheets, patient wallet cards, and other resource information to help encourage discussion of the use of complementary health practices. To order a free toolkit, call the NCCAM Clearinghouse at 1-888-644-6226. For more information on Time to Talk or to read the full NCCAM/AARP report on CAM use communication, please visit nccam.nih.gov/timetotalk.

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Resources From the National Institutes of Health

National Center for Complementary and Alternative Medicine nccam.nih.gov

MedlinePlus—Complementary and Alternative Medicine www.nlm.nih.gov/medlineplus/alternativemedicine.html

MedlinePlus—Herbs and Supplements www.nlm.nih.gov/medlineplus/druginfo/herb_All.html

National Cancer Institute—Office of Cancer Complementary and Alternative Medicine www.cancer.gov/cam

National Institute on Aging—Age Page on Dietary Supplements www.nia.nih.gov/health/publication/dietary-supplements

Office of Dietary Supplements ods.od.nih.gov

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1 Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. CDC National Health Statistics Report #12. 2008.

2 AARP, NCCAM. Complementary and Alternative Medicine: What People 50 and Older Discuss With Their Health Care Providers. Consumer Survey Report; April 13, 2011.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.
NCCAM Publication No.: 
D381-G