Complementary and Alternative Medicine in an Integrated Health Care Delivery System: Users of Chiropractic, Acupuncture, and Massage Services.

introductionComplementary and alternative medicine research has relied primarily on survey data from community populations rather than from patient populations receiving these services in integrated health care delivery systems (IHDS).

objectivesTo describe patients seeking chiropractic, acupuncture, or massage therapy in a dedicated Center for Complementary Medicine (CCM) within an IHDS.

methodsPatient surveys at the initial CCM visit included chief complaint, prior treatments, and relief with treatment (0% to 100% relief). A modified Brief Pain Inventory assessed average and current pain (0 = no pain; 10 = unbearable pain) and interference with life domains (1 = does not interfere; 10 = completely interferes). Demographics and CCM provider type were obtained from medical records. Analysis included patients who completed the survey.

resultsBetween 2007 and 2014, a total of 27,225 patients sought CCM services (median age = 50 years). Most (62%) were female, and 73% were white. Modalities included chiropractic (66.9%), acupuncture (18.1%), and massage (15.0%). Spine/truncal pain was most commonly reported (70.5%). A majority of patients (59%) saw their physician for their condition, 59% had not used CCM services previously, and 60% received medications for their condition. Mean ratings included pain relief with prior treatment (30.07%, standard deviation [SD] = 27.01%), current pain (4.33, SD = 2.4), and functional impairment ranging from 3.03 (SD = 3.09) for relationships to 5.42 (SD = 3.22) for enjoyment of life.

conclusionSpine/truncal pain was the most common complaint and chiropractic the most common modality among patients receiving CCM services in an IHDS. More than one-third of patients self-referred to the CCM.