Foster D F, Phillips R S, Hamel M B, Eisenberg D M
Center for Alternative Medicine Research and Education, and Department of Medicine, Harvard Medical School, Boston, Massachusetts 02215, USA.
J Am Geriatr Soc. 2000 Dec;48(12):1560-5. doi: 10.1111/j.1532-5415.2000.tb03864.x.
Because there are few data describing alternative medicine use in older populations, we analyzed a nationally representative survey to quantify and characterize the use of alternative medicine in people aged 65 and older.
We utilized data collected in a nationally representative, random, telephone survey of adults, measuring use of conventional medical services and use of 20 alternative medicine therapies in the last 12 months.
A total of 2,055 adults, 311 of whom were aged 65 and older and who constituted our sample of older Americans.
Overall, 30% of people aged 65 and older used at least one alternative medicine modality in the last year compared with 46% of those less than age 65 (P < .001), and 19% of older people saw a provider of alternative medicine within the past year compared with 26% of those less than age 65. The alternative medicine modalities used most commonly by those aged 65 and older were chiropractic (11%), herbal remedies (8%), relaxation techniques (5%), high dose or mega-vitamins (5%), and religious or spiritual healing by others (4%). Older persons with a primary care provider used alternative medicine more frequently (34% vs 7% P < .05) than those with no primary care provider. Patients who saw their physician more frequently were more likely to use alternative medicine (0 visits 7%, 1-2 visits 22%, 3-6 visits 35%, 7 or more visits 44% P < .05). Six percent of older patients were taking both herbs and prescription drugs. Of older patients who used alternative medicine, 57% made no mention of their use of any alternative modality to their doctor.
Thirty percent of Americans aged 65 and older reported using alternative medicine (amounting to 10 million Americans based on extrapolations to census data) and 19% visited an alternative medicine provider (making 63 million visits based on extrapolations to census data) within the past year. The two modalities used most commonly were chiropractic and herbs, both of which may be problematic in older patients. Physicians should ask all patients, including those aged 65 and older, about their use of alternative medicine, and in those aged 65 and older, physicians should ask specific questions about the user of chiropractic and herbal medicine.
由于描述老年人群使用替代医学的数据较少,我们分析了一项全国代表性调查,以量化和描述65岁及以上人群使用替代医学的情况。
我们利用了在一项全国代表性的随机电话调查中收集的数据,该调查针对成年人,测量了过去12个月中常规医疗服务的使用情况以及20种替代医学疗法的使用情况。
共有2055名成年人,其中311人年龄在65岁及以上,他们构成了我们的美国老年样本。
总体而言,65岁及以上的人群中,有30%在过去一年中至少使用了一种替代医学方式,而65岁以下的人群中这一比例为46%(P <.001);在过去一年中,19%的老年人看过替代医学提供者,而65岁以下的人群中这一比例为26%。65岁及以上人群最常使用的替代医学方式是脊椎按摩疗法(11%)、草药疗法(8%)、放松技巧(5%)、高剂量或超大剂量维生素(5%)以及他人的宗教或精神治疗(4%)。有初级保健提供者的老年人比没有初级保健提供者的老年人更频繁地使用替代医学(34%对7%,P <.05)。看医生更频繁的患者更有可能使用替代医学(0次就诊7%,1 - 2次就诊22%,3 - 6次就诊35%,7次或更多次就诊44%,P <.05)。6%的老年患者同时服用草药和处方药。在使用替代医学的老年患者中,57%没有向医生提及他们使用任何替代方式的情况。
据对人口普查数据的推断,65岁及以上的美国人中有30%报告使用替代医学(相当于1000万美国人),19%拜访过替代医学提供者(据对人口普查数据的推断,有6300万次就诊)。最常使用的两种方式是脊椎按摩疗法和草药疗法,这两种疗法在老年患者中都可能存在问题。医生应该询问所有患者,包括65岁及以上的患者,关于他们使用替代医学的情况,对于65岁及以上的患者,医生应该询问关于脊椎按摩疗法和草药使用的具体问题。