Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Pain Med. 2010 Jan;11(1):16-24. doi: 10.1111/j.1526-4637.2009.00767.x.
We used Andersen's behavioral model of healthcare utilization to assess the relationship between sociodemographic, physical and psychosocial factors, and Complementary and Alternative Medicine (CAM) use among chronic pain patients. Three practitioner-based alternative therapies were considered: acupuncture, biofeedback/relaxation training, and manipulation services.
A retrospective analysis of self-reported clinical data with 5,750 black and white adults presenting for initial assessment between 1994 and 2000 at the University of Michigan Multidisciplinary Pain Center was performed.
CAM therapies were used in high frequencies, with 34.7% users. Specifically 8.3% used acupuncture, 13.0% used biofeedback/relaxation, and 24.9% used manipulation techniques. Race and age were predisposing factors associated with CAM use. Blacks used less biofeedback/relaxation and manipulation services than whites. Aging was related to more acupuncture, but less biofeedback/relaxation use. Women marginally used more biofeedback/relaxation services than men, and education was positively associated with all three CAM use. Perceived pain control was a consistent enabling factor positively correlated with the use of all three CAM services. Among need factors, pain characteristics and physical health were positively associated with at least one of the modalities. Depressive symptoms were not related to CAM services use.
This study identifies variable patterns of CAM usage based on sociodemographic and health factors in chronic pain patients. Overall, who uses CAM depends on the modality; however, education, pain severity, and pain duration are persistent correlates of CAM usage regardless of the therapy considered. We found that mental health, as measured by depressive symptoms, had no noticeable impact on CAM usage among chronic pain patients. The clinical, policy, and research implications of CAM use are discussed.
我们采用安德森医疗保健利用行为模型，评估社会人口学、身体和心理社会因素与慢性疼痛患者补充和替代医学（CAM）使用之间的关系。考虑了三种基于从业者的替代疗法：针灸、生物反馈/放松训练和推拿服务。
对 1994 年至 2000 年间在密歇根大学多学科疼痛中心首次就诊的 5750 名黑人和白人成年人的自我报告临床数据进行回顾性分析。
CAM 疗法的使用率很高，有 34.7%的患者使用过。具体来说，8.3%的患者使用过针灸，13.0%的患者使用过生物反馈/放松，24.9%的患者使用过推拿技术。种族和年龄是与 CAM 使用相关的倾向因素。黑人使用生物反馈/放松和推拿服务的比例低于白人。随着年龄的增长，针灸的使用频率增加，但生物反馈/放松的使用频率降低。女性使用生物反馈/放松服务的比例略高于男性，而教育与所有三种 CAM 使用均呈正相关。感知疼痛控制是一个一致的促进因素，与所有三种 CAM 服务的使用均呈正相关。在需求因素中，疼痛特征和身体健康与至少一种模式呈正相关。抑郁症状与 CAM 服务的使用无关。
本研究根据慢性疼痛患者的社会人口学和健康因素，确定了 CAM 使用的不同模式。总体而言，谁使用 CAM 取决于所采用的模式；然而，教育、疼痛严重程度和疼痛持续时间是与 CAM 使用相关的持续因素，无论考虑哪种治疗方法。我们发现，心理健康（如抑郁症状）对慢性疼痛患者的 CAM 使用没有明显影响。讨论了 CAM 使用的临床、政策和研究意义。
