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Use of and Interest in Complementary and Alternative Therapies Among Clinicians and Adult Members of the Kaiser Permanente Northern California Region: Results of a 1996 Survey

To assess use of complementary and alternative therapies and interest in including them among member services, questionnaires were mailed to randomly selected clinicians and adult Health Plan members of the Kaiser Permanente Northern California (KPNC) Region in Spring 1996. Responses were received from 61% (n=624) of adult primary care (APC) physicians, 70% (n=157) of obstetrics/gynecology (ob/gyn) clinicians, and 50% (2 surveys, n=1,507 and n=17,735) of adult Health Plan members. Nearly 90% of clinicians reported recommending at least one type of alternative therapy in the previous 12 months. Approximately 50% of members reported ever using at least one type of alternative therapy, and 31% of these members reported doing so in the past 12 months. Use was higher among women and among members under age 65 years. Chiropractic, acupuncture, massage, and relaxation training/meditation were the methods most often cited by members and clinicians, and management of pain or stress were the most frequently cited reasons for use. Ob/gyn clinicians recommended herbal and homeopathic medicines, special diets, and megadoses of vitamins and other supplements more often than adult primary care physicians. Two thirds of APC physicians and three fourths of ob/gyn clinicians were at least moderately interested in recommending alternative therapies, and nearly 70% of young and middle-aged members and 50% of senior adult members were interested in having alternative therapies incorporated into their health care. Clinicians and members requested manipulative and behavioral medicine therapies more frequently than homeopathic or herbal medicines. Many clinicians were reluctant to recommend types of therapy not covered by the Health Plan, but clinicians also did not want the Health Plan to cover complementary and alternative modalities without validating their effectiveness.