Development of an Integrative Medicine Program at an FQHC in Chicago

Description

A Northwestern University Capstone Project

Abstract

Importance: Use of Complementary and Alternative Medicines (CAM) is a vital piece of information for practicing physicians, and community health clinics developing integrative medicine programs.Objective: To systematically review literature-based evidence about the most commonly used types of CAM by Hispanic patients, and to survey type of CAM familiarity, type of CAM interest, and barriers of CAM attitudes among providers at a Chicago FQHC.Data Sources: PubMed and a study reference list were searched for studies about the most commonly used types of CAM in Hispanic patients. Survey data was compiled from provider respondents.Study Selection: Descriptive studies with varying sample size and unassessed quality about all types of CAM use in Hispanics, but not about specific types of CAM use only, were reviewed.Data Extraction and Synthesis: One investigator independently read search titles, reviewed studies, and excluded certain reviewed studies to produce the resulting reviewed studies. Desired information from resulting studies was presented in a table and narrated in the results section. The survey was administered via SurveyMonkey and emailed to a provider listserv; data was manicured and displayed in Excel. No statistical hypothesis testing was conducted.Main Outcomes and Measures: Most common type of CAM used, prevalence of general CAM use, and reason for CAM use in Hispanics. Provider familiarity of and interest in types of CAM; physician attitudes towards CAM barriers.Results: Fifteen studies resulted from the review and exclusion process. Only one study focused on juvenile Hispanics. Sample size varied from 31 to 3,050. Twelve studies listed either herbs or supplements as the most common type of CAM used. Prevalence of CAM use ranged from 30% to 90%. Weight loss, pain, and type 2 diabetes were all mentioned as reasons for CAM use. Forty-six out of 252 providers responded to the survey. The majority of respondents were MDs with little prior education on CAM. Meditation/Relaxation was the most familiar, nutrition therapy was of most interest, and cost of care the biggest barrier for CAM referral, among providers.Conclusions and Relevance: A substantial number of Hispanics use CAM for various diseases, and among those that do, herbs and supplements are most often used. Providers have little prior education on CAM and their familiarity of and interest in types of CAM are different from what their Hispanic patients actually use.

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