Race, Pain, and Beliefs Associated with Interest in Complementary and Alternative Medicine among Inner City Veterans.

OBJECTIVE: To investigate the prevalence and determinants of complementary and alternative medicine (CAM) interest level among a racially diverse cohort of inner city veterans who receive primary care at the VA Medical Center. DESIGN: Cross-sectional survey study SETTING: Philadelphia VA Medical Center SUBJECTS: Primary care patients (n = 258) METHODS: Interest in CAM was measured using a single item question. Patient treatment beliefs were assessed using validated instruments. We evaluated factors associated with patient interest in CAM using a multivariate logistic regression model. RESULTS: In this sample of 258 inner city primary care VA patients, interest in CAM was high 80% (n = 206). Interest in CAM was strongly associated with African American race [adjusted odds ratio (AOR) 2.19, 95% Confidence Interval (CI) 1.05-4.60, P = 0.037], higher levels of education (AOR 4.33, 95% CI 1.80-10.40, P = 0.001), presence of moderate to severe pain (AOR 2.02, 95% CI 1.02-4.78, P = 0.043), and expectations of benefit from CAM use (AOR 1.21, 95% CI 1.06-1.36, P = 0.004). CONCLUSIONS: CAM approaches have broad appeal within this inner city cohort of veterans, particularly among African Americans, those that experience pain and those that expect greater benefit from CAM. These findings may inform the development of patient-centered integrative pain management for veterans.

Patients' Perspectives on Integrating Acupuncture into the Radiation Oncology Setting.

INTRODUCTION: Acupuncture has potential as a supportive care service for cancer symptom management. However, little is known about patients' willingness to use acupuncture in the context of conventional cancer care. METHODOLOGY: We conducted a cross-sectional survey study among patients with cancer during their last week of fractionated/external beam radiotherapy (RT). The main outcome variable was self-reported likelihood of using acupuncture during RT. Knowledge about acupuncture and pain severity was measured along with socio-demographic and clinical variables. Multivariate logistic regression was performed to identify factors associated with willingness to use acupuncture. RESULTS: Among the 305 participants, 79 (26.4%) were likely to use acupuncture during RT if such services were offered at a reasonable price, 143 (46.9%) had no knowledge of acupuncture, and 206 (67.6%) reported having pain. In multivariate analyses, non-Whites (adjusted odds ratio [AOR] 1.94, 95% Confidence Interval [CI] 1.06-3.56), and those with pain (AOR 2.52, CI 1.25-5.10) were more interested in using acupuncture. In addition, patients with preexisting knowledge about acupuncture were also more likely to use acupuncture than those without this knowledge (AOR 2.23, CI 1.28-3.88). CONCLUSIONS: Patients of non-White race, those with pain or those with prior knowledge about acupuncture were more willing to utilize acupuncture during RT. Since half of the patients had no knowledge about acupuncture, interventions to improve patients' knowledge are needed to facilitate the successful integration of acupuncture into cancer care.