Complementary and Alternative Medicine in an Integrated Health Care Delivery System: Users of Chiropractic, Acupuncture, and Massage Services.

Introduction: Complementary and alternative medicine research has relied primarily on survey data from community populations rather than from patient populations receiving these services in integrated health care delivery systems (IHDS).

Objectives: To describe patients seeking chiropractic, acupuncture, or massage therapy in a dedicated Center for Complementary Medicine (CCM) within an IHDS.

Methods: Patient surveys at the initial CCM visit included chief complaint, prior treatments, and relief with treatment (0% to 100% relief). A modified Brief Pain Inventory assessed average and current pain (0 = no pain; 10 = unbearable pain) and interference with life domains (1 = does not interfere; 10 = completely interferes). Demographics and CCM provider type were obtained from medical records. Analysis included patients who completed the survey.

Results: Between 2007 and 2014, a total of 27,225 patients sought CCM services (median age = 50 years). Most (62%) were female, and 73% were white. Modalities included chiropractic (66.9%), acupuncture (18.1%), and massage (15.0%). Spine/truncal pain was most commonly reported (70.5%). A majority of patients (59%) saw their physician for their condition, 59% had not used CCM services previously, and 60% received medications for their condition. Mean ratings included pain relief with prior treatment (30.07%, standard deviation [SD] = 27.01%), current pain (4.33, SD = 2.4), and functional impairment ranging from 3.03 (SD = 3.09) for relationships to 5.42 (SD = 3.22) for enjoyment of life.

Conclusion: Spine/truncal pain was the most common complaint and chiropractic the most common modality among patients receiving CCM services in an IHDS. More than one-third of patients self-referred to the CCM.