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Open Access Highly Accessed Research article

Use of complementary and alternative medicine by older adults – a cross-sectional survey

Katharina Schnabel1, Sylvia Binting1, Claudia M Witt23 and Michael Teut1*

Author Affiliations

1 Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin, D-10098 Berlin, Germany

2 Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland

3 University of Maryland School of Medicine, Center for Integrative Medicine, Baltimore, USA

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BMC Geriatrics 2014, 14:38  doi:10.1186/1471-2318-14-38

Published: 26 March 2014

Abstract

Background

Very little is known about complementary and alternative medicine (CAM) use by older adults in Germany. The aim of this study was to investigate the use of CAM and other health promoting substances (e.g., herbal teas) by older adults of at least 70 years of age.

Methods

A cross-sectional questionnaire study was conducted among persons of ≥70 years from metropolitan Berlin and rural parts of Brandenburg, Germany. Recorded were: demographics, current use of CAM, medical diagnoses, users’ opinions and preferences.

Results

A total of 400 older adults, living as ‘self-reliant’ (n = 154), ‘home care service user’ (n = 97), or ‘in nursing home’ (n = 149), and with the legal status ‘without guardian’ (n = 355) or ‘with guardian’ (n = 45) were included (mean age 81.8 ± 7.4 years, 78.5% female). Any type of CAM used 61.3% of respondents (dietary supplements 35.5%, herbal medicines 33.3%, and external preparations 26.8%); 3.0% used drug-interaction causing preparations. Usage was based on recommendations (total 30.3%; in 20.0% by friends or family and 10.4% by pharmacists), own initiative (27.3%), and doctors’ prescription (25.8%). Participants with legal guardian took almost solely prescribed dietary supplements. Of the others, only half (58.7%) informed their general practitioner (GP) of their CAM use. Participants expected significant (44.9%) or moderate (37.1%) improvement; half of them perceived a good effect (58.7%) and two-thirds (64.9%) generally preferred a combination of CAM and conventional medicine. More than half (57.9%) stated that they could neither assess whether their CAM preparations have side effects, nor assess what the side effects might be. Strongest predictors for CAM use were two treatment preferences (vs. ‘conventional only’: ‘CAM only’, OR = 3.98, p = 0.0042 and ‘CAM + conventional’, 3.02, 0.0028) and the type of health insurance (‘statutory’ vs. ‘private’, 3.57, 0.0356); against CAM use two subjective assessments predicted (vs. ‘CAM causes no harm’: ‘CAM causes harmful drug interactions’, 0.25, 0.0536 and ‘I cannot assess side effects’, 0.28, 0.0010).

Conclusion

Older German adults frequently use CAM. They perceived it as an effective complement to conventional medicine, but are not sufficiently informed about risks and benefits.

Keywords:
Older adults; CAM; Dietary supplements; Nursing home; Residential care; Legal guardian