Complementary Therapies in Medicine (2004) 12, 99—111 Determinants of complementary alternative medicine (CAM) use Ahmad Al-Windi * Family Medicine Stockholm, Karolinska Institutet, Alfred Nobels all´ e 12, SE-141 83 Huddinge, Sweden KEYWORDS Complementary alternative medicine (CAM); General practitioner (GP); Consultation; Country of birth; Medical record; Perceived health; Physician; Questionnaire Summary Objective: Theaimofthisstudywastodescribethepatternofuseofcomplementary alternative medicine (CAM) and identify the determinants of CAM use in a multi- ethnic Swedish primary health care practice population. Methods: A questionnaire was handed out to 1433 patients aged 16 years and above who visited the Jordbro Health Centre (JHC) in Stockholm, Sweden, between 14 January and 30 June 2002. The results were linked to computerised medical records. Results: Seventeen percent of respondents had consulted a CAM provider during the preceding year and many patients had consulted several types of CAM providers. The most frequently CAM used was massage, followed by acupuncture, chiropractic and naprapathy. Inthelogisticregression,whenadjustingfortheinfluenceofpossibleconfounders, chronic disease and physical activity were the most important predictors of consul- tations with CAM providers. Users of CAM had had a higher number of consultations with medical professionals than had non-users of alternative medicine. Conclusions: In our study population CAM, defined here as ‘‘manual therapy’’, was used in addition to traditional therapies and was related to high use of health care services. Chronic disease and physical activity were significantly and independently related to use of CAM. © 2004 Elsevier Ltd. All rights reserved. Introduction During the last few decades complementary alter- native medicine (CAM) has received a great deal of attention and has gained in popularity, particularly among specific patient groups. 1—3 The reasons for this popularity have been variously discussed but no consensus has been reached. 4 Many types of CAM, such as acupuncture, chiropractic and other manip- * Tel.: +46 736 821 109; fax: +46 8 524 488 06. E-mail address: ahmad.al-windi@slpo.sll.se. ulative therapies, have been recognised and some of them are financed by taxes, while others are paid, either by the insurance companies, or by the employer or out of pocket by the patients. 5,6 In the literature, divergent results are presented regarding the proportion of the population using various types of CAM. For example, Eisenberg et al. showed that 0.9% of their sample reported having visited an acupuncturist during the previ- ous year compared with 0.7% based on the Medi- cal Expenditure Panel Survey (MEPS). 2,7 However, several authors from different parts of the world report escalating costs and prevalence of the use 0965-2299/$ — see front matter © 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ctim.2004.09.007