Almost 90% of respondents believe that the use of alternative medicine is common and that over the years interest in alternative medicine services has increased. The three most frequent reasons mentioned by the respondents were wider access to information (online forums, Facebook groups) (57.4%), a decline in trust in the medical profession (54.1%), fear of traditional treatment (50.8%). According to healthcare professionals from New Zealand, the reasons for using alternative medicine include failure of conventional treatment, positive effects of the CAM methods used earlier, and supplementation of the treatment already applied [4]. The results of the Anbari study have shown that the most important reason for using CAM is the fear of side effects of medical treatment [8]. According to the authors, a dynamic increase in CAM uses might correspond to an increase in public interest in a holistic approach to health as an opposition to full bureaucracy and schematic approach to diseases in traditional medicine [1, 9].
Our study demonstrated that 62% of respondents believed that innovation but also “exotics” of alternative medicine induced the use of this form of treatment. According to a study conducted among German healers and their clients, an important aspect of using CAM was the fact that their clients believed that their relations with the healer supported the healing process. The clients described the healer's empathy and personality as the model to follow. Trust in the healer, his empathy, understanding and acceptance, as well as devoting enough time to talk about all relevant aspects of treatment and answer the client's questions, was considered an essential part of treatment [10]. The above results are partly consistent with our findings, as 54% of respondents in our survey believed that the decline in trust in the medical profession had a huge impact on increased interest in alternative medicine services; however, too short medical visits were not considered a significant reason for this increase (6.6%). Similarly, a friendly atmosphere of visits to practitioners of alternative treatment methods was found to be the factor inclining towards CAM.
Many patients do not admit that they use CAM. The available studies have demonstrated that physicians can play an important role in facilitating patient preferences by being open to talk about alternative methods, which can increase the frequency of disclosure of this information. It has been shown that such an approach of a physician, accepting and not valuing the patient's CAM activities, can have positive effects [6]. In the United States, only 44% in 2004 and about 71% of physicians in 2012 were willing to refer their patients to CAM specialists, which demonstrates increased popularity of CAM amongst physicians [11]. In Poland, the attitude of the medical community towards CAM differs from the data cited above; 48% of respondents believe that physicians in Poland should be able to recommend alternative methods and to combine conventional and alternative medical treatments.
According to the study conducted in Iran, only 21% of healthcare workers have a negative attitude towards CAM [12]. The study by Aveni has also shown that most healthcare professionals have a positive attitude toward CAM and believe that the use of CAM may be useful in treating patients [13]. In the present study, however, 54.1% of respondents had a negative attitude towards alternative medicine, and only 6.6% positive. Moreover, when asked about their attitude towards patients using CAM, the responses were as follows: positive – 3.3%, neutral- 57.4%, and negative – 39.3%. Furthermore, the knowledge of healthcare professionals in Iran regarding CAM methods mostly concerned exercise therapy (51.7%), herbal medicine (51.7%), vitamin supplements (51.4%), nutritional therapy (46.9%), music therapy (28.4%), bloodletting (27.6%), magnet therapy (24.4%), and hydrotherapy (24.1%) [12]. In another study, the most common methods were massages, non-herbal supplements, and music therapy [14].
A study conducted in Babol, a central city in northern Iran, has revealed that the CAM methods most frequently applied include herbal medicine, traditional medicine, homeopathy, chiropractic treatment, acupuncture, reflexology, and massage [15]. In Europe, the methods most applied are herbal medicine, homeopathy, chiropractic treatments, and acupuncture [16]. In our study, five most popular alternative methods were: acupuncture (82%), homeopathy (80%), acupressure (78.7%), herbal medicine (78.7%), and bioenergy therapy (68.9%). The studies involving healthcare professionals from New Zealand have shown that the practice and referral of patients to some forms of CAM therapy is a common phenomenon and regards about 30% of GPs. In addition, many of them personally use massages and CAM methods to cope with ailments; however, about 45% have noticed the lack of reliable scientific evidence and research concerning safety of CAM therapy.
The study findings available in literature have shown that there is a need for better regulation of CAM procedures and products [4]. An interesting example of the implementation of methods not used by academic medicine into the standards of care offered by public medical institutions can be observed in Brazil. Initially, 5 alternative practices were approved for use in the public health care system; now, this number has increased to 29. Moreover, there are no studies describing the use of certain methods, such as thermotherapy/cryotherapy or anthroposophical medicine [17]. The majority of the physicians surveyed in a multi-centre study in Italy observed the therapeutic effects of CAM, including improved well-being of patients. Nevertheless, as many as 70% of them do not use CAM methods themselves [18]. In our survey, 54.1% of respondents admit that they know a physician who uses some elements of alternative medicine in practice.