Patient Disclosure of the Use of Complementary and Alternative Medicine to Their Obstetrician/Gynecologist EDITORIAL COMMENT

Most studies investigating patient use of complementary and alternative medicine (CAM) in the United States have reported that 30% to 40% use some form of CAM. Consistent with these estimates, the 2007 National Health Interview Survey found that more than 42% of respondents use some form of CAM. There has been a significant concern that patients do not report CAM use to their physician. Data in a landmark study published in 2001 showed that two-thirds of American patients using CAM did not discuss it use with their physician. There are several reasons as to why obstetrician/gynecologists and other physicians should be aware of the use of CAM by their patients: some forms of CAM place patients at potential risk when used alone or in combination with other treatments. CAM may be used as a substitute for conventional medical therapy. Moreover, the fetus of a pregnant patient may also be put at risk by such use. This study was designed to determine the present extent of patient disclosure of CAM use to an obstetrician/ gynecologist over a 12-month period. Data obtained from the 2007 National Health Interview Survey showed that 2673 women were in contact with an obstetrician/gynecologist during the preceding year, and these women comprised the study population. A total of 35.8% (n = 956) of the respondents used at least one form of CAM during the preceding year. The women reported use of the following 12 CAM therapies (in descending percentage of use): herbal supplements (19.5%), massage (13.1%), yoga (11.2%), chiropractic/osteopathic manipulation (9.9%), homeopathic treatment (2.2%), and acupuncture (2.1%). Of the women using some form of CAM, only 51.8% reported the use to a physician. It is likely that most patients using some form of CAM who do not inform their physician of such usage would do so if asked. Limited exposure to CAM among practicing physicians may explain, in large part, their reluctance to initiate discussion of this topic with patients.