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Use of Alternative Therapies in Older Outpatients in the United States and Japan

Prevalence, Reporting Patterns, and Perceived Effectiveness

^a Geriatric Research, Education and Clinical Center, Saint Louis VA Medical Center, Missouri
^b Division of Geriatrics, Missouri
^c Department of Internal Medicine, Missouri
^d Saint Louis University School of Medicine, Missouri
^e Department of Nursing and Health Care, Tokyo Metropolitan Institute of Gerontology, Japan
^f Department of Nursing, College of Medicine, Soonchunhyang University, Choongnam, Korea
^g Department of Internal Medicine, Tokyo Metropolitan Geriatric Hospital, Japan

Joseph H. Flaherty, 1402 South Grand Boulevard, Room M238, St. Louis, MO 63104 E-mail: flaherty{at}slu.edu.

Decision Editor: Larry E. Johnson, MD, PhD

Background. The purpose of this study was to determine the prevalence, patterns of reporting, and perceived effectiveness of alternative medical therapies (ATs) among older white American, African American, and Japanese outpatients.

Methods. This study used a questionnaire to interview participants (N = 593; age, >59 y), who were outpatients of geriatric outpatient clinics in Saint Louis, Missouri, and Tokyo, Japan (white Americans, n = 180; African Americans, n = 106; and Japanese, n = 307).

Results. Use of >1 AT was greatest among older Japanese (74.3%), followed by white Americans (61.1%) and African Americans (47.2%; p < .001). The most common ATs used among the Japanese (and significantly more than the white and African American groups) were lifestyle diet, herbal therapy, massage, acupressure, and acupuncture. The white and African American groups were more frequent users of relaxation techniques and spiritual healing compared with the Japanese group. Contrary to prior studies of the general population, the use of >1 AT did not correlate with any sociodemographic variables. Reported use of ATs to doctors was low but similar in all three groups (white Americans = 48%, African Americans = 42%, and Japanese = 46%). Perceived effectiveness was high but similar in all three groups (white Americans = 85%, African Americans = 92%, and Japanese = 84%). Although chronic conditions were common reasons for use of ATs, nonmedical reasons (e.g., general health or religious reasons) were also common.

Conclusions. Use of ATs was greater in Japan than in the United States, but for both countries, use by older persons was greater than previous reports of the general population. Because sociodemographic variables do not predict use, and reported use to doctors is low and perceived effectiveness is high, increased awareness and understanding about ATs by health care professionals seems imperative.

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