A third of patients who use complementary and alternative medicine hide the fact in consultations with conventional medicine providers, with potential safety implications, a study suggests.
Australian researchers found that one in three complementary medicine users do not disclose their use of alternative therapies to their medical providers.
“Disclosure is only going to become more and more important for public safety”
They warned that this posed a significant direct and indirect risk of adverse effects and harm due to unsafe concurrent use of complementary medicine and conventional medicine use.
Their systematic review looked at prevalence and characteristics of disclosure of complementary medicine use in 86 study papers published from 2003 to 2016, with further analysis of 14 papers. It follows previous research in 2003.
Lead study author Hope Foley said: “This figure has hardly changed since the last review of the topic 13 years ago.
“This is despite the fact that the authors of every paper included in our review called for improved communication between doctors and patients to facilitate better disclosure,” she said.
The study findings, published in the journal Scientific Reports, found that disclosure of complementary medicine use was influenced by the communication style of the clinician.
Researchers said reasons for non-disclosure included clinicians simply not asking about it, fear of disapproval and a perception of disclosure as unimportant.
A belief that clinicians lacked complementary medicine knowledge, lacked time, and a patient belief that such therapies were safe were also cited as reasons for non-disclosure.
Meanwhile, reasons for disclosure and complementary medicine use included enquiry by clinicians, a belief that clinicians would support it, give advice on it or that disclosure was important for safety.
“Disclosure of complementary medicine use is central to wider patient management and care”
Among those patients who did disclose its use, negative or discouraging responses were reported by a minority of respondents representing less than 20% of disclosers or were not reported at all.
The researchers stated: “As complementary medicine becomes more separate from mainstream health services, disclosure is only going to become more and more important for public safety.”
They concluded that discussions and subsequent disclosure of complementary medicine use “may be facilitated by direct inquiry” about it by clinicians.
“The initiation of conversations about complementary medicine with patients and provision of consultations characterised by person-centred, collaborative communication by medical providers may contribute towards increased disclosure rates,” they said.
They added: “This is a topic which should be treated with gravity. Disclosure of complementary medicine use is central to wider patient management and care in contemporary clinical settings, particularly for primary care providers acting as gatekeeper in their patients’ care.”