Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study
Massimiliano Berretta, Luca Rinaldi, R. Taibi, Paolo Tralongo, Alberto Fulvi, Vincenzo Montesarchio, Giordano Madeddu, Paolo Magistri, Sabrina Bimonte, Marco Trovò, Patrizia Gnagnarella, Arturo Cuomo, Marco Cascella, Arben Lleshi, Guglielmo Nasti, Sergio Facchini, Francesco Fiorica, Raffaele Di Francia, Giuseppe Nunnari, Giovanni Francesco Pellicanò, Aurelio Guglielmino, Marco Danova, Sabrina Rossetti, Alfonso Amore, Anna Crispo, Gaetano Facchini
Abstract
Purpose: Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate the physician knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy among physicians. Methods: A questionnaire was administered to 438 physicians from 11 Italian hospitals who predominantly treat patients with chronic disease, to collect personal and professional data and information on attitudes towards CAM and its possible role in Traditional Medicine (TM). Results: Of the 438 participants, most were specialists in oncology (18%), internal medicine (17%), surgery (15%), and radiotherapy (11%). Most worked at university (44%) and research hospitals (31%). Forty-two percent of participants believed that CAM could have an integrative role within TM. Oncologists were those physicians best informed on CAM (58%). Physicians working at research Institutes or University hospitals had a greater knowledge of CAM than those employed at general hospitals (p<0.0001), and those involved also in research activity had a greater knowledge about CAM than those who were not (p<0.003). Length of work experience was significantly related to CAM knowledge. Moreover, 55% of participants suggest CAM interventions to their patients and 44% discuss CAM with them. The best-known interventions were acupuncture, Aloe vera and high-dose vitamin C. Conclusion: CAM use by patients with chronic disease and/or cancer has become a topical issue for the scientific community and physicians. Knowing the reasons that prompt these patients to use CAM and guiding them in those decisions would improve their treatment and outcomes and also benefit healthcare systems. Our findings contribute to a greater understanding of CAM knowledge, attitudes, and practice among Italian physicians. Further studies are necessary to evaluate the kind of CAM effective and to work towards an integrated model of health-care.