The use of complementary and alternative medicine (CAM) is widespread around the world including Croatia. The number of studies that investigate both quantitative and qualitative use of CAM in ...Croatia is limited. The aim of this study was to investigate the use of CAM among family medicine patients in the town of Čakovec and the rate they report it to their family doctor. This was a cross-sectional study in a sample of 300 patients that visited primary health center for any reason. We used anonymous questionnaire already employed in a previous investigation (Čižmešija et al. 2008), which describes socioeconomic characteristics, modalities of CAM use, and reasons for use. We also added questions on the type of herbs used and use of over-the-counter vitamin and mineral supplements. On data analysis we used descriptive statistics, χ2-test and Fisher's exact test, while the level of statistical significance was set at p ≤ 0.05. The response rate was 76%. Out of the total number of patients, 82% used some modality of CAM. Women, patients with secondary school education, employed and retired persons used CAM more often. Students and pupils reported least use of CAM. The most commonly used were herbs (87%), bioenergy (29%), diet therapy (28%), chiropractics (22%), and homeopathy and acupuncture (11% each). Vitamin and mineral supplements were used by 77% of study subjects. CAM was most frequently used for respiratory, urinary and musculoskeletal problems, as well as to improve overall health condition. Of the respondents that reported CAM use, 55% believed it would help them, 43% used it because they wanted to try something new, while only 2% indicated dissatisfaction with their physician as the reason for using CAM. Statistically, there were more subjects that used CAM and did not notify their family doctor about it, which could indicate poor communication between family doctors and health care users. Our results are consistent with a previous quantitative study conducted in Croatia and with literature data on the countries with a predominant use of western medicine. Qualitative data from previous studies in Croatia could explain the cultural and socioeconomic context of CAM use. Dissatisfaction with their physician as the reason for using CAM was rarely indicated, suggesting that CAM most probably fills the gap between successful and unsuccessful treatment, and perception that evidence based medicine has its own limitations. The arguments to turn to CAM therapy could involve poor doctor to patient ratio, i.e. 1750 patients per family medicine doctor on average, and the 20% increase in the number of diseases and conditions diagnosed by family medicine units. In conclusion, these results suggest that the use of CAM is common among patients in family medicine. When taking patient history, doctors should ask about CAM use and be aware of the patient beliefs and lifestyle. When patients strongly believe in CAM methods, there is the need of making compromise in therapy, with explanation of the possible side effects and at the same time continuous follow up. There is the need of additional education of family doctors and population about good and bad effects of CAM. In Croatia, accent should be on herbalism because this modality is most widespread.
Upotreba komplementarne i alternativne medicine (KAM) prisutna je u svim zemljama svijeta pa tako i u Hrvatskoj. Cilj rada je istražiti korištenje KAM kod pacijenata u obiteljskoj medicini u Domu ...zdravlja u Čakovcu. Istraživanje je bilo presječno s uzorkom od 300 ispitanika i odazivom od 76 %. Od ukupnog broja ispitanika 82 % ih koristi neki oblik KAM-a. Žene češće koriste KAM, kao i osobe sa srednjom stručnom spremom, zaposleni i umirovljenici. Studenti i učenici najmanje koriste KAM. Najčešće se koristi ljekovito bilje 87 %, zatim bioenergija 29 %, dijetoterapija 28 %, kiropraktika 22 %, homeopatija i akupunktura 11 %. Vitaminske i mineralne dodatke koristi 77 % ispitanika. KAM se najviše koristi za liječenje bolesti dišnog sustava, mokraćnog sustava, mišićno-koštane boli, te za poboljšanje općeg stanja. Od ispitanika koji koriste KAM, 55 % vjeruje da će im pomoći, a 43 % koriste KAM, jer žele pokušati nešto novo, dok ih je samo 2 % navelo nezadovoljstvo svojim liječnikom kao razlog korištenja KAM-a. Statistički je više onih koji koriste KAM, a nisu obavijestili svog liječnika u primarnoj zdravstvenoj zaštiti o tome, što ukazuje na moguću slabiju komunikaciju liječnika obiteljske medicine i korisnika zdravstvene zaštite. Ovi rezultati upućuju na potrebu za cjelokupnom edukacijom zdravstvenih radnika i populacije o dobrim i lošim učincima komplementarne i alternativne medicine.
