Academic journal article Journal of the Medical Library Association

Information-Seeking Behavior in Complementary and Alternative Medicine (CAM): An Online Survey of Faculty at a Health Sciences Campus*

Academic journal article Journal of the Medical Library Association

Information-Seeking Behavior in Complementary and Alternative Medicine (CAM): An Online Survey of Faculty at a Health Sciences Campus*

Article excerpt

Background: The amount of reliable information available for complementary and alternative medicine (CAM) is limited, and few authoritative resources are available.

Objective: The objective is to investigate the information-seeking behavior of health professionals seeking CAM information.

Methods: Data were gathered using a Web-based questionnaire made available to health sciences faculty affiliated with the University of California, San Francisco.

Results: The areas of greatest interest were herbal medicine (67%), relaxation exercises (53%), and acupuncture (52%). About half the respondents perceived their CAM searches as being only partially successful. Eighty-two percent rated MEDLINE as a useful resource, 46% personal contacts with colleagues, 46% the Web, 40% journals, and 20% textbooks. Books and databases most frequently cited as useful had information about herbs. The largest group of respondents was in internal medicine (26%), though 15% identified their specialties as psychiatry, psychology, behavioral medicine, or addiction medicine. There was no correlation between specialty and patterns of information-seeking behavior. Sixty-six percent expressed an interest in learning more about CAM resources.

Conclusions: Health professionals are frequently unable to locate the CAM information they need, and the majority have little knowledge of existing CAM resources, relying instead on MEDLINE. Medical librarians need to educate health professionals in the identification and use of authoritative CAM resources.

INTRODUCTION

The National Center for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative medicine (CAM) as "a broad range of healing philosophies (schools of thought), approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available" [1]. CAM covers a wide range of therapies and practices popularly referred to as simply "alternative" or "complementary" medicine. It includes acupuncture, herbal medicine, homeopathy, traditional Chinese medicine (TCM), and a host of other practices.

Over the past decade, use of CAM therapies by the American public has increased dramatically. This use was brought to the attention of many health professionals in the 1990s by surveys carried out by David Eisenberg's group at the Center for Alternative Medicine Research and Education, Beth Israel Deaconess Medical Center [2, 3]. These studies indicated that as many as four out of ten Americans used alternative medicine therapies, with the total number of visits to alternative medicine practitioners exceeding visits to all U.S. primary care physicians [4]. Other surveys have since confirmed the continued widespread use of CAM therapies in the United States and in other industrialized Western nations [5]. Most significantly, in a recent paper, Kaptchuk and Eisenberg suggested that the United States is witnessing a major paradigm shift in the structure of contemporary health care, where the current dominant biomedical-based system is being replaced by "medical pluralism," in which people use therapies and practices from a variety of healing systems [6].

For both information specialists and health care professionals, finding reliable information for even the more widely known areas of CAM can be a daunting task. First of all, efficacy and safety data based on standard clinical trials are significantly lacking, so often little published information exists in the mainstream biomedical literature. Second, bibliometric studies have shown that much CAM information is scattered in a large number of journals, published in many languages [7]. Furthermore, important information can often only be found in the difficult-to-find "gray literature," such as trade journals, pamphlets, conference proceedings, and market research reports [8]. Federally funded institutions such as NCCAM and the National Library of Medicine (NLM) have tried to remedy this by developing tools that facilitate access to CAM information in the journal literature: such as CAM on PubMed, a subset of PubMed. …

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