Complementary and alternative medicine use by solid organ transplant recipients in the United States

Background. Evidence shows that Americans increasingly use complementary and alternative medicine (CAM): 36% in 2002, to 38.3% in 2007. Though a significant part of received care, it is not considered an integrated component of our health care system in literature, practice, or policymaking. Few studies have examined CAM use by the hundreds of thousands of solid organ (kidney, pancreas, lung, heart, liver, small bowel) transplant recipients in the United States. These individuals often live with chronic medical conditions and are high-use patients in our health care system, which invests heavily in transplantation as a medical intervention.;Methods. An online survey program collected self-reported data on CAM use and integrative health care (IHC) preferences by U.S. solid organ transplant recipients (reached via email requests for participation) in 2010. The survey incorporated 2007 National Health Interview Survey CAM questions and IHC questions developed for this study.;Results. Transplant recipient subjects (n=788) used CAM at a higher rate (56.9%) than the general public and most commonly sought CAM for musculoskeletal and mental health issues. Higher education and female gender were correlates for CAM use. Nearly half (49.7%) integrate their own CAM and medical care although 49.6% want others serving as integrators. Medical doctors ranked highest (46.9%) as desired integrators; trained IHC professionals (21.3%) followed.;Conclusions. This study found that transplant recipients utilize CAM at higher rates and for different reasons than the general population, they are willing to share health care opinions via online surveys, and additional research is needed to better understand transplant recipients' beliefs and behaviors. There are implications for clinical care, training, research, federal policy, and strategic collaborations to improve care and outcomes for transplant recipients. These include recommendations to: (1) incorporate increasing graft and recipient survival rates as a federal transplantation policy goal, (2) provide CAM and IHC training for transplant professionals, and (3) plan a strategic initiative to obtain recognition of solid organ transplant recipients as a special chronic disease population for inclusion in the rollout of patient-centered medical home demonstration projects under the Patient Protection and Affordable Care Act of 2010.