Ethnicity the most important personal characteristic in predicting complementary medicine use

A survey of older adults in rural North Carolina shows that they widely use complementary medicine therapies, but tend to focus on folk or home remedies, such as taking a daily "tonic" of vinegar or using Epsom salts.

"What most people think about as complementary medicine - acupuncture, homeopathy and massage therapy - they aren't using at all," said Thomas Arcury, Ph.D., lead researcher, from Wake Forest University School of Medicine. "Their use is largely limited to home remedies, vitamins and minerals."

The goal of the study, which is reported in the March issue of Journal of Gerontology: Social Sciences, was to learn more about what complementary and alternative medicine (CAM) therapies older adults are using and why.

"We want to understand how people make decisions about managing their health," said Arcury. "If we understand how people are treating themselves, the information can be useful for physicians."

Researchers found that the majority of participants don't use CAM therapies to treat diabetes or other chronic diseases.

"They are using CAM for prevention or for treating symptoms (a headache, a sore throat, a cut) but not for treating a chronic condition," wrote the authors. "CAM use among these rural older adults is largely a form of self-care."

Arcury said it is common to use some of the therapies, such as vinegar or honey, as a general "tonic."

"I've talked to older adults who'll tell you should take two tablespoons of vinegar every day in a glass of warm water because it's good for you," he said. "They aren't treating anything in particular."

The study divided CAM therapies in eight categories to better document which types of therapies are being used. The categories (and examples) are: food home remedies (honey, lemon and garlic), other home remedies (tobacco, Epsom salts, and salves), vitamins (multivitamins, folic acid and vitamin E), minerals (calcium, magnesium and zinc), herbs (gingko biloba, ginseng and Echinacea), popular manufactured products (flax seed, amino acids and glucosamine sulfate), CAM therapies (imagery, biofeedback and energy healing) and CAM practitioners (chiropractor, herbalist and acupuncturist).

More than half of participants used food home remedies (52 percent) and other home remedies (57 percent). Vitamins were used by 45 percent of participants and minerals by 17 percent. Interestingly, only 6 percent of participants used herbs for self-care.

"We have learned over the years that people in this community didn't learn about herbs," said Arcury. "When they were growing up, their grandmothers may have used chamomile tea. But, doctors were coming into these communities, so they weren't home-doctored by their grandmothers and didn't learn about the herbs. However, the use of home remedies has continued here."

Researchers found that ethnicity was the most important personal characteristic in predicting CAM use. African-Americans and Native Americans were 81 percent and 76 percent (respectively) more likely to use food home remedies than whites and more than twice as likely to use other home remedies.

The ELDER (Evaluating Long-term Diabetes Self-management among Elder Rural Adults) study assessed complementary medicine use among 701 rural adults over age 65 with diabetes. Participants were selected from two rural North Carolina counties with a high proportion of ethnic minorities and people living below the poverty level.

Participants were interviewed in their homes about their health and use of complementary and alternative medicine therapies. Participants were asked if they had used each item for any purpose in the past year and if they had used it specifically for diabetes.