Complementary therapy: General Practitioners' referral and patients' use in an urban multi-ethnic area

Author(s): Natel, N., Robinson, N.

Abstract: Objectives: To determine the use of complementary therapies by patients attending hospital outpatients. to investigate local General Practitioners' (GP's) provision of and referral to complementary therapies. Design: Semi-structured interviews with clinic patients and postal questionnaires to GPs. Subjects: One hundred patients from three medical outpatient clinics (diabetes, rheumatology, chest) at Central Middlesex Hospital and all 275 local GPs in Brent and Harrow. Main outcome measures: Patients' self-reported use of and experience of complementary therapies. Patterns of local GP provision of and referral to complementary therapists. Results: A high level of complementary therapy use (68%) was reported by outpatients. Asian and Black patients reprted greater complementary therapy use than white patients (76%, 85% and 52% respectively). Of users, over half reported that they did not inform their GP about this use and would use a complementary therapy first before consulting with their GP. The form of complementary therapy used vaired according to ethnic group. White patients favoured acupuncture and homoeopathy, black patients herbal remedies and Asian patients favoured herbal and Ayurvedic remedies. Almost all patients felt that complementary therapies should be available on the NHS. Most GPs (86%) were involved in arranging complementary therapy referrals (particularly for acupuncture, osteopathy and homoeopathy) although patients were apparently unaware that GPs could make such referrals. Two-third of GPs would use a local service if it was available. Both patients and GPs reported that complementary therapies were most likely to be requested for pain, musculoskeletal and nervous problems. Conclusions: Complementary therapy use was common amongst patients attending hospital clinics and GPs were often asked for referrals to complementary practitioners. There is a need for doctors to be more aware of the scope of comöementary therapies to ensure appropriate communication and referral.

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