Why consumers maintain complementary and alternative medicine use: A qualitative study. Presented at ECIM 2009.

Question: Consumers are thought to use CAM because they are attracted to attributes of specific CAM therapies and discouraged by negative experiences of conventional medicine. Research evidence supports this hypothesis, but there remains a need to distinguish between factors and processes involved in the initial uptake of therapies and those involved in their subsequent maintenance. We therefore conducted a qualitative study to explore and describe consumers’ reasons for maintaining or stopping CAM use.Methods: This was a qualitative study. We interviewed 46 CAM consumers and 9 CAM practitioners, in two high-street CAM clinics in the UK. The interviews were analysed thematically using techniques from grounded theory.Results: Consumers described and evaluated their CAM experiences along four dimensions: interpersonal (e.g. interactions with practitioners), physical (e.g. sensations such as touch or pain during treatment), affective (e.g. empowerment) and cognitive (e.g. beliefs about treatment). They evaluated their experiences in relation to their individual needs and expectations; financial considerations could limit maintenance of CAM use. Practitioners emphasised the effectiveness of treatment and themselves as contributing to consumers maintaining treatment, and recognised the role of financial considerations in decisions to stop CAM use.Conclusions: Further work is needed to test and extend our findings in other settings. This study suggests that experiences of conventional medicine are of limited importance after the decision to initiate CAM. Experiences of CAM were foremost in our consumers’ decisions to maintain or stop specific CAM therapies. Maintenance of CAM could occur even if consumers’ experiences were not entirely positive. CAM practitioners may have a vital role to play in ethically supporting consumers’ decisions to maintain CAM use.