Complementary and Alternative Medicines: The Knowledge, Attitudes and Practices of Dietitians in Maine

Consumer interest in complementary/alternative medicines (CAM) has increased substantially in the past thirty years. This is due to the growing knowledge of the link between diet and disease, as well as the cost and accessibility of health care. Despite substantial advances in the medical treatment of disease, many people seek patient-directed, nonprescription approaches to prevent and treat disease. In fact, it has been estimated that consumers spend over $ 13 billion each year on CAM. More people are taking ownership of their own health, and have thus turned to nonprescription measures for the prevention and treatment of disease. For the purpose of this research, CAM was defined as treatments and approaches to health outside the scope of traditional Western medicine, used in the prevention or treatment of disease. Three facets of CAM were studied, including nutrient supplements, functional foods and herbal products. Nutrient supplements were defined as nutrients taken to supplement the diet for the purpose of preventing or treating disease; functional foods as foods which provide a physiologic benefit in addition to its nutrient content and which may prevent or treat disease; and herbal products as products made from a plant with leaves, seeds, flowers or roots and used for preventing or treating disease, not as a seasoning. Surveys were mailed to all dietitians and diet technicians (n=412) on the Maine Dietetic Association mailing list by a modified Dillman method. This involved a letter of intent, followed by the survey package, a reminder postcard, and a replacement survey package to non-responders. The rate of response to the survey was 63%. This high response rate to the survey is indicative of great interest in this topic. This is one of the first published surveys regarding the knowledge, attitudes and practices of dietetics professionals about complementary and alternative medicine. The high response rate is indicative of great interest in CAM. Dietetic professionals in Maine are most confident in and satisfied with their knowledge of nutrient supplements and functional foods. They are much less confident in and satisfied with their knowledge of herbal products. Respondents believe in the safety and effectiveness of nutrient supplements and functional foods, but not herbal products. Dietetics professionals in Maine have partly incorporated CAM into their regular practice. Respondents do intend to integrate CAM into their future practice and provide CAM recommendations to clients. Dietetic professionals in Maine identified great interest in and a need for future training in CAM. The results of this survey may aid the American Dietetic Association in the development of continuing education training requirements regarding complementary and alternative medicine, as well as undergraduate educational requirements to become a registered dietitian. It may also help educational institutions modify their programs to better prepare students to educate consumers and provide CAM counselling. The results will help the ADA determine interest in continuing education for conferences, workshops and educational materials