Does trust in health care influence the use of complementary and alternative medicine by chronically ill patients?

Background: Patients’ trust in health care (professionals) is essential for the effectiveness of health care, especially for chronically ill patients, since chronic diseases are by definition (partly) incurable. Therefore, it may be understandable that the chronically ill turn to complementary and alternative medicine (CAM), often in addition to regular care. The relationship between trust in health care (professionals) and CAM use in chronically ill patients have not been reported until now. In this study, we examine (i) chronically ill patients’ trust in health care (professionals), (ii) their use of CAM, and (iii) the relation between trust and CAM use. Methods: The sample comprises respondents of the nationwide Dutch ‘Panel of Patients with Chronic Diseases’ (PPCD). Patients were selected by their GPs on the basis of diagnoses of chronic diseases. In total, 1625 chronically ill patients (>25 years) were included. Trust and CAM use were measured by means of a written questionnaire (2003). Statistical analyses used were t-tests, Chi-square and one-way analysis of variance, and logistic regression analysis. Results: The less trust patients have in regular health care in the future the more they will be inclined to use CAM, when controlling for socio-demographic and disease characteristics. Female, young, and higher educated patients are more likely to use CAM, whereas patients suffering from cardiovascular diseases, patients with diabetes, and patients with asthma/COPD are less likely to use CAM. Conclusions: Trust is an important concept in health care use and a significant issue in CAM use by chronically ill patients. CAM use may increase, at least by chronically ill patients, if the relatively low trust in future health care will stay at the same level.(aut. ref.