Aims: Examine 1) stability of use of complementary and alternative medicine (CAM) of breast cancer patients, 2) reasons for CAM use, and 3) sociodemographic, clinical, and psychological predictors of CAM use.
Methods: CAM use was assessed after adjuvant therapy and six months later. Following the CAM Healthcare Model, CAM use was divided into use of provider-directed (guided) and self-directed (self-help) CAM. Stability and reasons for CAM use were examined with McNemar’s tests and descriptive statistics. Cross-sectional and longitudinal associations between predictors and CAM use were examined with univariate and multivariate logistical analyses.
Results: Approximately 18% of the respondents used provider-directed CAM services, and 57% of the women used self-directed CAM, at each of the two assessments (N=176). Use of provider-directed and self-directed CAM was stable over time.
Twenty-four percent of the women who used provider-directed CAM, used it to influence the course of cancer after adjuvant therapy, while 52% of the women who used self-directed CAM, used that for that purpose. Within six months these percentages rose to 47% and 65% respectively. At least 95% of the women used provider-directed respectively self-directed CAM to influence well-being, at both assessments.
Openness to experience predicted use of provider-directed CAM, after adjusting for other predictors (OR=1.14, 95% CI 1.03-1.24, p<.01 after adjuvant therapy; OR=1.10, 95% CI 1.00-1.20, p<.05 six months later). Clinical distress predicted use of self-directed CAM, after adjusting for other predictors (OR=2.17, 95% CI 1.09-4.32, p<.05 after adjuvant therapy).
Conclusions: CAM use is stable over time. It is meaningful to distinguish provider-directed from self-directed CAM. Based on the results, providers are advised to plan a ‘CAM-talk’ before adjuvant therapy, and discuss patients’ expectations about influence of CAM on the course of cancer. Providers may address patients’ preferences for provider- or self-directed CAM. Distressed patients most likely need information about self-directed CAM.