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Medical Decision Making, Vol. 24, No. 1, 64-79 (2004)
DOI: 10.1177/0272989X03261567
© 2004 Society for Medical Decision Making

Alternative Medicine or "Alternative" Patients: A Qualitative Study of Patient-Oriented Decision-Making Processes with Respect to Complementary and Alternative Medicine

Opher Caspi, MD, PhD

Department of Medicine, College of Medicine, University of Arizona Health Sciences Center, PO Box 245153, Tucson, AZ 85724-5153;ocaspi{at}ahsc.arizona.edu

Mary Koithan, RN, PhD

Michael W. Criddle, BS

Background.Theory and clinical practice suggest that complementary and alternative medicine (CAM) decisionmaking processesmaydiffer from those used in conventional medicine. If so, understanding the differences could improve patient-provider communication around treatment options. Objectives.To examine patient-oriented decision-making processes relative to CAM use.Population.Adults with chronic rheumatological disorders who utilize allopathic medicine only, CAM only, or both.Method.An exploratory, cross-sectional naturalistic design with thematic and content analyses.Results.Three distinct decision paths were developed, differing substantially on the importance of provider trust, disease severity/prognosis, willingness to experiment, intuitive/spiritual factors, and outcomes evidence. Conclusions.These divergent decision paths indicate the possibility of "alternative patients," not just "alternative therapies." Since informed decisions, tailored to the patient, would likely lead to sustainable improvements in health care outcomes, the findings may facilitate providers’ capacity to effectively advise patients about treatment alternatives and CAM use.

Key Words: complementary and alternative medicine • decision making • qualitative methods


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