Barriers to patient referral for Complementary and Alternative Medicines and its implications on interventions

Aim: To study the perceptions of Complementary and Alternative Medicine (CAM) among healthcare professionals and identify factors associated with referral for CAM treatment.

Methods: An anonymous, self-administered survey was conducted in April 2008. All doctors, registered nurses, physiotherapists and occupational therapists in Tan Tock Seng Hospital were invited to participate. Data were analysed using SPSS v15.

Results: The overall response rate was 61.9%. Most respondents perceived their knowledge of CAM to be limited and had little personal experiences with CAM. Few had referred a small percentage of their patients for CAM therapies. Nonetheless, 62.2% of respondents believed that CAM would be safe when practiced by trained professionals and only 6.5% agreed that physicians should warn patients against CAM. Respondents who did not refer patients for CAM therapy cited lack of personal knowledge on the subject (53.4%); not knowing a suitable CAM practitioner (29.0%); and not thinking it was necessary (14.6%). The key reasons for referring were patients' preferences (58.0%); efficacy of CAM for specific conditions (39.1%); and when other treatment modalities were unsuccessful (21.9%). Most respondents (82.7%) had favourable attitudes and expressed interest in attending CAM seminars.

Conclusion: The majority of western-trained healthcare professionals perceived their knowledge of CAM to be low. Most referrals to CAM were made because their patients believed in CAM. Limited personal knowledge and experiences were associated with lower referrals. However, they were interested to know about the common CAM modalities. This suggests the need for more CAM education interventions for healthcare professionals.