Factors associated with self-care activities among adults in the United Kingdom: a systematic review
BACKGROUND The prevalence and cost of regular use of non-prescribed alternative medicines are rising around the world, yet, little evidence is available that demonstrates the safety, efficacy, or effectiveness of specific alternative medicine interventions. It is of interest to understand how and why these practices have become so popular in different societies with different health care organizations and provisions, and which factors predict the regular use of alternative medicines. METHODS We assessed the prevalence and the predictors of regular use of non-prescribed vitamin supplements, cod liver oil, primrose oil, and garlic in a cross-sectional population-based study in South London of 1,577 men and women, aged 40-59 years (883 women, 523 White, 549 of African origin and 505 of South Asian origin), when allowing for potential confounders. RESULTS The prevalence of regular users of alternative medicines was 10.4% (164/1,577); 7.4% (116) made regular use of non-prescribed vitamin supplements, whereas 5.3% (84) used either cod liver oil, primrose oil, or garlic preparations. When adjusted for age, ethnicity and social class, women were more likely than men to use at least one alternative medicine (OR 2.09 [95% CI 1.45-3.00]). This was true both for vitamin supplements (1.98 [1.29-3.03]) and for oil or garlic supplements (1.91 [1.17-3.14]). The use of oil or garlic (P<.005) but not vitamin supplements (P=.32) varied by ethnic group. In particular, Black people of African origin were more likely to use alternative medicines than either Whites (1.78 [1.07-2.94]) or South Asians (1.66 [1.07-2.59]), the least common users. People in social classes IV and V were less likely to use alternative medicines (0.53 [0.31-0.90]) than those in social classes I and II, though this was due more to lesser use of non-prescribed vitamin supplements than of cod liver oil, primrose oil or garlic. These associations were not attenuated by further adjustment for body mass index, smoking, marital status and age at leaving full-time education. CONCLUSIONS The regular users of alternative medicines in London are more likely to be women, of African origin, and of higher socioeconomic status. Given the lack of evidence of efficacy and safety of these alternative medicines, it is important to understand the cultural differences in values and beliefs about traditional medicine that may underlie these findings.