Predictive factors of complementary and alternative medicine use in the general population in Europe: A systematic review

Aim: To identify predictive factors of CAM use in the general population in Europe. Methods: We performed a systematic review to summarize and analyse the published data on factors predictive of CAM use by the general population in Europe. The Cumulative Index to Nursing and Allied Health Literature, Google Scholar, Psyclnfo, PubMed and the Web of Science databases were systematically searched up to August 2, 2018. We selected observational studies (case-control, cohort and cross-sectional) of adults conducted in Europe. Risk of bias was determined using the ROBINS-I tool recommended by the Cochrane Group. Results: Over six thousand articles were identified of which 49 met our inclusion criteria. Twenty three studies investigated the consultation of CAM practitioners, five looked at the use of CAM products, one concerned CAM practices and twenty studied combinations of these. Female gender and self-reported chronic disease are predictive factors of CAM practitioner use. In contrast, marital status is not a predictive factor for consulting a CAM practitioner. Female gender is also a predictive factor of CAM product use. For all other factors investigated, no clear conclusions could be drawn. Conclusion: We found no clear specificity of the use of CAM practitioners versus conventional health practitioners. Other directions of public health research should be explored, rather than assuming that there is specificity.