Original Article

Prevalence and Costs of Complementary/Alternative Medicine among Traumatic Patients in Iran: A Nationwide Population-based Study


Background: This study was aimed to determine the prevalence, predictors and cost of CAM practitioner use among traumatic patients in Iran.

Methods: This cross-sectional household survey of a nationally representative sample of Iranians 15 to 64 yr old was conducted in 2011, using a three-stage cluster sampling. Short Form Injury Questionnaire 7 (SFIQ7) was utilized through face-to-face interviews and data on demographics, history of injuries, mechanism, site and type of injury, type and place of the treatment were attained. Via telephone calls, service use and costs of treatment were also collected.

Results: The prevalence of CAM practitioner use in injured people and victims seeking medical care was 0.7% and 4.1%, respectively in 3-month interval in 2011. There were no significant sociodemographic differences between victims who seek unconventional settings and those who seek conventional treatment. The most common injury description treated by CAM providers was as follows: fracture (type of injury), upper limb (site of injury), fall (mechanism of injury) and cast, splint, and physiotherapy (type of treatment). The average medical cost of CAM practitioner was US$14.7 while this amount in the conventional setting was US$195.5.

Conclusion: Use of CAM is not very common among injured people in Iran. However, due to lack of formal training, CAM usage has possible side effects.



1. Murray CJ, Vos T, Lozano R et al (2012). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859):2197-223.
2. Naghavi M, Wang H, Lozano R et al (2015). Global, regional, and national age-sex specific all-cause and cause-specific mor-tality for 240 causes of death, 1990-2013: a systematic analysis for the Global Bur-den of Disease Study 2013. Lancet, 385(9963):117-71.
3. Farahani AK, Shahrjerdi S (2013). Orthope-dics in Folk Medicine (Case Study of Folk Orthopedics in Arak City, Iran). Quran and Medicine, 2(1): 30-32.
4. Murray RH, Rubel AJ (1992). Physicians and healers—unwitting partners in health care. N Engl J Med, 2;326(1):61-4.
5. Eisenberg DM, Davis RB, Ettner SL et al (1998). Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA, 11;280(18):1569-75.
6. Bausell RB, Lee WL, Berman BM (2001). Demographic and health-related corre-lates of visits to complementary and al-ternative medical providers. Med Care, 1;39(2):190-6.
7. Druss BG, Rosenheck RA (1999). Associa-tion between use of unconventional ther-apies and conventional medical services. JAMA, 18;282(7):651-6.
8. Mackenzie ER, Taylor L, Bloom BS, Hufford DJ, Johnson JC (2003). Ethnic minority use of complementary and al-ternative medicine (CAM): a national probability survey of CAM utilizers. Altern Ther Health Med, 1;9(4):50-56.
9. Oldendick R, Coker AL, Wieland D, Ray-mond JI, Probst JC, Schell BJ, Stopskopf CH (2000). Population-based survey of complementary and alternative medicine usage, patient satisfaction, and physician involvement. South Med J, 93(4):375-81.
10. Paramore LC (1997). Use of alternative ther-apies: Estimates from the 1994 Robert Wood Johnson Foundation national ac-cess to care survey. J Pain Symptom Manage, 28;13(2):83-9.
11. Rafferty AP, McGee HB, Miller CE, Reyes M (2002). Prevalence of complementary and alternative medicine use: state-specific estimates from the 2001 Behavioral Risk Factor Surveillance System. Am J Public Health, 92(10):1598-600.
12. Bodane C, Brownson K (2002). The grow-ing acceptance of complementary and al-ternative medicine. Health Care Manag (Frederick), 20(3):11-21.
13. Harris P, Rees R (2000). The prevalence of complementary and alternative medicine use among the general population: a sys-tematic review of the literature. Complement Ther Med, 30;8(2):88-96.
14. Ernst E (2000). Prevalence of use of com-plementary/alternative medicine: a sys-tematic review. Bull World Health Organ, 78(2):258-66.
15. Ernst E (1998). Usage of complementary therapies in rheumatology: a systematic review. Clin Rheumatol, 1;17(4):301-5.
16. Ernst E (1997). Complementary AIDS ther-apies: the good, the bad and the ugly. Int J STD AIDS, 1;8(5):281-5.
17. Ernst E, Cassileth BR (1998). The preva-lence of complementary/alternative med-icine in cancer: a systematic review. Cancer, 15;83(4):777-82.
18. Boon H, Stewart M, Kennard MA et al (2000). Use of complementary/alternative medicine by breast cancer survivors in Ontario: prevalence and perceptions. J Clin Oncol, 1;18(13):2515-21.
19. Ernst E (1999). Prevalence of complemen-tary/alternative medicine for children: a systematic review. Eur J Pediatr, 1;158(1):7-11.
20. Madsen H, Andersen S, Nielsen RG, Dol-mer BS, Høst A, Damkier A (2003). Use of complementary/alternative medicine among paediatric patients. Eur J Pediatr, 1;162(5):334-41.
21. Schaefer T (2004). Epidemiology of com-plementary alternative medicine for asth-ma and allergy in Europe and Germany. Ann Allergy Asthma Immunol, 31;93(2):S5-10.
22. Patrick L (1999). Hepatitis C: epidemiology and review of complementary/alternative medicine treatments. Altern Med Rev, 4(4):220-38.
23. Egede LE, Ye X, Zheng D, Silverstein MD (2002). The prevalence and pattern of complementary and alternative medicine use in individuals with diabetes. Diabetes Care, 1;25(2):324-9.
24. Rahimi-Movaghar A, Amin-Esmaeili M, Motevalian A et al (2014). The Iran men-tal health survey: design and field proce-dures. Iran J Psychiatry, 9:96-109.
25. Kish, L (1949). A procedure for objective respondent selection within the house-hold. J Am Stat Assoc, 44: 380–387.
26. Sharif-Alhoseini M, Saadat S, Rahimi-Movaghar A et al (2012). Reliability of a patient survey assessing "Short Form In-jury Questionnaire 7" in Iran. Chin J Traumatol,15(3):145-7.
27. Hafezi-Nejad N, Rahimi-Movaghar A, Motevalian A et al (2014). A nationwide population-based study on incidence and cost of non-fatal injuries in Iran. Inj Prev, 20(5):e9.
28. Hafezi-Nejad N, Rahimi-Movaghar A, Motevalian A et al (2015). Population-based incidence and cost of non-fatal in-juries in Iran: a consistent under-recognized public health concern. Public Health, 129(5):483-92.
29. Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD (2012). Use and ac-ceptance of complementary and alterna-tive medicine among the general popula-tion and medical personnel: a systematic review. Ochsner J, 12(1):45-56.
30. Eisenberg DM, Kessler RC, Foster C, Nor-lock FE, Calkins DR, Delbanco TL (1993). Unconventional medicine in the United States--prevalence, costs, and pat-terns of use. N Engl J Med, 28;328(4):246-52.
31. Tindle HA, Davis RB, Phillips RS, Eisenberg DM (2005). Trends in use of comple-mentary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med, 1;11(1):42-49.
32. MacLennan AH, Wilson DH, Taylor AW (1996). Prevalence and cost of alternative medicine in Australia. Lancet, 2;347(9001):569-73.
33. MacLennan AH, Wilson DH, Taylor AW (2002). The escalating cost and prevalence of alternative medicine. Prev Med, 31;35(2):166-73.
34. Visser GJ, Peters L (1990). Alternative medi-cine and general practitioners in The Netherlands: towards acceptance and in-tegration. Fam Pract, 1;7(3):227-32.
35. Ernst E, Willoughby M, Weihmayr TH (1995). Nine possible reasons for choos-ing complementary medicine. Perfusion, 11: 356 – 8.
36. Barnes PM, Powell-Griner E, McFann K, Nahin RL (2004). Complementary and al-ternative medicine use among adults: United States, 2002. Adv Data, 27;(343):1-19.
37. Leung PC, Ko EC, Siu WS, Pang ES, Bik-san Lau C (2016). Selected topical agents used in Traditional Chinese Medicine in the treatment of minor injuries-a review. Front Pharmacol, 7:16.
38. Eze KC (2012). Complications and co-morbidities in radiographs of patients in traditional bone setters’ homes in Ogwa, Edo State, Nigeria: a community-based study. Eur J Radiol, 81(9):2323-8.
39. Aderibigbe SA, Agaja SR, Bamidele JO (2013). Determinants of utilization of tra-ditional bone setters in Ilorin, North Central Nigeria. J Prev Med Hyg, 54(1):35-40.
40. Onuminya JE (2006). Performance of a trained traditional bonesetter in primary fracture care. S Afr Med J, 96(4):320-2.
41. Dada AA, Yinusa W, Giwa SO (2011). Re-view of the practice of traditional bone setting in Nigeria. Afr Health Sci, 11(2):262-5.
42. Omololu AB, Ogunlade SO, Gopaldasani VK (2008). The practice of traditional bonesetting: training algorithm. Clin Or-thop Relat Res, 466(10):2392-8.
43. Garba ES, Deshi PJ (1998). Traditional bone setting: a risk factor in limb amputation. East Afr Med J, 75(9):553-5.
IssueVol 47 No 10 (2018) QRcode
SectionOriginal Article(s)
Complementary/alternative medicine, Trauma, Population survey, Prevalence, Cost

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
KALANTAR MOTAMEDI MH, ABOUIE A, HAFEZI-NEJAD N, SAADAT S, RAHIMI-MOVAGHAR A, MOTEVALIAN A, AMIN-ESMAEILI M, SHARIFI V, HAJEBI A, EBRAHIMI A, RAHIMI-MOVAGHAR V. Prevalence and Costs of Complementary/Alternative Medicine among Traumatic Patients in Iran: A Nationwide Population-based Study. Iran J Public Health. 2018;47(10):1558-1566.