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Wednesday, 18 October 2006


Carol E. Blixen, PhD1, Noah J. Webster, MA2, Adam T. Perzynski, MA2, Eleanor P. Stoller, PhD3, Joshua J. Terchek, BA2, Stephanie W. Kanuch, MEd4, Andrew J. Hund, MA2, Richard A. McCormick, PhD2, and Neal V. Dawson, MD4. (1) Cleveland Clinic, Cleveland, OH, (2) Case Western Reserve University, Cleveland, OH, (3) Wake Forest University, Winston-Salem, NC, (4) Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH

Purpose: Patients often consult informal sources, including the internet, to aid them with treatment decisions about their disease. In light of the growing use of complimentary and alternative medicine practices (CAM) such as the use of herbs, supplements, acupuncture, etc, among patients with hepatitis C (HCV), we explored the topics surrounding patients' decisions to use CAM therapies for this disease as discussed on the internet.

Methods: Two sources of cross-sectional textual data were collected from the internet and analyzed for this study: (1) 307 electronic illness narratives posted on the topic of HCV from eight English language websites; and (2) 264 threaded discussions that included 534 discussants from four internet sites on the topic of HCV. The data were analyzed by first importing the text files into NVIVO (qualitative data management software) and coding any reference to CAM. Next, using the procedure of open-coding, the researchers independently reviewed the CAM text and generated a list of descriptive codes (topics). The researchers then met to compare lists and agree on a final version of the codes and their sub-categories.

Results: Nine descriptive codes, related to information sharing and decision making about the use of CAM for HCV, emerged from analysis of the qualitative data: 1) Reasons for Using CAM (liver health, dissatisfaction with traditional treatment, treatment of symptoms and side effects); 2) Research and Education on CAM (internet, books, seeking advice from others); 3) Types of CAM Used (herbs, supplements, behavioral, CAM provider based therapies); 4) Types of CAM Providers Seen (homeopaths, naturopaths, herbalists, acupuncturists, etc); 5) Therapeutic Regimens of CAM (combinations, dosages, frequency); 6) Perceived Results of CAM (positive, negative); 7) Cost Issues of CAM (price, insurance); 8) Re-evaluation of CAM Use (continue, discontinue); and 9) Sharing Experiences/Giving Advice about CAM Use.

Conclusions: The internet is a venue where a large amount of information about CAM is shared and a powerful tool for aiding patients in the medical decision making process. In order to assist patients with HCV in choosing therapies that are efficacious and safe, healthcare providers need to be aware of the wide range of topics that impact on the decision to use CAM therapies, and be able to discuss them with their patients.

See more of Poster Session V
See more of The 28th Annual Meeting of the Society for Medical Decision Making (October 15-18, 2006)