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Trends in Complementary Alternative Therapies' Use

Section Editor(s): Donnelly, Gloria F. PhD, RN, FAAN, FCPP; Editor in Chief

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doi: 10.1097/HNP.0000000000000388
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The National Center for Complementary Integrative Health reported that Americans' out-of-pocket expenditures for complementary integrative health products and modalities exceeds $30 billion annually,1 rising steadily for the past 2 decades. In addition to spending on dietary and other supplements excluding vitamins/minerals, complementary integrative modalities with the greatest surge in usage were yoga and meditation. From 2012 to 2017, the practice of yoga rose from 9.5% to 14.3% and meditation from 4.1% to 14.2% of the national sample, with women primarily responsible for this rise.2 Concurrent with these trends is the offering of complementary integrative interventions and services by US hospitals. A survey, supported by the American Hospital Association and the Samueli Institute, reported a 5% increase over 3 years from 37% to 42%, in the number of responding hospitals offering complementary/alternative services.3 Further, many of the top-rated US hospitals and academic medical centers offer “natural healing alternatives” such as Chinese herbal therapy, acupuncture and acupressure, massage, homeopathy, meditation, yoga, aromatherapy, art therapy, Reiki, guided imagery, and hypnotherapy.4 These hospital offerings are most likely a response to consumer demand for less invasive and nonaddictive forms of symptom and pain management for which the public will pay.

The widespread use of complementary/alternative therapies dictates a review of nursing program curricula at the undergraduate, graduate, and continuing education levels. Are nurses sufficiently prepared to practice holistic interventions in practice environments? The American Holistic Nurses Association offers a review, recommendation, and endorsement process to ensure the educational soundness of certificates and programs preparing nurses to practice complementary/alternative interventions and understand their theoretical and cultural underpinnings and their interactions with traditional medical model interventions.5

In 2019, the World Health Organization (WHO) published a report on the use and regulation of complementary integrative modalities worldwide.6 With 179 countries responding, the WHO report highlights the growing importance of “traditional” medicine practices (ie, complementary/alternative therapies) in addressing the health needs of populations through a more systematic integration of “traditional practices” in primary health care. The references below can serve as rich resources to nurses serving in practice or educational roles. The rising number of internationally based manuscript submissions to Holistic Nursing Practice is validation of worldwide trends and nurses' pioneering efforts to document the efficacy of complementary/integrative practices.

—Gloria F. Donnelly, PhD, RN, FAAN, FCPP
Editor in Chief


1. National Health Interview Survey. Americans spend $30 billion a year out of pocket on complimentary health approaches. Published June 22, 2016. Accessed February 13, 2020.
2. Clarke TC, Barnes PM, Black LI, Stussman BJ, Mahin R. Use of yoga, meditation and chiropractors among US adults aged 12 and older. NCHS Data Brief, No. 325, November 2018. Accessed February 13, 2020.
3. Henkel G. Survey: steady increase in complementary alternative medicine (CAM) offerings in US hospitals. The Hospitalist. Published February 2012. Accessed February 14, 2020.
4. Keefe J. Here are the alternative therapies offered by top hospitals. Published March 7, 2017. Accessed February 14, 2020.
5. American Holistic Nurses Association. AHNCC Endorsed Nursing Programs in Holistic Health. Accessed February 14, 2020.
6. World Health Organization. WHO Global Report on Traditional and Complementary Medicine 2019. Geneva, Switzerland: World Health Organization; 2019.
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