Complementary and Alternative Medicine Utilization: Moving Beyond Prevalence Estimates Toward Context-Specific Integration and Health Policy

Dear Editor, I read with great interest the recent article by Nemesure et al 1 which examined the utilization of complementary and alternative medicine (CAM) among US adults using data from the 2022 National Health Interview Survey (NHIS).Their analysis demonstrated that approximately 37% of US adults engaged in at least 1 CAM practice during the preceding 12 months, with meditation, yoga, chiropractic care, and massage therapy emerging as the most frequently utilized modalities.The study further identified younger age, female sex, higher educational attainment, anxiety, and better selfreported health as significant predictors of CAM utilization.Importantly, the authors reported that improving overall health, rather than treating a specific illness, was the predominant motivation for CAM use. 1 This study provides valuable nationally representative evidence regarding contemporary CAM utilization in the United States and makes a meaningful contribution to the growing discourse on integrative medicine.By identifying demographic and psychosocial factors associated with CAM adoption, the authors establish a useful foundation for clinicians, researchers, and policymakers seeking to better understand evolving patient preferences.Their findings reinforce the growing recognition that health promotion is increasingly viewed through a holistic framework encompassing physical, psychological, and emotional well-being.While the study successfully quantifies CAM utilization and its associated factors, an important gap remains regarding the influence of cultural context and health system characteristics on CAM adoption.Utilization patterns observed in the United States may not be directly transferable to countries where traditional healing systems are deeply embedded within cultural practices, healthcare accessibility differs substantially, and regulatory oversight of CAM remains heterogeneous.Consequently, prevalence estimates alone provide limited guidance for developing globally applicable integrative healthcare strategies.This limitation is particularly relevant in the Philippine setting, where traditional, complementary, and alternative medicine has long coexisted with conventional healthcare.The enactment of the Traditional and Alternative Medicine Act of 1997 (Republic Act No. 8423) formally recognized the role of traditional medicine and established institutional support for research, regulation, and integration through the Philippine Institute of Traditional and Alternative Health Care. 2 Despite this legislative framework, evidence describing actual utilization patterns, patient motivations, clinical outcomes, and physician attitudes toward CAM remains relatively limited compared with that available in high-income countries.Furthermore, disparities in healthcare access between urban and rural communities may encourage greater reliance on traditional healers, herbal medicine, and culturally rooted therapeutic practices that are not fully captured by internationally standardized CAM classifications.These contextual differences underscore the need for locally generated evidence to guide evidence-informed integration of CAM into national healthcare systems.Another important consideration concerns the interpretation of the reported association between CAM utilization and better health outcomes.Because the NHIS employs a cross-sectional design, causal relationships cannot be established.1 Individuals reporting better health may simply be more proactive in adopting preventive wellness behaviors, including CAM practices, rather than experiencing improved health because of CAM use itself.Likewise, the observed association between anxiety and CAM utilization may reflect increased health-seeking behavior among psychologically distressed individuals