Self-Management of Stress with Complementary and Alternative Medicine: Factors That Influence and Inform Decision Making - A Systematic Review of the Literature

Background: Stress, sometimes referred to as psychological distress, is common in Australia and many people choose to self-medicate by purchasing over-the-counter complementary and alternative medicine (CAM) products from pharmacies. Aims: This review has five aims: to determine the philosophical underpinnings of CAM use in the general population and also in those who experience a mental health disorder, notably psychological distress; to find more specific reasons for CAM use in those two population groups; and to examine the influences and information sources relating to CAM purchases in pharmacy, particularly for stress. Materials and Methods: This review was conducted using a systematic approach across relevant databases and using specific inclusion criteria. Results: Examination of 47 studies produced a disparate group of findings. Consumers of CAM in the general population often related to the modality with a philosophical congruence (e.g., holistic views and personal empowerment) and more specifically the ability to actively and positively self-manage their health. Those with mental health disorders felt similarly, but also exhibited a negative attitude to conventional treatments, often considering CAM safer and more appropriate. A more specific reason forCAMadoption in the wider population was prior usage and self-belief of effectiveness. Only one study examined CAM use in those with a mental health disorder indicating a "last resort" attitude. In six studies, one being Australian, it was demonstrated that family and friends were common sources of influence and information; however, no studies were found relating to CAM usage in those with psychological distress. Conclusion: CAM use both in the general Australian population and in those self-managing stress is common. These groups share some philosophical viewpoints. Family and friends often guide decision making in the first group, but almost nothing is known of those suffering stress, indicating a dire need for research. Implications indicate an extended role for pharmacists and pharmacy staff in this area.