Abstract
BackgroundAlthough a quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce. The purpose of this study is to: 1) estimate the prevalence and odds of CAM use among participants with hypercholesterolemia, hypertension, diabetes, and obesity; and 2) examine the effects of chronic condition dyads and triads on the use of CAM modalities, specifically manipulative and body-based methods, biological treatments, mind-body interventions, energy therapies, and alternative medical systems.MethodsData were obtained from the 2012 National Health Interview Survey and the Adult Alternative Medicine supplement. Statistical analyses were restricted to persons with self-reported hypercholesterolemia, hypertension, diabetes, or obesity (n = 15,463).ResultsApproximately 37.2% of the participants had just one of the four chronic conditions, while 62.4% self-reported multiple comorbidities. CAM use among participants was as follows (p < 0.001): hypercholesterolemia (31.5%), hypertension (28.3%), diabetes (25.0%), and obesity (10.8%). All combinations of disease dyads and triads were consistently and significantly associated with the use of mind-body interventions (2–4%, p < 0.001). Two sets of three dyads were associated with use of manipulative methods (23–27%, p < 0.05) and energy therapies (0.2–0.3%, p < 0.05). Use of biological treatments (0.04%, p < 0.05) and alternative systems (3%, p < 0.05) were each significant for one dyad. One triad was significant for use of manipulative methods (27%, p < 0.001).ConclusionsThese findings point to future directions for research and have practical implications for family practitioners treating multimorbid patients.
Highlights
A quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce
Study design and participants This cross-sectional study consists of men and women ages 18 years and older who responded to the 2012 National Health Interview Survey (NHIS), a nationally-representative surveillance system administered by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS)
Overall CAM use proportions in general, CAM use in participants with two or more chronic conditions, and a comparison of the adjusted odds of CAM use for those participants with one chronic condition versus two or more conditions are presented in Table 2 Table 3 provides the bivariate proportions for CAM use among disease dyads and triads for the five CAM domains
Summary
A quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce. More than a quarter of Americans are estimated to have multiple comorbidities, we identified few studies [8] assessing the effect of specific combinations of chronic diseases (dyads and triads) on use of CAM. None of these studies focused on patients with cardiovascular risk factor combinations such as hypertension, hypercholesterolemia, diabetes, and obesity, all of which are conditions of increasing prevalence and public health significance. Whereas the prevalence of hypertension among adults in the U.S has remained relatively constant at 30% since 1999 [9,10,11], the prevalence of diabetes (9–12%), hypercholesterolemia (25–27%), and obesity (31–36%) has been steadily increasing in the past decade [9]
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