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Association Between Complementary and Alternative Medicine Use, Preventive Care Practices, and Use of Conventional Medical Services Among Adults With Diabetes

¹ Department of Medicine, Division of General Internal Medicine, Medical University of South Carolina, Charleston, South Carolina
² Ralph H. Johnson VA Medical Center, Charleston, South Carolina

Address correspondence and reprint requests to Leonard E. Egede, MD, Medical University of South Carolina, Center for Health Care Research, 135 Cannon St., Suite 403, Charleston, SC 29425. E-mail: egedel{at}musc.edu

OBJECTIVE—To assess the association between complementary and alternative medicine (CAM) use, preventive care practices, and use of conventional medical services among adults with diabetes.

RESEARCH DESIGN AND METHODS—We analyzed data on 2,474 adults with diabetes. We created an overall CAM-use category based on use of any of the following: diets, herbs, chiropractic care, yoga, relaxation, acupuncture, ayuverda, biofeedback, chelation, energy healing, Reiki therapy, hypnosis, massage, naturopathy, and homeopathy. We used multiple logistic regression to assess the effect of CAM use on preventive care practices (receipt of influenza and pneumonia vaccines) and use of conventional medical services (number of primary care and emergency department visits). STATA was used for statistical analysis to account for the complex survey design.

RESULTS—A total of 48% of adults with diabetes used some form of CAM. CAM use was independently associated with receipt of pneumonia vaccination (odds ratio 1.56 [95% CI 1.26–1.94]) but not significantly associated with receipt of influenza vaccination (1.17 [0.92–1.48]). CAM use was independently associated with visiting the emergency department (1.34 [1.06–1.70]), having six or more primary care visits (1.44 [1.14–1.83]), and having eight or more primary care visits (1.66 [1.22–2.25]).

CONCLUSIONS—In contrast to the findings of previous studies, CAM use appears to be associated with increased likelihood of receipt of preventive care services and increased emergency department and primary care visits. CAM use may not be a barrier to use of conventional medical services in adults with diabetes.

Abbreviations: CAM, complementary and alternative medicine • NHIS, National Health Interview Survey

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