Use of Complementary and Alternative Medicine and Self-Rated Health Status: Results from a National Survey
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Despite the absence of conclusive evidence of effectiveness, complementary and alternative medicine (CAM) is used by 4 of 10 adults in the US; little is known about the association between CAM use and health status.
To determine the relation between CAM use and self-reported health status and health improvement over time.
Design and Participants
We performed a secondary database analysis using data from the 2007 National Health Interview Survey of non-institutionalized US residents conducted by the National Center of Health Statistics of the Center for Disease Control. We identified CAM users and compared them to non-users. We used multivariable logistic regression to model the health status of respondents. We controlled for confounders including socio-demographic, clinical, and behavioral factors. The models were evaluated for discrimination and calibration.
The likelihood of respondents to report ‘Excellent’ current health and ‘Better’ health than in the prior year.
Based on 23,393 respondents, we found 37% of U.S. adults used complementary and alternative medicine and 63% did not use any CAM. Compared to those who did not use CAM, CAM users were more likely to rate their health as ‘Excellent’ (adjusted-odds ratio (AOR) = 1.14, 95% CI = [1.03,1.26]). Similarly, CAM users were more likely to report their health as ‘Better’ than in the prior year (AOR = 1.64, 95% CI = [1.49,1.83]). The c-statistics for the two models were 0.755 and 0.616, respectively.
We found a significant association between CAM use and self-rated excellent health and health improvement over the prior year. Prospective trials are required to determine whether CAM use is causally related to excellent health status and better health than in the prior year.
Key wordsNHIS National 2007 survey self-rated health status improvement CAM use mind–body complementary alternative logistic regression c-statistics acupuncture ayurveda chiropractic osteopathic medicine massage therapy integrative care energy healing diet supplements herbal traditional medicine yoga tai chi qigong meditation deep breathing relaxation
Dr. Nguyen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Nguyen and Phillips were responsible for study concept and design as well as acquisition of data. Nguyen, Phillips, Davis, and Kaptchuk were responsible for analysis and interpretation of data and critical revision of the manuscript for important intellectual content. Nguyen, Phillips, and Kaptchuk drafted the manuscript. Nguyen and Davis carried out the statistical analysis, while Phillips obtained funding and supervised the study
We would like to thank Dr. Helen Meissner for her communication on the calculation of the NHIS-comorbidity index and Patricia M. Barnes for her communication on the CAM prevalence calculation.
Conflicts of Interest
Dr. Nguyen was supported by an Institutional National Research Service Award (T32AT00051) from the National Institutes of Health (NIH). Prof. Ted Kaptchuk is supported by a Mid-Career Investigator Award from the National Center for Complementary and Alternative Medicine (NCCAM), NIH (K24 AT004095). Drs. Roger Davis and Russell Phillips are supported by a Mid-Career Investigator Award from the NCCAM, NIH (K24 –AT000589). The funding organizations had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of NCAAM or the NIH.
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