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糖尿病成年患者使用补充与替代医学、预防保健措施及传统医疗服务之间的关联。

Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes.

作者信息

Garrow Donald, Egede Leonard E

机构信息

Department of Medicine, Division of General Internal Medicine, Medical University of South Carolina, 135 Cannon St., Suite 403, Charleston, South Carolina 29425, USA.

出版信息

Diabetes Care. 2006 Jan;29(1):15-9. doi: 10.2337/diacare.29.01.06.dc05-1448.

Abstract

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.

摘要

目的

评估糖尿病成年患者使用补充和替代医学(CAM)、预防保健措施以及常规医疗服务之间的关联。

研究设计与方法

我们分析了2474名糖尿病成年患者的数据。我们根据是否使用以下任何一种方式创建了一个总体CAM使用类别:饮食、草药、脊椎按摩疗法、瑜伽、放松疗法、针灸、阿育吠陀医学、生物反馈疗法、螯合疗法、能量疗法、灵气疗法、催眠疗法、按摩、自然疗法和顺势疗法。我们使用多元逻辑回归来评估CAM使用对预防保健措施(接种流感和肺炎疫苗)以及常规医疗服务使用(初级保健就诊次数和急诊科就诊次数)的影响。使用STATA进行统计分析以考虑复杂的调查设计。

结果

共有48%的糖尿病成年患者使用了某种形式的CAM。CAM使用与接种肺炎疫苗独立相关(比值比1.56 [95%置信区间1.26 - 1.94]),但与接种流感疫苗无显著关联(1.17 [0.92 - 1.48])。CAM使用与去急诊科就诊独立相关(1.34 [1.06 - 1.70]),与进行6次或更多次初级保健就诊独立相关(1.44 [1.14 - 1.83]),以及与进行8次或更多次初级保健就诊独立相关(1.66 [1.22 - 2.25])。

结论

与先前研究的结果相反,CAM使用似乎与接受预防保健服务的可能性增加以及急诊科和初级保健就诊次数增加相关。在糖尿病成年患者中,CAM使用可能不是使用常规医疗服务的障碍。

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