Department of Psychology, University of Sheffield, Sheffield, United Kingdom.
Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
Am J Cardiol. 2018 Jul 1;122(1):170-174. doi: 10.1016/j.amjcard.2018.03.014. Epub 2018 Mar 29.
Evidence indicates that use of Complementary Health Approaches (CHAs) is common in patients with cardiovascular disease (CVD) and has benefits and risks. Yet, disclosure of CHA use to physicians is not uniformly high. The present study aimed to assess the prevalence and patterns of CHA use and disclosure in patients with CVD in a nationally representative US sample. Use of specific CHA modalities and the predictors and reasons for nondisclosure were examined. In the 2012 National Health Interview Survey, a nationally representative sample of adults aged 18+ was used, and 12,364 patients who reported being diagnosed with CVD were analyzed using weighted bivariate and logistic regression. Analyses revealed that 34.75% of patients with CVD had used CHA in the previous year. Women, those with higher education and income, who had functional limitations, greater mental distress, and healthier lifestyles were significantly more likely to use CHA. Nonvitamin, nonmineral supplements was the most prevalent CHA used (19.22%). Rates of nondisclosure were highest among younger and better educated CHA users. In patients with CVD who did not disclose CHA use to their physician (33.67%), 45.51% said the reason was because physician did not ask; 8.75% said the reason was because they were not using CHA at the time. In conclusion, over 1/3 of patients with CVD used CHA in the previous year, and nonvitamin, nonmineral supplements were the most commonly used modality. The findings underscore the importance of provider-initiated communication about CHA use in patients with CVD to minimize the potentially harmful consequences of nondisclosure.
证据表明,在心血管疾病(CVD)患者中,补充健康方法(CHAs)的使用很常见,并且具有益处和风险。然而,向医生披露 CHA 的使用情况并不统一。本研究旨在评估在具有全国代表性的美国 CVD 患者样本中 CHA 的使用和披露的流行率和模式。检查了特定 CHA 方式的使用情况以及不披露的预测因素和原因。在 2012 年全国健康访谈调查中,使用了全国代表性的 18 岁以上成年人样本,对报告患有 CVD 的 12,364 名患者进行了加权双变量和逻辑回归分析。分析表明,34.75%的 CVD 患者在过去一年中使用过 CHA。女性、受教育程度和收入较高、有功能障碍、精神困扰较大以及生活方式较健康的人更有可能使用 CHA。非维生素、非矿物质补充剂是使用最普遍的 CHA(19.22%)。年轻和受教育程度较高的 CHA 用户的不披露率最高。在未向医生披露 CHA 使用情况的 CVD 患者(33.67%)中,45.51%的人表示原因是医生没有询问;8.75%的人表示原因是他们当时没有使用 CHA。总之,超过 1/3 的 CVD 患者在过去一年中使用了 CHA,非维生素、非矿物质补充剂是最常用的方式。研究结果强调了在 CVD 患者中由提供者发起的关于 CHA 使用情况的沟通的重要性,以最大限度地减少不披露的潜在有害后果。