MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Monthly Archives: August 2016

An analysis of the 2012 National Health Interview Survey Data examined the associations between self-reported use of various forms of complementary and alternative medicine (CAM) therapies (dietary supplements, mind-body practices) and the number of days missed from job or business in the past 12 months due to illness or injury. Multivariable Poisson regression was used to determine the association between CAM use and absence from work among individuals with one or more chronic disease (n = 10,196).

Over half (54 %) of the study population reported having one chronic disease, while 19 % had three or more conditions. The three most common chronic diseases were high cholesterol (48 %), arthritis (35 %) and hypertension (31 %). More participants used dietary supplements (72 %) while fewer individuals reported using mind-body practices (17 %) in the past twelve months. Over half of individuals reported missing any number of days from job or business due to illness or injury (53 %). Of those who had missed any days from work, 42 % missed one or two days, 36 % missed three to five days, and 23 % missed six days or more.

In multivariable Poisson regression adjusting for demographic variables (race, age, gender, income, education) and potential confounders (BMI, general health, and use of CAM to improve energy), the rate of missing days from job or business in the past 12 months among those who used mind-body therapy was significantly greater than those who did not use these practices (IRR = 1.55, 95 % CI: 1.09, 2.21) (Table 4). Similar association was observed for dietary supplements use (IRR = 1.13, 95 % CI: 0.85, 1.51) (Table 4), although the result was not significant.

The authors concluded: Although nearly all individuals who practiced mind-body therapies reported being in good to excellent health, these individuals had a higher rate of absenteeism compared to non-users. Previous studies have shown that many individuals with chronic illness use CAM with the intent of alleviating the symptoms associated with chronic illness but this body of evidence is limited. Further studies are needed to examine the potential effects of these self-managed CAM therapies on the symptoms associated with chronic disease. Additionally, future studies should explore how managing these symptoms through the integration CAM therapies chronic disease management and employee programs could have a positive effect on absence from work, school, and other responsibilities.

How can these finding be interpreted?

The authors offer two possible explanations: Self-administered CAM practices may be more accessible to individuals with chronic disease regardless of socioeconomic status and other demographic factors. Alternatively, CAM use without the advisement of a practitioner may be harmful due to lack of knowledge on proper technique or dosage.

I am sure there are other ways to make sense of these data. How about this interpretation, for instance: CAM-use and absenteeism have in common that they are the things that the ‘worried well’ tend to do. Thus the two phenomena correlate because they are a characteristic of a certain type of consumer.

Yes, I am just guessing, because the data certainly does not give us anything like a conclusive explanation.

Nonetheless, one thing seems to be fairly clear: CAM-use in this population is not a thing that motivates consumers to go to work.

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