How often have we heard that, even if so-called alternative medicine (SCAM) does not improve the more tangible health outcomes, at least it does improve the quality of life of those who use it. But is that popular assumprion correct?
The present study investigated the use of SCAM and its relationship with health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus. A total of 421 patients with type 2 diabetes mellitus who met the inclusion criteria were recruited in this cross-sectional study. The researchers recorded the use of SCAM, such as:
HRQOL was assessed by EuroQOL.
A total of 161 patients (38.2%) with type 2 diabetes mellitus used some type of SCAM. The use of supplements and/or health foods was the highest among SCAM users (112 subjects, 26.6%). HRQOL was significantly lower in patients who used some SCAM (0.829 ± 0.221) than in those without any SCAM use (0.881 ± 0.189), even after adjustments for confounding factors [F(1, 414) = 2.530, p = 0.014].
The authors concluded that proper information on SCAM is needed for patients with type 2 diabetes mellitus.
We have often discussed whether SCAM use improves or reduces QoL. The evidence is mixed.
Some studies of often poor quality suggest that SCAM improves QoL, e.g.:
- Can massage improve the quality of life?
- The effect of acupuncture on myelosuppression and quality of life in women with breast cancer
- SCAM-Use and Quality of Life in Patients with Breast Cancer
- Acupuncture is said to improve the quality of life of migraineurs, but I am unconvinced
- Yoga improves quality of life, fatigue and sleep of breast cancer patients
However, other studies suggest that SCAM has no effect or even reduces QoL, e.g.:
- Mistletoe for cancer: Does it improve patients’ quality of life?
- Alternative therapies: do they really improve the quality of life of cancer patients?
- Chiropractic improves quality of life: another bogus claim?
- Homeopathy for cancer? Unsurprisingly, the evidence is not positive.
- Multidisciplinary versus chiropractic care for low back pain
- Use of alternative medicine hastens death of cancer patients
The authors of the present study contribute further evidence to the discussion:
Huo et al. evaluated HRQOL in 17,923 patients with bronchial asthma using the Behavioral Risk Factor Surveillance System, and showed that HRQOL was significantly lower in patients with than in those without the use of CAM . Opheim et al. also demonstrated that HRQOL was significantly lower in inflammatory bowel disease (IBD) patients with than in those without the use of CAM . These findings indicate that the use of some CAM is associated with lower HRQOL. Consistent with previous findings, HRQOL was significantly lower in patients with the use of some CAM than in those without any CAM in the present study.
The issue is obviously complex. Findings would depend on the type of patient and the form of SCAM as well on a multitude of other factors. Moreover, it is often unclear what was the cause and what the effect: did SCAM cause low (or high) QoL or did the latter just prompt the use of the former?
In view of this confusion, it is probably safe to merely conclude that the often-heard blanket statement that SCAM improves QoL is not nearly as certain as SCAM enthusiasts want it to be.