title: Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes.
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.
  
  
  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.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, Medical University of South Carolina, 135 Cannon St., Suite 403, Charleston, South Carolina 29425, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Garrow
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D000529:Complementary Therapies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States