title: Prospective investigation of complementary and alternative medicine use and subsequent hospitalizations.
abstract: BACKGROUND
  The prevalence of complementary and alternative medicine (CAM) use has been estimated to be as high as 65% in some populations. However, there has been little objective research into the possible risks or benefits of unmanaged CAM therapies.
  
  
  METHODS
  In this prospective study of active duty US Navy and Marine Corps personnel, the association between self-reported practitioner-assisted or self-administered CAM use and future hospitalization was investigated. Cox regression models were used to examine risk of hospitalization due to any cause over the follow-up period from date of questionnaire submission, until hospitalization, separation from the military, or end of observation period (June 30, 2004), whichever occurred first.
  
  
  RESULTS
  After adjusting for baseline health, baseline trust and satisfaction with conventional medicine, and demographic characteristics, those who reported self-administering two or more CAM therapies were significantly less likely to be hospitalized for any cause when compared with those who did not self-administer CAM (HR = 0.38; 95% CI = 0.17, 0.86). Use of multiple practitioner-assisted CAM was not associated with a significant decrease or increase of risk for future hospitalization (HR = 1.86; 95 percent confidence interval = 0.96-3.63).
  
  
  CONCLUSIONS
  While there were limitations to these analyses, this investigation utilized an objective measure of health to investigate the potential health effects of CAM therapies and found a modest reduction in the overall risk of hospitalization associated with self-administration of two or more CAM therapies. In contrast, use of practitioner-assisted CAM was not associated with a protective effect.
authors.affiliation: Department of Defense Center for Deployment Health Research, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. tyler.smith2@med.navy.mil
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
authors.forename: Besa
authors.initials: B
authors.lastname: Smith
authors.forename: Margaret A K
authors.initials: MA
authors.lastname: Ryan
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States