title: Complementary and alternative medicine use and absenteeism among individuals with chronic disease.
abstract: BACKGROUND
  It is estimated that over half of the adult U.S. population currently has one or more chronic conditions, resulting in up to an estimated $1,600 in productivity loss annually for each employee with chronic disease. Previous studies have suggested that integrating alternative or complementary health approaches with conventional medicine may be beneficial for managing the symptoms, lifestyle changes, treatment, physical and psychosocial consequences that result from chronic illness.
  
  
  METHODS
  Using the 2012 National Health Interview Survey Data, we 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).
  
  
  RESULTS
  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. The rate of missing days from job or business due to injury or illness increased among those who reported use of mind-body practices (Incidence Rate Ratio (IRR) = 1.55, 95 % CI: 1.09, 2.21). There was no association between use of dietary supplements and absenteeism (IRR = 1.13, 95 % CI: 0.85, 1.51).
  
  
  CONCLUSIONS
  In a population of individuals with chronic disease, individuals who reported use of mind-body practices had higher rate of absenteeism due to injury or illness. Future studies should examine the effects CAM on symptoms associated with chronic disease and whether managing these symptoms can reduce absence from work, school, and other responsibilities.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 703, New York, NY, 10032, USA. jm3996@cumc.columbia.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mongiovi
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 703, New York, NY, 10032, USA.
authors.forename: Zaixing
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 703, New York, NY, 10032, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Absenteeism; Chronic disease; Complementary and alternative medicine; Dietary supplements; Employee health; Mind-body practices