Complementary and alternative medicine use and absenteeism among individuals with chronic disease

https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-016-1195-9

• Jennifer MongioviEmail author,
• Zaixing Shi and
• Heather Greenlee

BMC Complementary and Alternative MedicineBMC series – open, inclusive and trusted201616:248

DOI: 10.1186/s12906-016-1195-9

©  The Author(s). 2016

Received: 19 November 2015

Accepted: 7 July 2016

Published: 27 July 2016

Open Peer Review reports

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.

Keywords

Dietary supplements Mind-body practices Complementary and alternative medicine Employee health Absenteeism Chronic disease

Background

It is currently estimated that over half of the adult U.S. population has one or more of the following chronic diseases: hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis, hepatitis, weak or failing kidneys, current asthma, chronic obstructive pulmonary disease [1]. The rate of chronic disease is expected to double the population growth rate by 2020, resulting in 157 million Americans living with at least one chronic illness [2]. By this time, the cost burden of chronic illness is projected to account for over 80 % over of total health spending, including medical costs and job-productivity loss [2, 3].

Chronic conditions have a significant financial impact not only on individuals living with chronic disease but their employers as well. In 2012 it was estimated that lost productivity from absenteeism and presenteeism cost the U.S. economy nearly $1.1 trillion with another $227 billion spent on disease treatment. [4]. Absenteeism is nonattendance from work while presenteeism refers to at-work performance deficits [5]. Reducing absenteeism can save upwards of $1,600 in productivity loss annually for each employee with chronic conditions [6]. U.S. disease treatment costs have the potential to be reduced by over $200 billion [3].

Prior studies have hypothesized that the use of complementary and alternative medicine (CAM) may aid in reducing the stress of chronic disease for employers by improving employee health, therefore, decreasing absenteeism [7, 8]. CAM is often used alongside conventional medicine with the intention of decreasing the severity of both physical and mental symptoms of chronic disease, as well as promoting general well-being [9, 10]. Motives for CAM use include improving health and desire to do something for oneself [11, 12]. CAM healthcare approaches often originate outside of conventional medicine and are practiced together with (complementary/integrative) or instead of (alternative) conventional medicine [13]. These approaches can be provided by a practitioner or self-managed, managing the symptoms, treatment, physical and psychosocial consequences and lifestyle changes that arise from living with chronic disease [14]. Self-managed practices can be used to relieve some of the symptoms associated with chronic disease, improve self-efficacy, and provide individuals a sense of control over and engagement in their own health [14, 15, 16].

While many studies have examined the effect of CAM on alleviating symptoms, few have examined how these practices may affect the burden of chronic disease on the population. We used the 2012 National Health Interview Survey (NHIS) data to examine the association between using CAM and the number of days missed from a job or business due to illness or injury by individuals with chronic conditions. We hypothesized that the use of CAM is associated with fewer numbers of sick days taken from work due to engagement in more preventive healthcare behaviors, thus having better health status. Analyses examined the association between CAM use and days missed from job or business due to injury or illness as well as possible predictors of missed days among individuals with chronic conditions.