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Implications for Integrated Care

Carol M. Baldwin, RN, PhD, HNC; Kathi Long, RN, ANP; Kendall Kroesen, PhD; Audrey J. Brooks, PhD; Iris R. Bell, MD, MD(H), PhD

Arch Intern Med. 2002;162:1697-1704.

Background  Complementary and alternative medicine (CAM) use and expenditures are on the rise in the United States. Although civilian users of CAM have been well described, little is known about military veteran users of CAM.

Objective  To describe military veteran CAM users in the southwestern United States.

Methods  The study population comprised 508 military veterans randomly selected from Southern Arizona Veterans Administration Health Care System (Tucson) primary care patient lists, who had agreed to participate in a telephone interview. The ² test was used to analyze CAM use by demographic characteristics, military service, military-related health outcomes, and physician-diagnosed health complaints. Logistic regression was used to determine predictor variables.

Results  Of the 508 subjects, 252 (49.6%) reported CAM use. Military veteran CAM users were significantly more likely to be non-Hispanic white, earn more than $50 000 per year (both P<.05), and have greater than 12 years of education (P<.01). Current high daily stress, perceived negative impact of military life on physical or mental health, and physician-diagnosed chronic illnesses (eg, gastrointestinal problems, insomnia, and asthma) were statistically associated with CAM use. Regression analysis provided adjusted odds ratios and indicated that ethnicity (non-Hispanic white), higher education, greater current daily stress, and overseas military experience were significant predictors of CAM use by these veterans (each P<.05).

Conclusions  Ethnicity, education, income, and several chronic health complaints are consistent with civilian CAM use. Findings also suggest, however, that physicians providing conventional medical care need to be aware of experiences unique to CAM-using military veterans.

From the Southern Arizona Veterans Administration Health Care Services Research Service Line (Drs Baldwin, Kroesen, Brooks, and Bell and Ms Long); and the Departments of Medicine (Drs Baldwin and Bell), Psychology (Drs Baldwin, Brooks, and Bell), Psychiatry (Dr Bell), and Family and Community Medicine (Dr Bell), Arizona Respiratory Center (Dr Baldwin), and the Program in Integrative Medicine (Dr Bell), University of Arizona, Tucson.

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