Analysis of Traditional Chinese Medicine Utilization for Adults with One or More Chronic Conditions in Taiwan

• Main Authors: Ting-Yi Cheng, 鄭婷宜
• Other Authors: Yiing-Jenq Chou
• Format: Others
• Language: en_US
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/asb39k

博士 === 國立陽明大學 === 公共衛生研究所 === 104 === Introduction: The prevalence of chronic conditions and multiple chronic conditions (MCC) has been gradually increasing in recent years around the world. Traditional Chinese medicine (TCM) is effective for treating chronic conditions. Numerous people with chronic conditions like to use TCM treatment or integrated treatment of TCM and Western medicine (WM). Our study explored the associations between MCC and TCM use, and the use of specific types of TCM therapy among adults in Taiwan. We also explored TCM use by adults with seven common types of chronic conditions. In addition, our study also analyzed the trends of TCM use among adults with one or more chronic conditions and in older adults (aged 50+) with MCC from 2000 to 2010 in Taiwan. Methods: (1) A national representative sample in 2005 was used to explore the associations between MCC and TCM use. The Chronic Condition Indicator and the Clinical Classifications System created by the U.S. Agency for Healthcare Research and Quality were used to define the number of chronic conditions of adults and select the common seven types of chronic conditions of adults. Logistic regressions adjusted for demographic characteristics were used to analyze the associations. The frequency of TCM use among adults with different numbers of chronic conditions was quantified. In addition, (2) three national representative randomly sampled cohorts in 2000, 2005 and 2010 were used to analyze that the trends in the usage rate and mean frequency of TCM use for adults with one or more chronic conditions and for older adults with MCC from 2000 to 2010. The relative change in the usage rate and mean frequency were calculated between 2005 (2010) and 2000. Results: (1) TCM use for adults with ≧ 5 chronic conditions (Odds ratio (OR) 1.86) was higher than TCM use for adults with 2–4 chronic conditions (OR 1.51) and TCM use for adults with one chronic condition (OR 1.48). The increase in the OR of the use of Chinese herbs and traumatology manipulative therapy according to the number of chronic conditions was not as substantial as that of acupuncturemoxibustion. The frequency of TCM use exhibited an increasing trend with the increase in the number of chronic conditions (P < .001). Among the seven common types of chronic conditions for adults, TCM use for adults with arthropathy (OR 2.01) was the highest. (2) Moreover, there was a significant increasing trend in the usage rate of TCM in adults with one chronic condition (p<0.0001), with ≧5 chronic conditions (p=0.0199), with cancer (p=0.0002), with hypertension (p<0.0001), with arthropathy (p=0.0061), and with other types of chronic conditions (p<0.0001) apart from the seven common chronic conditions from 2000 to 2010. There was also a significant increase in the average frequency of TCM use in adults, regardless of the type of their chronic condition(s) (p<0.0001). There was a significant increasing trend in the usage rate of TCM at age 65-74 years (p<0.0001), for females (p< 0.0001), for the socioeconomic status (SES) < US$640 group (p=0.0351), ≧ US$1280 group (p<0.0001) and others group (p<0.0001), as well as for residents of southern Taiwan (p<0.0001). Average frequency of TCM use rose significantly regardless of age, gender, SES, or geographic region (p<0.0001) in older adults with MCC from 2000 to 2010. Conclusion: The probability and frequency of TCM use increased as the number of chronic conditions increased. The probability of Chinese herbs use, traumatology manipulative therapy use, and, particularly, acupuncturemoxibustion use, increased as the number of chronic conditions increased. We suggest that government policy makers emphasize administering integrated TCM and WM care to people with chronic conditions, especially in people with MCC. TCM use steadily increased in adults with certain types of chronic conditions and in older adults with MCC from 2000 to 2010. We need to pay more attention to and explore the causes of this steady increase in TCM use, and provide more appropriate TCM services for these people in the future.