Traditional Chinese Medicine Use for Health-Related Quality of Life, a Secondary Analysis of the INCLD Health Data

Abstract

Background: Traditional Chinese Medicine (TCM) commonly employs acupuncture and herbal medicine, both of which are growing in popularity in the United States. These treatments are commonly used in overall health maintenance to promote health and for disease prevention. However, there is a lack of information on how TCM affects Health-Related Quality of Life (HRQoL). Objectives: The objectives of this study are to evaluate the association of TCM and self-reported HRQoL measures, and to explore the association of TCM and both medication use and medical comorbidities. Methods: Data collected and analyzed were from the International Cohort on Lifestyle Determinants of Health (INCLD Health) study and identified a prospective cohort of students reporting the concurrent use of acupuncture and Chinese herbal medicine. Generalized Estimating Equations with a working independence correlation structure were used for cross-sectional analyses for baseline and six-month follow-up observations. The HRQoL outcomes included the PROMIS®-29 profile, the Perceived Stress Scale, and the Personal Wellbeing Index, modified. The covariate-adjusted estimates were reported for HRQoL measures, and odds ratios were reported for the associations of TCM use and medication and comorbidities. Results: Of the 173 observations at baseline, 48 were classified as using TCM. Of the 90 observations at the six-month follow-up, 31 were classified as using TCM. PROMIS®-29 instrument scores indicated values congruent with the average United States adult population at both baseline and follow-up for both groups, with only slightly higher scores for fatigue and anxiety. At baseline, TCM use was associated with lower Perceived Stress, and higher perceptions of mental, spiritual, personal, social, and overall wellness. At follow-up, TCM use was associated with lower Perceived Stress, and higher perceptions of physical and overall wellness. These differences at baseline and follow-up were considered statistically significant, but were not considered clinically meaningful. Medication use and the presence of comorbidities were not associated with TCM. Conclusions: TCM use over six months was not associated with further improvements in HRQoL. Comorbidities and medication use did not appear to affect an individual’s decision to use TCM. The small sample size and a healthy cohort limit the ability to detect meaningful changes in HRQoL from the use of TCM. With more individuals using TCM for health maintenance, future research should focus on HRQoL outcomes.