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Complementary and Alternative Medicine Use in United States Adults With Liver Disease

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To describe the complementary and alternative medicine (CAM) use in US adults with liver disease.


The prevalence and patterns of CAM use among US adults with liver disease have not been well characterized. The 2012 National Health Interview Survey is considered the most current and comprehensive source of information on CAM use in US adults.


Using the results of the 2012 National Health Interview Survey, the prevalence of CAM use, most common modalities used, reasons for CAM use, perceived benefits, perceived helpfulness and importance, and disclosure of CAM to health care providers were compared between adults with and without liver disease.


Of the 647 adults with liver disease, 41% reported using CAM in the prior year, compared with 33% of adults without liver disease. The most common modality was herbs and supplements (23%), and 3% of respondents reported consumption of a potentially hepatotoxic substance in the previous 30 days. Only a small proportion of CAM therapies were used specifically for liver disease, with milk thistle being the most common. Among respondents with liver disease, CAM was used more commonly for anxiety or depression, fatigue, and substance use. The majority believed that these therapies improved health. Nearly one-third of therapies were not reported to health care providers, mostly due to failure of the provider to ask.


CAM use, particularly herbs and supplements, is prevalent among US adults with liver disease. Many do not disclose their CAM use to their providers, despite some using potentially hepatotoxic substances.
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Keywords: complementary therapies; drug-induced liver injury; milk thistle; patient acceptance of health care; surveys and questionnaires

Document Type: Research Article

Affiliations: 1: Division of Gastroenterology, Department of Medicine, Duke University School of Medicine 2: Departments of Medicine, Division of Gastroenterology 3: Biostatistics and Bioinformatics, Duke University School of Medicine 4: Departments of Medicine, Division of Gastroenterology, Duke Clinical Research Institute, Durham, NC

Publication date: July 1, 2017

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