ICCs are associated with high morbidity and mortality in the US. Evidence suggests that CAMs and anti-inflammatory medications (Rx) are used to reduce inflammation among those with ICCs.

Objective: We determined the prevalence and the factors associated with the use of CAMs and Rx in adults with ICCs using two nationally US representative datasets.

Methods: The study sample (N=7,061, representing 12.78 million adults) was drawn from the restricted linked National Health Interview Survey (NHIS- 2012 and 2017) and Medical Expenditure Panel Survey (MEPS- 2013 and 2018) dataset provided by the Agency for Healthcare Research and Quality. Two anti-inflammatory classes of drugs (NSAIDs and Corticosteroids) and three CAM modalities (mind-body, manipulative, and whole medical system) were included. We created a composite variable with four categories: 1) CAM+Rx 2) CAM+NoRx 3) NoCAM+Rx 4) NoCAM+NoRx. Rx and pain variables were extracted from the MEPS. CAMs, ICCs, Social Determinants of Health(SDoH), and other explanatory variables were derived from the NHIS. Unadjusted and adjusted multinomial logistic regressions were used to determine factors associated with the CAM/Rx use (reference group = NoCAM+NoRx).

Results: Prevalence rates of the composite variables were: 7.3%(CAM+Rx), 20.7%(CAM+NoRx), 18.1%(NoCAM+RX), 54.0%(NoCAM+NoRX). One in four adults reported extreme or moderate pain. In adjusted analysis, pain, SDoH(education and poverty status), female sex, and physical activity were associated with CAM+Rx use. For example, compared to adults with no/mild pain, those with pain were more likely to use CAM+Rx (CAM+Rx- AOR = 3.04 95% CI (2.19, 4.22), p < 0.001). Adults with lower levels of education and income were less likely to use CAM+Rx. Females were more likely to use CAM+Rx.

Conclusions: This study underscores the importance of SDoH on the use of CAM+Rx among adults with ICCs. Effective pain management may require innovative approaches that go beyond the traditional treatments.