Chapter 5: Medication Use and Complementary Health Approaches

LEARNING OBJECTIVES

1. Compare the use of prescription and over-the-counter medications and complementary health approaches between women and men.

2. Describe common complementary health approaches used by women across the lifespan.

INTRODUCTION

Human life expectancy in the United States (US) is 78.6 years for all races and origins as of 2016.¹ Mean life expectancy has increased and subsequently plateaued over the past century—from 47.3 years in 1900, 68.2 years in 1950, to 76.8 years in 2000—and is attributed to improvements in public health programs and chronic disease management.^1,2 While this general upward trend has held true, women have a greater life expectancy than men, living on average 81.1 years compared to 76.1 years for men of similar demographics.¹ Women may also experience a greater degree of morbidity during their lifetime than men; thus, the greater longevity afforded to women may be of a relatively poorer quality.^3,4

Studies demonstrated that women tend to use significantly more health care services and spend more money on health care than men. The greatest disparity in health care resource utilization between women and men has been noted to be in individuals aged 45 to 64 years.⁵ Studies have shown that women have a higher percentage of prescription medication use and risk of polypharmacy than men.⁶ Women also tend to seek out preventive care, female-specific care, and general medical care more frequently than men.^7-9 In addition, women frequently use complementary health approaches (CHAs; previously referred to as complementary and alternative medicine or complementary and integrative therapies), in many cases more often than men.^10-12

Greater than 30% of US adults and more than 12% of US children have reported using health care approaches outside of conventional medicine.¹³ Patients use a variety of terms interchangeably to describe this use, including alternative, complementary, or traditional. Complementary medicine can be defined as a nonmainstream health practice used in addition to conventional medicine. Alternative medicine can be defined as a nonmainstream health practice used in lieu of conventional medicine and is much less common. Integrative medicine is a way of involving conventional health care and CHA in a coordinated manner.

The National Center for Complementary and Integrative Health (NCCIH; previously the National Center for Complementary and Alternative Medicine) of the National Institute of Health (NIH) categorizes CHA into three subgroups (Table 5-1):¹⁴ natural products; mind and body practices; and a third, less well-defined category meant to capture other practices that do not generally fit into either of the two aforementioned subgroups.^13-15 CHAs that include natural products utilize herbs (or botanicals), vitamins, minerals, and probiotics; and they are often sold and consumed as dietary supplements or self-care therapies. The second CHA subgroup, mind and body practices, includes a diverse array of techniques or procedures that are taught, performed, or administered by an ...