Exploring association of spiritual perspectives with complementary medicine use among patients with Type 2 diabetes in Israel

Background. Spirituality, as distinct from religiosity, has become a most common term in complementary and alternative medicine (CAM) discourse. The association between religiosity and spirituality in the context of CAM use is a complex one and is worthy of being researched in specific local cultural contexts. Objective. Exploring the association between CAM use and religiosity, in patients with and without diabetes Type 2 attending primary care clinics in Northern Israel. Research design and methods. Research assistants administered a questionnaire developed to assess CAM use in primary care to a convenience sample of patients attending seven primary care clinics. Results. Of the 3742 respondents, 485 (12.9%) reported having Type 2 diabetes. Respondents with diabetes reported more overall CAM use during the previous year (46.9% vs. 42%, P=0.049). A logistic regression model of patients with diabetes Type 2 indicated that CAM use was associated with higher self-assessed religiosity [Exp(B)=1.898, 95% CI for Exp(B) 1.02-3.529, P=0.043]. CAM use among patients with diabetes was also associated more with female gender, higher education, and age under 60. The positive association between CAM use and degree of self-assessed religiosity was further studied in sub-populations of Jewish and Arab patients with diabetes Type 2. A logistic regression model of the Jewish population indicated significant association between CAM use and higher religiosity [Exp(B)=3.668, 95% CI for Exp(B) 1.232-10.922, P=0.02]. Conclusion. Primary care physicians need to be aware of a possible association between religiosity and CAM use in patients with diabetes. Physicians may consider adding questions on CAM and religiosity to routine clinical interviews in order to enrich their dialog with diabetes patients.