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A composite variable summed the number of chronic conditions each subject reported (range, 0–13).It was conservatively assumed that any missing value for a single condition would be recoded as a “no” response.Energy healing therapy, biofeedback, hypnosis, yoga, tai chi, qi gong, and mind–body therapies such as guided relaxation were collapsed into one mind–body therapy variable because they are similar behavioral CAM therapies.

The chronic condition variables selected from the 2012 data set were those that best reflected the definition of a chronic condition (4).

Studies examining comorbid conditions and CAM use have collapsed CAM into any use versus no use, whereas in reality, CAM therapies represent a heterogeneous group of behaviors that differ in type, usage, and bodies of evidence on efficacy.

Understanding use of specific CAM modalities among people with multiple chronic conditions could increase knowledge about CAM therapies and disease management.

Studies to date suggest that people with chronic conditions are more likely to use CAM, and people with additional conditions have an increased likelihood of overall CAM use (5,7,8,9,11,16–18).

However, one study among patients with chronic liver disease showed an inverse association between additional comorbidities and current CAM use (19).

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