Dietary Supplement and Prescription Medication Use Among US Military Service Members With Clinically Diagnosed Medical Conditions: The US Military Dietary Supplement Use Study

Abstract

Background: Use of prescription medications (PMs) with dietary supplements (DSs) can be hazardous because of potential adverse interactions, but patterns of dual use in military service members (SMs) has not been examined.

Objective: Investigate dual use of filled PMs (FPMs) and DSs, factors associated with dual use, and dual use among SMs with clinically diagnosed medical conditions (CDMCs).

Design: Cross-sectional. Data on FPMs and CDMCs were obtained from medical surveillance records. Between December 2018 and August 2019, participants completed a questionnaire on DS use in the previous 6 months.

Participants: A stratified random sample of 26,880 SMs from all military services.

Main outcome measures: Prevalence of dual use of FPMs with DSs within a 6-month period, demographic/lifestyle factors associated with dual use, and prevalence of dual use among SMs with CDMCs.

Statistical analysis: Prevalences were calculated as percents, χ² statistics examined differences across various strata of demographic and lifestyle characteristics, and univariable and multivariable logistic regression determined the odds of using FPMs with DSs for various CDMCs.

Results: About one-half (49%) of SMs had dual use of FPMs with DSs in the 6-month period. Dual use was higher among women; increased with older age, more formal education, higher body mass index, and more physical activity; was highest among American Indian SMs and lowest among Asian SMs; was higher among former tobacco users; and was highest among Army personnel and lowest among Marine Corps personnel. The overall prevalence of dual use in the 6-month period was higher among those with a CDMC than those without (62% vs 19%), and this relationship was maintained for 20 International Classification of Diseases, Revision 10, code groupings covering virtually all CDMCs.

Conclusion: This is the first study to document a high prevalence of dual FPMs and DSs in SMs, especially among those with CDMCs.

Keywords: Combination products; Mineral; Multivitamin/multimineral; Prohormone; Vitamin.