Utilization of Chinese medicine for respiratory discomforts by patients with a medical history of tuberculosis in Taiwan

Yang, Su-Tso; Lin, Yi-Rong; Wu, Mei-Yao; Chiang, Jen-Huai; Yang, Pei-Shan; Hsia, Te-Chun; Yen, Hung-Rong

Patients newly diagnosed with TB (ICD-9-CM codes 010-018 and A02) (n = 36,660) were selected from the database. To avoid the inclusion of patients who did not have the disease, we set the inclusion criteria to allow only patients who were newly diagnosed with TB from January 1, 1997, to December 31, 2010, with clinical records from at least 2 months and treatment with first-line TB medication prescriptions (isoniazid, rifampin, pyrazinamide & ethambutol) (n = 8306). Because the prevalence and etiology of TB infections in children were different, and the medical services-seeking behaviors among children or adolescents were mainly dominated by their parents, children with TB infections were not included in our objectives. Therefore, we further excluded patients who were less than 18 years of age or who had missing information related to birth and sex (n = 401). A total of 7905 TB patients were then included. Therefore the sample inclusion criteria is as following: (1) TB diagnosed between January 1, 1997 and December 31, 2010. (2) 18 years old or over. (3) Clinical records for at least 2 months with complete demographic information (4) Record of treatment with first-line TB medication prescriptions. CM users were defined as those who had visited CM clinics and had CM outpatient clinical records of TB or respiratory diseases (ICD-9-CM codes 786.x or 460-519). Non-CM users were defined as those who never visited CM clinics after the initial diagnosis of TB. To investigate TB patients complicated with long-term respiratory discomforts, we further excluded those clinical visits with a non-TB or respiratory diagnosis (n = 3980). Finally, a total of 3925 TB patients were then categorized into CM users (n = 2051) and non-CM users (n = 1874) (Fig. 1 ). Taiwan is a country with a population of 23 million. Taiwan has a geographical area of 36,000 km 2 . There were 23 cities and 359 townships in Taiwan and many of its residents live within urban cities. The residential areas of 23 cities in Taiwan were classified into 4 levels of urbanization based on the population density (people/km 2 ), the ratio of the population with varying educational levels, and the number of physicians per 100,000 people. Level 1 represents the highest urbanized level, while 4 represents the lowest level. Levels 1 and 2 of this urbanization were defined as urban areas, while levels 3 and 4 were classified as rural areas [29] .