Background:
Traditional, Complementary, and Integrative Medicine (TCIM) is widely used in Germany. Approximately 70% of the German population report lifetime use, with 32% indicating usage within the past year and 18% currently. This study examines the association between TCIM utilization and health-related factors, including sociodemographic characteristics and health-related quality of life (HRQoL) in Germany.

Methods:
An online survey of 4,065 German adults (aged 18–75) was conducted in 2022. HRQoL was assessed with globally recognized and extensively validated instruments using the EQ-5D-5 L descriptive system and index values. We compared HRQoL based on age, gender, income, TCIM use and attitudes, medical conditions, dietary patterns, and social milieus (Sinus-Milieus®). The EQ-5D-5 L index ranges from 1 (perfect health) to ≤ 0 (death), EQ VAS from 100 (best imaginable health) to 0 (worst imaginable health).

Results:
The mean ± standard error and median (interquartile range) were 68.2 ± 0.4 and 73.0 (32.5) for EQ VAS, and 0.85 ± 0.00 and 0.92 (0.18) for the EQ-5D-5 L index. Lower HRQoL was observed among women, older adults, and individuals with lower socioeconomic status. TCIM users within the past 12 months (31.8%) had significantly lower EQ-5D-5 L index scores (0.82 ± 0.01; 0.90 [0.17]) than non-users (0.87 ± 0.00; 0.94 [0.17]; p < 0.001) and reported a significantly higher disease burden (88.0% vs. 68.6%). Musculoskeletal disorders were the most common condition (35.8%), associated with an EQ-5D-5 L index of 0.71 ± 0.01 and EQ VAS of 56.9 ± 0.6. Neurological conditions were linked to the lowest HRQoL, whereas allergies were associated with the highest. Dietary patterns significantly influenced HRQoL, with pescatarians reporting the highest and raw foodists the lowest scores. Among social milieus, the “Precarious Milieu” had the lowest EQ-5D-5 L index (median 0.86 [0.28]), while the “Performer Milieu” had the highest (0.97 [0.11]).

Conclusion:
The findings underscore the influence of sociodemographic and socioeconomic determinants on HRQoL and highlight health disparities across social groups. The inverse association between TCIM use and HRQoL may reflect a higher burden of chronic conditions and unmet healthcare needs among TCIM users. Further research is warranted to investigate causal relationships and the role of TCIM in addressing complex health challenges.

Trial registration:
ClinicalTrials.gov (NCT05530720).