Non-prescription complementary treatments used by rheumatoidarthritis patients attending a community-based rheumatology practice

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Abstract:

Abstract Background: 

Over 80% of rheumatoid arthritis (RA) patients haveused some type of complementary medicine (CM) at some time. Littleis known about RA patients’ perceptions of the efficacy,hazards and costs associated with CM use relative to physician-prescribedmedicine. These data may be helpful in better understanding patients’ needsand in improving their care. Aims: 

To determine the prevalence and features of CM use among RA patientsattending a community-based private rheumatology practice. CM was definedas treatment that was initiated by the patient, excluding treatmentthat had been prescribed or spec¬≠ifically recommended bytheir doctor. Methods: 

A telephone-administered questionnaire was used to survey a stratifiedrandom sample of 200 RA patients who had attended the practice withinthe preceding year. The main outcome measures were: (i) CMuse in the past year, (ii) patient expenditure onCM, (iii) patients’ perceptionsof CM and (iv) characteristics of patientsusing CM. Results: 

One hundred and six patients responded (response rate 53%)and 101 completed the interview. Seventy-four patients (73.3%)had used some form of CM in the past year. There were 68 (67.3%) patientswho had utilized complementary therapies and 32 patients (31.7%)who had consulted a complementary practitioner for their RA. Themost commonly used treatments were dietary (64 instances) and behavioural/cognitivetherapies (45 instances). Prescription medicine was considered morebeneficial than either form of CM, and users and non-users of CMheld a similar perception of the efficacy of ¬≠prescriptionmedicine. The median amount spent on RA treatment per month was $A7(range 0−91) for complementary treatments, $A26(1−270) for complementary practitioners and $A7(0−80) for pres¬≠cription medicine. Women weremore likely to have consulted a CM practitioner (OR = 1.5;95% CI : 1.2−1.9), as were patientswho were not receiving a pension (OR = 1.7;95% CI : 1.1−2.6). Conclusions: 

This study confirmed that CM use is prevalent among RA patientsattending a community-based private rheumatology practice. Despitelesser perceived benefit, patients spent at least as much moneyon CM as they did on prescription medicine. These findings suggestthat there are other factors motivating the use of alternative treatments.(Intern Med J 2002; 32: 208−214)

Keywords: alternative medicine; community medicine; complementary medicine; rheumatoidarthritis; rheumatology

Document Type: Research Article

DOI: http://dx.doi.org/10.1046/j.1445-5994.2002.00213.x

Affiliations: 1: Epidemiologyand Preventive Medicine and 2: Centre forComplementary Medicine, Monash Institute of Public Health, Melbourne,Victoria, Australia

Publication date: May 1, 2002

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