Arthritis News - 1999
In 1997 Americans
spent as much out-of-pocket money for complementary and alternative medicine
(CAM) as they did for all physician services, and visited practitioners
of alternative medicine almost twice as frequently as primary care physicians.
It was estimated that 4 out of 10 patients in 1997 used CAM for chronic
conditions. However, there has been concern that patients do not routinely
disclose their CAM treatments to their physicians perhaps because of fear
of disapproval. Furthermore, it is not clear which patients are rountinely
using CAM.
In a recent study, Rao, et al (Ann Intern Med. 131(6):409-16, 1999) examined the use of CAM in a sample of patients with rheumatic diseases from private and university-based rheumatology practices. [They did not include biofeedback, exercise, meditation or prayer in their list of CAM.] Of the patients who were invited to participate, approximately 50% agreed and were enrolled. The authors ascertained that nearly two thirds of patients reported having used at least one type of CAM for their rheumatologic condition; 56% were currently using CAM; and 24% had used three or more types of CAM. Most patients found CAM to be helpful. The most commonly reported reason for using CAM was to relieve pain, and nearly half reported that they used CAM because their prescription medications were ineffective. Only 10% of patients used CAM because they thought it would cure their condition. Half of the patients discussed their use of CAM with their physicians. The most commonly reported reason for not discussing their CAM use with their physician was that the physician did not ask; fear of disapproval was rarely cited as the reason. The most frequent users of CAM were patients with severe pain, with osteoarthritis and who had a college degree. Patients who most frequently discussed CAM with their physicians were those with fibromyalgia and those who used CAM regularly and frequently.
Editorial Comment: These results may not be generalizable to patients without arthritis. Furthermore, only 50% of invited patients enrolled in the study, thereby introducing potential bias into the results. Nonetheless, this study is interesting and indicates that many patients with arthritis us CAM and are not afraid to discuss these treatments with their physicians. Physicians may elicit more information about CAM use among their patients by direct inquiry.