Use of complementary therapies for arthritis among patients of rheumatologists – fibromyalgia related research

BACKGROUND: Use of complementary and alternative medicine

(CAM) is common among persons with chronic conditions.

OBJECTIVE: To identify correlates of and describe patients’

perspective on use of CAM for rheumatologic conditions.

DESIGN: Telephone survey.

SETTING: Three university practices

and three private rheumatology practices.

PATIENTS: 232 of 428

eligible consecutive patients (54%) with scheduled


MEASUREMENTS: Patients answered questions on CAM

use, functional status, pain, provider satisfaction, and

health services utilization. Chart reviews provided

demographic information and rheumatologic diagnoses. Bivariate

analyses identified correlates of four CAM outcomes (history,

magnitude, and frequency of CAM use and communication about

CAM use with a physician), and multiple logistic regression

identified independent correlates of regular CAM use.


Approximately two thirds of the respondents (n = 146) had used

CAM. Of these 146 respondents, 82 (56%) currently used CAM and

132 (90%) regularly used CAM or had done so in the past.

Fifty-five respondents (24%) had used three or more types of

CAM. In multivariate analyses, persons who used CAM regularly

were more likely to have osteoarthritis (odds ratio, 5.6 [95%

CI, 1.9 to 16.8]), severe pain (odds ratio, 2.5 [CI, 1.4 to

4.8]), and a college degree (odds ratio, 2.6 [CI, 1.3 to 5.4])

than patients who had never used CAM. Nearly half of the

respondents discussed CAM use with their physicians. The most

common reasons for not disclosing CAM use were that the

physician had not asked about it and that the patient forgot

to tell the physician; fear of disapproval was rarely cited.

Discussions about CAM use between patient and physician

occurred more frequently among patients with fibromyalgia and

persons who regularly used CAM or used several types of CAM.

CONCLUSIONS: Patients with rheumatologic conditions frequently

use CAM. Severe pain and osteoarthritis predict regular use of

CAM but do not predict a greater likelihood of discussing CAM

use with physicians. Routine inquiry by physicians will

probably detect CAM use.

Rao JK, Mihaliak K, Kroenke K, Bradley J, Tierney WM, Weinberger M

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