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