Complementary alternative medicine in rheumatic diseases: Causes, choices, and outcomes according to patients

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Abstract

Objective:

The knowledge of physicians about complementary and alternative medicine (CAM) applications is limited. However, especially in chronic diseases, patients and their relatives can often refer to CAM applications. Rheumatic diseases are chronic in nature presenting with a wide clinical spectrum. Despite developing treatment options, achieving treatment goals may not always be possible. For this reason, patients seek different treatment and use traditional and complementary medicine. The aim of this study was to investigate causes, consequences, and the frequency of applying to CAM in rheumatic diseases.

Methods:

Ninety-five patients admitted to the rheumatology outpatient clinic were enrolled in the study. Health assessment questionnaire and short-form-36 were used to determine the quality of life of patients. Anxiety and depression symptoms were screened by the Hospital Anxiety and Depression scale, a questionnaire that was filled-in by the patients themselves. Also, patients were questioned about their place of residence, level of education, diagnosis, CAM modality types, application reasons, and outcomes. Chi-square test was used to analyze categorical data. Parametric data were analyzed using Student t-test, and nonparametric data were analyzed using Mann–Whitney U test.

Results:

Thirty-two of our patients had applied to CAM modalities (phytotherapy [34.45%], cupping therapy [21.8%], acupuncture [12.5%], hirudotherapy [12.5%], food supplement [12.5%], and ozone treatment [6.25%]). Only 31.3% of the patients informed their doctors about CAM applications. 47.8% of fibromyalgia patients and 29.2% of patients with inflammatory rheumatic diseases had applied to CAM. Gender, working status, income level, smoking, and alcohol habits were not associated with the application to CAM. However, none of the residents of the village, 14.3% of the residents of the district center, and 41.1% of the residents of the city center had applied to CAM modality. The rate of applying to CAM was 18.2% for those who cannot read and write. The application ratio of CAM is over 40% among secondary school, high school, and university graduates.

Conclusion:

Among patients with rheumatic diseases, application to CAM is quite common. Very few patients inform their physicians about applying to CAM. Contrary to what is presumed, the rate of applying CAM applications is lower among those living in rural areas and with low education levels.

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The 1987 American College of Rheumatology (ACR; formerly, the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticized for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA. A joint working group from the ACR and the European League Against Rheumatism developed, in 3 phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease--this being the appropriate current paradigm underlying the disease construct "rheumatoid arthritis." In the new criteria set, classification as "definite RA" is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints (score range 0-5), serologic abnormality (score range 0-3), elevated acute-phase response (score range 0-1), and symptom duration (2 levels; range 0-1). This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimize the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct "rheumatoid arthritis."

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Frank H.J van den Hoogen, Dinesh Khanna, Jaap Fransen … (2013)

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Author and article information

Journal

Journal ID (nlm-ta): Eur J Rheumatol

Journal ID (iso-abbrev): Eur J Rheumatol

Title: European Journal of Rheumatology

Publisher: Medical Research and Education Association

ISSN (Print): 2147-9720

ISSN (Electronic): 2148-4279

Publication date Collection: January 2022

Publication date (Electronic): 08 February 2022

Volume: 9

Issue: 1

Pages: 36-41

Affiliations

[1 ]Department of Emergency Medicine, Bingöl State Hospital , Bingöl, Turkey

[2 ]Department of Emergency Medicine, Ovacık State Hospital , Tunceli, Turkey

[3]Department of Rheumatology, Fırat University School of Medicine , Elazığ, Turkey

Author notes

Address for Correspondence: Süleyman Serdar Koca; Department of Rheumatology, Fırat University School of Medicine, Elazığ, Turkey E-mail: kocassk@yahoo.com

ORCID iDs of the authors: E.G. 0000-0001-9205-1072; I.C. 0000-0001-5680-4786; B.O. 0000-0001-9762-2401; A.K. 0000-0002-6725-4182; Z.A.A. 0000-0001-8155-8310; S.S.K. 0000-0003-4995-430X.

Cite this article as: Gozcu E, Cakmak I, Oz B, Karatas A, Akar ZA, Koca SS. Complementary alternative medicine in rheumatic diseases: Causes, choices, and outcomes according to patients. Eur J Rheumatol. 2021;9(1):36-41.