Background There are few randomised-controlled studies on the efficacy of Complementary/Alternative Medicine (CAMs). Lack of or misleading information for patients could lead to inappropriate management. There is little liaison or accountability between medical and CAM practitioners in the UK and little information on referral patterns and extent of knowledge about CAMs amongst rheumatologists. For this reason there may be a need for a structured departmental policy.
Aims To assess the number, type and cost of CAMs used by patients with Rheumatoid Arthritis (RA).
Methods A postal questionnaire was sent to 200 patients who are still attending The Early Rheumatoid Arthritis Study (ERAS), a long term observational study of early RA from 9 different regions of England. The ERAS database holds details of all drug therapies and outcomes on patients for up to 13 years follow up. The responses of the first 100 (n = 33M, 67F) patients are reported here.
Results 76 patients had used or were currently using CAMs (currently using n = 35, n = 41 have used). Reasons for their use were:- Symptom relief (n = 30), GP advice (n = 2), Rheumatologist advice (n = 2), wanting to find alternatives to Rheumatology drugs (n = 26), other (n = 9) and not recorded (n = 4). The most widely used CAMs were:- vitamin supplements (n = 53,73%), Homeopathy (n = 30,41%), copper bracelet (n = 31,42%), Acupuncture (n = 33,45%), Osteopathy (n = 29,40%), Aromatherapy (n = 19,26%), cod liver oil (n = 19, 26%) and multivitamins (n = 17,23%). 54 patients used more than one. Cost to each patient over the last year:- <£15 (n = 14), £15-£50(n = 16), £50-£100(n = 6), > 100(n = 8) and not recorded (n = 29). Of the 35 patients currently on CAMs, 22 were still on, and 6 had used second line (disease modifying) drugs.
Conclusion Our results show that 76% of RA patients were or had taken CAMs. These were in addition to second line (disease modifying) drugs, and not as alternatives. A few CAMs (e.g. acupuncture) are provided by some Health Service Hospitals, but generally were paid for by patients. The main reason for stopping were lack of efficacy and expense.
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