Background Several surveys indicate that the complementary and alternative medicine (CAM) use is especially prevalent in patients with chronic painful conditions like ankylosing spondylitis (AS). Despite good treatment options such as tumor necrosis factor alpha (TNFα) inhibitors in AS, it is seen that patients have applied for CAM use for many reasons including local regulatory funding requirements, potential risks and accessibility of biological treatments. Few studies have examined the frequency of CAM use, and associations between demographic and disease-related factors of it in AS.
Objectives To investigate the CAM usage of patients with AS and to determine the associated factors.
Methods Total of 123 patients with AS, who were being followed in a tertiary rheumatology outpatient clinic, were included to the study. The demographic and clinical features along with the behaviors about the CAM usage of the patients agreeing to participate were recorded to the “Patient Assessment Form”. The activity of the disease were determined with doctor global assessment (numeric visual analog scale (nVAS; 0–10), and Routine Assessment of Patient Index Data (RAPID)-3 score. The treatment adherence of the patients was assessed with the Morisky Green Levine Scale.
Results One hundred eleven patients (%90.2) were male, and mean age was 36.5±8.8 years. The mean disease duration and mean delay in diagnosis were 10.9±6.4, and 3.7±3.9 years, respectively. The mean RAPID3 score, doctor and patient global assessment were; 9.9±5.3, 2.8±1.9, and 4.6±2.7, respectively. While 79 patients (%64.2) were on anti-TNF treatment, 76 patients were receiving NSAIDs, and 35 patients (%28.5) reported an adverse event related with the treatment. Forty-five patients (%36.6) reported to use any CAM (previous or current) (Table1). The reasons reported by the patients for the usage of CAM; media in %13, recommendations from family members or relatives in %10.6. It has been found that in married patients, the ones with lower the Morisky Green Levine Scale score (high adherence), CAM usage was statistically high (p<0.05). Receiving NSAIDs or anti-TNF agents was not statistically associated with CAM usage. The underlying expectations for the usage of CAM were; considering it might be helpful in %27.6; considering it might heal in %17.9; to relieve the pain in %14.6; and preventing to deteriorate the disease status in %12.2.
Conclusions In our study, we found that approximately one third of our AS patients were using CAM. When compared with the literature related with other diseases, CAM usage in AS patients was somewhat lower. Our results have demonstrated that treatment adherence was higher in those using concomitantly CAM in their therapy.
Disclosure of Interest None declared