Use of complementary therapies for arthritis among patients of rheumatologists

Background: Use of complementary and alternative medicine (CAM) is common a mong 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 practice s. Patients: 232 of 428 eligible consecutive patients (54%) with scheduled app ointments. Measurements: Patients answered questions on CAM use, functional status, pa in, provider satisfaction, and health services utilization. Chart reviews p rovided demographic information and rheumatologic diagnoses. Bivariate anal yses identified correlates of four CAM outcomes (history, magnitude, and fr equency of CAM use and communication about CAM use with a physician), and m ultiple logistic regression identified independent correlates of regular CA M use. Results: Approximately two thirds of the respondents (n = 146) had used CAM . Of these 146 respondents, 82 (56%) currently used CAM and 132 (90%) regul arly 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 nev er used CAM. Nearly half of the respondents discussed CAM use with their ph ysicians. 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 ph ysician; fear of disapproval was rarely cited. Discussions about CAM use be tween patient and physician occurred more frequently among patients with fi bromyalgia and persons who regularly used CAM or used several types of CAM. Conclusions: Patients with rheumatologic conditions frequently use CAM. Sev ere 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.