Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2003; 8: 136
Chronic, unpredictable and progressive diseases such as rheumatoid arthritis (RA) leave patients feeling desperate and many try CAM. Few prevalence studies evaluating CAM in RA have been undertaken. This survey established the prevalence and perceived efficacy of CAMS.
Structured interviews recruited 200 patients satisfying the ARA criteria for RA. The perceived beneficial effects of CAMS were scored on a visual analogue scale (VAS) 0–100.
Eighty per cent of patients currently or previously used CAM for RA; median disease duration was 12 years. Twenty-seven different CAMS were used; median number used was 2 (range 1–12). The commonest were fish oils, copper bangles, evening primrose oil and acupuncture. Of CAM therapies, 55.2% were beneficial, particularly those involving therapist contact. Median scores on the VAS for the most beneficial therapies were massage (72), aromatherapy (47), acupuncture (41) and reflexology (35). A positive correlation between disease duration and number of CAMS used occurred (r = 0.3, P < 0.001). Patients felt CAM offered additional benefits to conventional medicine and were influenced by advertising. Patients unhappy with conventional medicine used more CAMS (median 4). Cessation of CAM due to lack of benefit or side-effects was common.
Rheumatoid arthritis patients are frequent users of CAM and research is lacking. Healthcare professionals will soon demand an evidence base matching that of mainstream medicine. As rheumatologists, we should address this with improved education and demand good methodology in future trails. Focusing limited resources on a few CAMS such as fish oils and acupuncture may be the appropriate way forward in our speciality.
