Assessment of health locus of control in the use of nonconventional remedies by patients with rheumatic diseases.

OBJECTIVE

To assess the prevalence and characteristics of the use of nonconventional remedies (NCR) and to determine the type of health locus of control that the users of NCR may have.

METHODS

We conducted a cross sectional survey of 200 patients with rheumatic diseases at 3 outpatient rheumatic clinics in Edmonton, Canada. A face-to-face structured interview was administered by a trained assistant to evaluate the prevalence of use, and patient beliefs, perceptions, and expectations in relation to NCR. To assess locus of control the Multidimensional Health Locus of Control (MHLC) instrument was applied.

RESULTS

One-hundred nineteen patients (60%) had used a total of 530 NCR (range 1-25) in the previous 12 months; 94 (79%) of these patients used 309 NCR (mean of 3, range 1-15 remedies). Forty-seven percent had received at least one NCR before the first rheumatology consultation, but an additional 8% initiated NCR after their initial contact with a rheumatologist at our clinics. Only 22 (18%) of the patients using NCR notified their rheumatologist about their use. The mean reported expenditures for the users of NCR in the past 12 months were $260.00 CDN per patient (range 0 to $3,520), and the mean reported expenditures for the ever users of NCR were $730.00 CDN (range 0 to $9,720). Patients who used NCR in the past 12 months were younger (52 +/- 14 vs 58 +/- 15 yrs; p = 0.003), slightly more disabled (1.26 vs 1.11, modified Health Assessment Questionnaire; p = 0.006), and in the middle income class (p < 0.001). Possible associations between MHLC and the use of NCR were assessed in different ways in the logistic regression models, including the entry of MHLC subscales as means or class intervals, and NCR as users versus no users, or as higher users (> 4 NCR) versus no users of NCR. The use of NCR, ever or in the past 12 months, did not have statistical association with any of the subscales of the MHLC.

CONCLUSION

In this survey over one-half of patients used NCR for treatment of their rheumatic disease. NCR were costly and the MHLC scales scores alone did not explain all the variance in health behaviors. Other contributing factors such as perceived severity of the disease, health motivation, or previous behavior should be addressed in further research.