Zochling J, March L, Lapsley H, Cross M, Tribe K, Brooks P
Institute of Bone and Joint Research, University of Sydney, Australia.
Ann Rheum Dis. 2004 May;63(5):549-54. doi: 10.1136/ard.2003.010637.
Patients with osteoarthritis commonly use complementary and alternative medicines (CAM), either as an adjunct to or in place of conventional analgesics.
To undertake a prospective investigation of the prevalence of CAM use for osteoarthritis and the direct costs incurred.
The subjects were 341 patients with osteoarthritis of the knee or hip drawn from central and northern Sydney, Australia, and comprising 83 community based patients and 258 awaiting joint replacement. Information on CAM use was obtained from prospective three monthly diaries. Variables of interest included health related quality of life scores. Prospective out of pocket costs were recorded over a 12 month follow up period.
The prevalence of CAM use was 40%, which falls within the range of previous studies. Average annual expenditure on CAM was 32.25 Australian dollars (range 0 to 603.30). CAM users were more likely to be female (odds ratio (OR) 1.8 (95% confidence interval, 1.1 to 3.0)), reported a higher level of bodily pain (OR 0.97 (0.95 to 0.99)), and were less likely to purchase conventional analgesics (OR 3.3 (1.6 to 7.0)), either prescribed or over the counter. Vitamin supplementation was the most common CAM reported, followed by celery extract, fish oils, and garlic extracts.
There are no good quality clinical trials to support the use of most preparations purchased by patients with osteoarthritis. There is a need for patient education on the risks and benefits of complementary medicine in osteoarthritis.
骨关节炎患者通常使用补充和替代医学(CAM),作为传统镇痛药的辅助手段或取而代之。
对骨关节炎患者使用CAM的患病率及直接费用进行前瞻性调查。
研究对象为341例来自澳大利亚悉尼中部和北部的膝或髋骨关节炎患者,其中包括83例社区患者和258例等待关节置换的患者。通过前瞻性的每三个月一次的日记获取关于CAM使用的信息。感兴趣的变量包括健康相关生活质量评分。在12个月的随访期内记录前瞻性自付费用。
CAM的使用率为40%,在先前研究的范围内。CAM的年均支出为32.25澳元(范围为0至603.30澳元)。CAM使用者更可能为女性(优势比(OR)为1.8(95%置信区间为1.1至3.0)),报告的身体疼痛程度更高(OR为0.97(0.95至0.99)),并且购买处方或非处方传统镇痛药的可能性较小(OR为3.3(1.6至7.0))。维生素补充剂是报告中最常见的CAM,其次是芹菜提取物、鱼油和大蒜提取物。
没有高质量的临床试验支持骨关节炎患者购买的大多数制剂的使用。需要对患者进行关于骨关节炎补充医学的风险和益处的教育。