Marsh Jacquelyn, Hager Christine, Havey Tom, Sprague Sheila, Bhandari Mohit, Bryant Dianne
Faculty of Health Sciences, Elborn College, The University of Western Ontario, London, ON, Canada.
Clin Orthop Relat Res. 2009 Oct;467(10):2705-22. doi: 10.1007/s11999-009-0764-3. Epub 2009 Mar 3.
Owing to the increasing prevalence, patient interest, and high risk of adverse effects associated with use of complementary and alternative medicine (CAM), investigation of this issue in an orthopaedic population is warranted. The objectives of this study were to (1) identify the prevalence of CAM use, (2) assess the level of communication between patients and physicians regarding CAMs, (3) uncover reasons for nondisclosure, and (4) identify potentially harmful interactions between CAMs and conventional therapy. We conducted a cross-sectional observational study among patients being treated in orthopaedic surgical clinics for osteoarthritis (OA). Of the 373 participants, 42.9% reported taking one or more CAMs, and 40.6% admitted their surgeons were unaware of their alternative therapy use. Reasons for nondisclosure included, the patient thought: (1) it was not important (29.7%); (2) the surgeon would not be interested (13.5%); and (3) their surgeon would not know about CAMs (8.2%). Twenty-two of 281 patients (7.8%) were taking alternative medicines that could interact with their blood pressure medication, 28.6% were taking anticoagulant/antiplatelet medication and also taking a CAM that could interact, and 5.9% were taking conventional pain medications along with a CAM that potentially could interact. Orthopaedic surgeons should make it part of their consultation to inquire about CAM use.
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
由于补充和替代医学（CAM）的使用日益普遍、患者关注度提高以及与之相关的不良反应风险较高，因此有必要在骨科人群中对这一问题进行调查。本研究的目的是：（1）确定CAM的使用 prevalence；（2）评估患者与医生之间关于CAM的沟通水平；（3）揭示不披露的原因；（4）确定CAM与传统疗法之间潜在的有害相互作用。我们在骨科手术诊所接受骨关节炎（OA）治疗的患者中进行了一项横断面观察研究。在373名参与者中，42.9%报告使用了一种或多种CAM，40.6%承认他们的外科医生不知道他们使用替代疗法。不披露的原因包括：患者认为（1）这并不重要（29.7%）；（2）外科医生不会感兴趣（13.5%）；（3）他们的外科医生不了解CAM（8.2%）。281名患者中有22名（7.8%）正在服用可能与他们的血压药物相互作用的替代药物，28.6%正在服用抗凝/抗血小板药物并且还在服用可能相互作用的CAM，5.9%正在服用传统止痛药物以及可能相互作用的CAM。骨科外科医生应将询问CAM的使用作为其会诊的一部分。
III级，治疗性研究。有关证据级别的完整描述，请参阅作者指南。
