关节炎患者对补充和替代医学的使用情况。
Use of complementary and alternative medicine among patients with arthritis.
作者信息
Callahan Leigh F, Wiley-Exley Elizabeth K, Mielenz Thelma J, Brady Teresa J, Xiao Changfu, Currey Shannon S, Sleath Betsy L, Sloane Philip D, DeVellis Robert F, Sniezek Joseph
机构信息
Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7280, USA.
出版信息
Prev Chronic Dis. 2009 Apr;6(2):A44. Epub 2009 Mar 16.
INTRODUCTION
Previous studies suggest that people with arthritis have high rates of using complementary and alternative medicine (CAM) approaches for managing their arthritis, in addition to conventional treatments such as prescription medications. However, little is known about the use of CAM by diagnosis, or which forms of CAM are most frequently used by people with arthritis. This study was designed to provide detailed information about use of CAM for symptoms associated with arthritis in patients followed in primary care and specialty clinics in North Carolina.
METHODS
Using a cross-sectional design, we drew our sample from primary care (n = 1,077) and specialist (n = 1,063) physician offices. Summary statistics were used to calculate differences within and between diagnostic groups, practice settings, and other characteristics. Logistic regression models clustered at the site level were used to determine the effect of patient characteristics on ever and current use of 9 CAM categories and an overall category of "any use."
RESULTS
Most of the participants followed by specialists (90.5%) and a slightly smaller percentage of those in the primary care sample (82.8%) had tried at least 1 complementary therapy for arthritis symptoms. Participants with fibromyalgia used complementary therapies more often than those with rheumatoid arthritis, osteoarthritis, or chronic joint symptoms. More than 50% of patients in both samples used over-the-counter topical pain relievers, more than 25% used meditation or drew on religious or spiritual beliefs, and more than 19% used a chiropractor. Women and participants with higher levels of education were more likely to report current use of alternative therapies.
CONCLUSION
Most arthritis patients in both primary care and specialty settings have used CAM for their arthritis symptoms. Health care providers (especially musculoskeletal specialists) should discuss these therapies with all arthritis patients.
引言
先前的研究表明，除了使用如处方药等传统治疗方法外，患有关节炎的人还经常使用补充和替代医学（CAM）方法来管理他们的关节炎。然而，关于按诊断分类的CAM使用情况，或者患有关节炎的人最常使用哪种CAM形式，我们所知甚少。本研究旨在提供有关北卡罗来纳州初级保健和专科诊所中患者使用CAM治疗关节炎相关症状的详细信息。
方法
采用横断面设计，我们从初级保健医生办公室（n = 1077）和专科医生办公室（n = 1063）抽取样本。汇总统计用于计算诊断组、执业环境和其他特征内部及之间的差异。使用在机构层面聚类的逻辑回归模型来确定患者特征对9种CAM类别以及“任何使用”这一总体类别的曾经使用和当前使用的影响。
结果
大多数接受专科医生治疗的参与者（90.5%）以及初级保健样本中略少比例的参与者（82.8%）至少尝试过1种针对关节炎症状的补充疗法。纤维肌痛患者比类风湿性关节炎、骨关节炎或慢性关节症状患者更频繁地使用补充疗法。两个样本中超过50%的患者使用非处方外用止痛药，超过25%的患者使用冥想或借助宗教或精神信仰，超过19%的患者使用脊椎按摩师服务。女性和受教育程度较高的参与者更有可能报告当前使用替代疗法。
结论
初级保健和专科环境中的大多数关节炎患者都使用过CAM来缓解他们的关节炎症状。医疗保健提供者（尤其是肌肉骨骼专科医生）应该与所有关节炎患者讨论这些疗法。
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