Complementary and alternative treatment methods in chronic rheumatic diseases in the Central Anatolia
More details
Hide details
Cumhuriyet University, Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Sivas, Turkey
Cumhuriyet University, Faculty of Medicine, Department of Rheumatology, Sivas, Turkey
Cumhuriyet University, Faculty of science and literature, Department of Anthropology, Sivas, Turkey
Online publish date: 2018-04-15
Publish date: 2018-04-15
Electron J Gen Med 2018;15(4):em60
The aim of the study is to identify the kind of traditional practices used for the rheumatic diseases in the central Anatolia.

Materials and methods:
A total of 440 volunteer patients with chronic rheumatic diseases including osteoarthritis (OA), fibromyalgia, rheumatoid arthritis (RA), spondyloarthropathy (SpA) , familial Mediterranean fever (FMF), Behçet’s disease (BD), systemic lupus erythematosus (SLE), and mixed connective tissue disease (MCTD) were enrolled in the study. All patients were administered a 36-item questionnaire.

Of the patients, 49.3 % were using CAM. Herbal medicine was the most commonly (58.1 %) preferred methods. The CAM was used by 86 (48%) of 179 patients with OA and by 51 (60%) of 85 patients with RA. The difference in the CAM use across the disease groups was not statistically significant (χ2=7.343; p=0.290). When the patients using or not using CAM were assessed according to their education status, it was found that CAM was used by 59 (66.3%) of 89 patients with university degree and indicating a statistically significantly higher number of patients from higher education status among the CAM users (χ2=17.651; p=0.001).

Our study results suggest that among patients with rheumatic disease, patients with RA more commonly resort to the methods of CAM.

1. Nahin RL, Barnes PM, Stussman BJ, Bloom B. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007. Natl Health Stat Report 2009;30(18):1-14.
2. Ramos-Remus C. Complementary and alternative practices in rheumatology, Best Practice & Research Clinical Rheumatology 2008;22(4):741-57. https://doi.org/10.1016/j.berh... PMid:18783748.
3. Farzaei MH, Farzaei F, Abdollahi M, Abbasabadi Z, Abdolghaffari AH, Mehraban B. A mechanistic review on medicinal plants used for rheumatoid arthritis in traditional Persian medicine. J Pharm Pharmacol 2016;68(10):1233-348. https://doi.org/10.1111/jphp.1... PMid:27417522.
4. Mbizo J, Okafor A, Sutton MA, Burkhart EN, Stone LM. Complementary and Alternative Medicine Use by Normal Weight, Overweight, and Obese Patients with Arthritis or Other Musculoskeletal Diseases. J Altern Complement Med 2016;22(3):227-36. https://doi.org/10.1089/acm.20... PMid:26938367.
5. Comella NFL, Matilla MF, Castellano Cuesta JA. Have complementary therapies demonstrated effectiveness in rheumatoid arthritis? Reumatol Clin 2016;12(3):151-57. https://doi.org/10.1016/j.reum... PMid:26711840.
6. Liu J, Pan J, Wang Y, Lin D, Shen D, Yang H. et al. Component analysis of Chinese medicine and advances in fuming-washing therapy for knee osteoarthritis via unsupervised data mining methods. J Tradit Chin Med 2013;33(5):686-91. https://doi.org/10.1016/S0254-....
7. Rajbhandary R, Bhangle S, Patel S, Sen D, Perlman A, Panush RS. Perspectives about complementary and alternative medicine in rheumatology. Rheum Dis Clin North Am 2011;37(1):1-8. https://doi.org/10.1016/j.rdc.... PMid:21220081.
8. Marsh J, Hager C, Havey T, Sprague S, Bhandari M, Bryant D. Use of alternative medicines by patients with OA that adversely interact with commonly prescribed medications. Clin Orthop Relat Res 2009;467(10):2705-722. https://doi.org/10.1007/s11999... PMid:19255814 PMCid:PMC2745447.
9. Dias PA, Guimarães AB, Albuquerque Ade O, de Oliveira KL, Cavalcante ML, Guimarães SB. Short-term complementary and alternative medicine on quality of life in women with fibromyalgia. J Integr Med 2016;14(1):29-5. https://doi.org/10.1016/S2095-....
10. Chatfield SM, Dharmage SC, Boers A, Martin BJ, Buchanan RR, Maksymowych WP, et al. Complementary and alternative medicines in ankylosing spondylitis: a cross-sectional study. Clin Rheumatol 2009;28(2):213-17. https://doi.org/10.1007/s10067... PMid:18985421.
11. Breuer GS, Orbach H, Elkayam O, Berkun Y, Paran D, Mates M, et al. Use of complementary and alternative medicine among patients attending rheumatology clinics in Israel. Isr Med Assoc J 2006;8(3):184-87. PMid:16599054.
12. Klingberg E, Wallerstedt SM, Torstenson T, Håwi G, Forsblad-d’Elia H. The use of complementary and alternative medicine in outpatients with inflammatory rheumatic diseases in Sweden. Scand J Rheumatol 2009;38:472-80. https://doi.org/10.3109/030097... PMid:19922024.
13. Lee MS, Yang CY, Lee SI, Joo MC, Shin BC, Yoo WH, et al. Use of complementary and alternative medicine by rheumatoid arthritis patients in Korea. Clin Rheumatol 2008;27(1):29-33. https://doi.org/10.1007/s10067... PMid:17541497.
14. Buchbinder R, Gingold M, Hall S, Cohen M. Nonprescription complementary treatments used by rheumatoid arthritis patients attending a communitybased rheumatology practice. Intern Med J 2002;32:208-14. https://doi.org/10.1046/j.1445... PMid:12036218.
15. Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009;11(3):229. https://doi.org/10.1186/ar2669 PMid:19519924 PMCid:PMC2714099.
16. Re ML, Schmidt S, Güthlin C. Translation and adaptation of an international questionnaire to measure usage of complementary and alternative medicine (I-CAM-G). BMC Complement Altern Med. 2012 20;12:259. https://doi.org/10.1186/1472-6....
17. Verkamp EK, Flowers SR, Lynch-Jordan AM, Taylor J, Ting TV, Kashikar-Zuck S. A survey of conventional and complementary therapies used by youth with juvenile-onset fibromyalgia. Pain Manag Nurs 2013;14(4):244-50. https://doi.org/10.1016/j.pmn.... PMid:24315277 PMCid:PMC3857559.
18. Ulusoy H, Güçer TK,Aksu. M, Arslan Ş, Habiboğlu A, Akgöl G, et al. The Use of Complementary and Alternative Medicine in Turkish Patients with Rheumatic Diseases. Turk J Rheumatol 2012;27(1):31-7. https://doi.org/10.5606/tjr.20....
19. Kav S, Hanoğlu Z, Algıer L. Use of Complementary and Alternative Medicine by Cancer Patients in Turkey: A Literature Review. International Journal of Hematology and Oncology 2008;18(1):32-6.
20. Millar WJ. Use of alternative health care practitioners by Canadians. Revue Canadienne de Sante Publique 1997;88(3):154–58. PMid:9260354.
21. Lind BK, Lafferty WE, Tyree PT, Diehr PK, Grembowski DE. Use of complementary and alternative medicine providers by fibromyalgia patients under insurance coverage. Arthritis and Rheumatism 2007;57(1):71–6. https://doi.org/10.1002/art.22... PMid:17266066 PMCid:PMC1853385.
22. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use.. The New England journal of medicine 1993;328(4):246–52. https://doi.org/10.1056/NEJM19... PMid:8418405.
23. MacLennan AH, Wilson DH, Taylor AW. Prevalence and cost of alternative medicine in Australia. The Lancet 1996;347(9001):569–73. https://doi.org/10.1016/S0140-....
24. Ramos-Remus C, Watters CA, Dyke L, Suarez-Almazor ME, Russell AS. Assessment of health locus of control in the use of nonconventional remedies by patients with rheumatic diseases. The Journal of Rheumatology 1999;26(11):2468-74. PMid:10555911.
25. Cronan TA, Kaplan RM, Kozin F. Factors affecting unprescribed remedy use among people with self-reported arthritis. Arthritis Care and Research 1993;6(3): 149–55. https://doi.org/10.1002/art.17... PMid:8130291.
26. Chandrashekara S, Anilkumar T, Jamuna S. Complementary and alternative drug therapy in arthritis. The Journal of the Association of Physicians of India 2002;50:225–27. PMid:12038653.
27. Zaman T, Agrawal S, Handa R. Complementary and alternative medicine use in rheumatoid arthritis: an audit of patients visiting a tertiary care centre. National Medical Journal of India 2007;20(5):236–39. PMid:18254519.
28. Tokem Y, Parlar Kilic S, Ozer S, Nakas D, Argon G. A multicenter analysis of the use of complementary and alternative medicine in Turkish patients with rheumatoid arthritis: holistic nursing practice review copy. Holist Nurs Pract 2014;8(2):98-05. https://doi.org/10.1097/HNP.00... PMid:24503747.
29. Wahner-Roedler DL, Vincent A, Elkin PL, Loehrer LL, Cha SS, Bauer BA. Physicians Attitudes Toward Complementary and Alternative Medicine and Their Knowledge of Specific Therapies: A Survey at an Academic Medical Center. Evid Based Complement Alternat Med 2006; 3(4):495–01. https://doi.org/10.1093/ecam/n... PMid:17173114 PMCid:PMC1697740.
30. Ernst E, Cassileth BR. The prevalence of complementary/alternative medicine in cancer. A systematic review. Cancer 1998;83(4):777-82. https://doi.org/10.1002/(SICI)...<777::AID-CNCR22>3.0.CO;2-O.
31. Begbie SD, Kerestes ZL, Bell DR. Patterns of alternative medicine use by cancer patients:Med J Aust 1996;165(10):545-48. PMid:8941239.
32. Risberg T, Lund E, Wist E. Use of non-proven therapies. Differences in attitudes between Norwegian patients with non-malignant disease and patients suffering fromcancer. Acta Oncol 1995;34(7):893-01. https://doi.org/10.3109/028418... PMid:7492377.