Association between physician–patient relationship and the use of complementary and alternative medicine in patients with rheumatoid arthritis

Abstract

IntroductionAlthough complementary and alternative medicine (CAM) use among patients with rheumatic diseases is extensive, discussions regarding these treatments occur rarely in the rheumatology setting, directly affecting the physician–patient relationship (PPR). ObjectivesThe aim of this study was to evaluate the association between patient-physician relationship and complementary and alternative medicine use. As secondary objectives, to describe the patient’s perspective towards CAM use and estimate the prevalence of CAM treatments used in patients with rheumatoid arthritis. Methods and materialsA descriptive cross-sectional survey was conducted, in which CAM use and physician–patient relationship were assessed by self-reported validated questionnaires (I-CAM-Q and PDRQ-9, respectively). ResultsThe study included a total of 246 outpatients of a tertiary care hospital. There were no significant differences between CAM users vs. non-users, or informers vs. non-informers in terms of physician–patient relationship measured by PDQR. The prevalence of CAM use at 3 and 12 months were 37.4% and 41.5%, respectively. The most frequent used CAM treatments were: chiropractice, acupuncture, and herbal products. A large majority (78.5%) of the patients expressed agreement to the discussion of CAM use with the rheumatologist, but only 31.3% of total CAM users did so because of fear of retaliation (54.4%). ConclusionDespite the extensive practice of CAM among patients with rheumatoid arthritis, most patients did not discuss these treatments with their physicians. Associations were found between MCA use and a lower patient’s treatment satisfaction and between physician–patient communication about CAM practice and a higher patient’s treatment satisfaction.