Abstract
BackgroundWe aimed to describe prevailing attitudes and practices of rheumatologists in the United States toward complementary and alternative medicine (CAM) treatments. We wanted to determine whether rheumatologists' perceptions of the efficacy of CAM therapies and their willingness to recommend them relate to their demographic characteristics, geographic location, or clinical practices.MethodsA National Institutes of Health-sponsored cross-sectional survey of internists and rheumatologists was conducted regarding CAM for treatment of chronic back pain or joint pain. In this study we analyzed responses only from rheumatologists. Response items included participant characteristics and experience with 6 common CAM categories, as defined by the National Institutes of Health. Descriptive statistics were used to describe attitudes to CAM overall and to each CAM category. Composite responses were devised for respondents designating 4 or more of the 6 CAM therapies as "very" or "moderately" beneficial or "very likely" or "somewhat likely" to recommend.ResultsOf 600 rheumatologists who were sent the questionnaire, 345 responded (58%); 80 (23%) were women. Body work had the highest perceived benefit, with 70% of respondents indicating benefit. Acupuncture was perceived as beneficial by 54%. Most were willing to recommend most forms of CAM. Women had significantly higher composite benefit and recommend responses than men. Rheumatologists not born in North America were more likely to perceive benefit of select CAM therapies.ConclusionsIn this national survey of rheumatologists practicing in the United States, we found widespread favorable opinion toward many, but not all, types of CAM. Further research is required to determine to what extent CAM can or should be integrated into the practice of rheumatology in the United States.
Highlights
We aimed to describe prevailing attitudes and practices of rheumatologists in the United States toward complementary and alternative medicine (CAM) treatments
The proportion of mainstream physicians who incorporated some form of CAM into their own practices ranged from 9% to 19%, and CAM referral rates ranged from 4% to 43% [5]
In the summer of 2007, a 12-page selfadministered questionnaire was mailed to a stratified random sample of 600 rheumatologists younger than 65 years in the United States as part of a larger national survey of health care providers’ perceptions about CAM, which was sponsored by the National Institutes of Health
Summary
We aimed to describe prevailing attitudes and practices of rheumatologists in the United States toward complementary and alternative medicine (CAM) treatments. Results of the National Health Interview Surveys in 2002 and 2007 showed that complementary and alternative medicine (CAM) use among patients with arthritis is very pervasive [1,2]. The odds ratio for ever-use of CAM among adults with arthritis was 1.59 compared with adults with no chronic diseases and was higher than CAM use among patients with any other common chronic diseases including cardiovascular disease and cancer [3]. It is clear, that patients’ use of CAM is an important clinical issue; this is especially true for rheumatologists and primary care physicians who treat arthritis. More recent surveys from countries such as Italy and Germany indicate an increasing trend of primary physicians incorporating CAM into their practices [6,7]
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