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Huang YY, Xin XH, Sultana R, Thumboo J, Yong FK. Prevalence and Factors Associated with Concomitant Chinese Medicine Use by Rheumatoid Arthritis Patients in A Multi-Ethnic Asian Population. Chin J Integr Med 2021; 28:223-228. [PMID: 34319508 DOI: 10.1007/s11655-021-3494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the prevalence, factors associated with and patterns of concomitant Chinese medicine (CM) with Western treatment use among patients with rheumatoid arthritis (RA) in a tertiary referral centre (Singapore General Hospital) in Singapore. METHODS We conducted a cross-sectional interviewer-administered survey of a consecutive sample of patients with RA in Singapore General Hospital centre regarding their CM use including data on patient demographics, disease characteristics, concomitant use of CM and reasons, concerns and disclosure patterns from March to August 2015. Univariate and multivariate logistic regression analyses were performed to determine the associations of CM use. RESULTS Prevalence of CM use among the 258 patients surveyed (male: female 42: 216; Chinese: Malay: Indian 191: 29: 34; mean age: 61 years; mean duration of RA: 10 years) was 46.1% (119/258). On multivariate analysis, Chinese ethnicity (OR, 95% CI: 4.11, 1.49-11.36), Chinese speakers (OR, 95% CI: 2.35, 1.03-5.54), middle-income group (OR, 95% CI: 2.53, 1.01-6.31) and greater learned helplessness (OR, 95% CI: 1.13, 1.04-1.22) were significantly associated with CM use. More CM users disclosed their CM use to CM physicians (87.3%, 96/110), sought advice from them on treatment interactions (59.4%, 57/96) and how best to combine treatments (49.0%, 47/96) than did so with rheumatologists (42.0%, 50/119; 40.0%, 20/50; and 42.0%, 21/50, respectively). Forty-two percentage (29/69) of patients who concealed CM use from rheumatologists because their rheumatologists did not specifically enquire about CM use. CONCLUSIONS Concomitant CM use among patients with RA treated in a tertiary referral centre in Singapore is high but voluntary disclosure is low. The associations identified can help doctors identify and enquire about CM use, minimizing potential adverse interactions.
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Affiliation(s)
- You-Yi Huang
- Duke-NUS Medical School, Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Xiao-Hui Xin
- Medicine Academic Clinical Program, Division of Medicine, Singapore General Hospital, Singapore, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Julian Thumboo
- Duke-NUS Medical School, Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Fong Kok Yong
- Duke-NUS Medical School, Singapore, Singapore. .,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
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Şentürk S, Efe Arslan D, Çetinkaya A. Association of complementary and integrative therapy use and symptoms among Turkish patients with familial Mediterranean fever. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:340-346. [PMID: 33549524 DOI: 10.1016/j.joim.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/31/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study explored the correlations between the use of complementary and integrative therapies (CITs) and symptoms among Turkish patients with familial Mediterranean fever (FMF). METHODS This is a cross-sectional and descriptive study. The study was conducted with 1119 FMF patients who were registered to the social networking site for Behcet's and the FMF Patients Association (Befemder) in Turkey, between January 2018 and February 2019. Data were collected using an online survey, for which a three-part questionnaire was created using a Google form. Descriptive statistics, chi-square test and logistic regression analysis were used to analyze the data. RESULTS It was determined that 53.2% of the individuals who participated in the research used various forms of CITs and that 32.8% used vitamin and mineral supplements (calcium, iron, and vitamin B12, C and D), 25.0% used nutritional supplements (fish oil and honey), and 24.6% used oral herbs (ginger, turmeric, green tea and rosemary) and mind-body methods (relaxation, respiration exercise and meditation). It was determined that the percentage of participants that used CITs was higher among women (odds ratio [OR] = 1.825; 95% confidence interval [CI] 1.421-2.344), those with joint pain (OR = 1.385; 95% CI 1.047-1.832), those with difficulty breathing (OR = 1.323; 95% CI 1.031-1.697), those with gastrointestinal symptoms (OR = 1.405; 95% CI 1.089-1.814) and those who had a family member with FMF (OR = 1.437; 95% CI 1.115-1.851). CONCLUSION More than half of the individuals used at least one type of CIT for symptom control.
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Affiliation(s)
- Sibel Şentürk
- Department of Nursing, Bucak Health School, Burdur Mehmet Akif Ersoy University, Burdur 15300, Turkey.
| | - Dilek Efe Arslan
- Department of Medical Services and Techniques, Vocational School of Health Services, Erciyes University, Kayseri 38000, Turkey
| | - Adil Çetinkaya
- Children's Emergency Service, Istanbul Education and Research Hospital, İstanbul 34000, Turkey
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The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis. Adv Rheumatol 2021; 61:6. [PMID: 33468233 DOI: 10.1186/s42358-021-00162-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) use is prevalent among patients living with arthritis. Such patients often seek information online, for the purpose of gaining a second opinion to their healthcare provider or even self-medication. Little is known about the quality of web-based consumer health information at the intersection of CAM and arthritis; thus, investigating the quality of websites containing this information was the purpose of this study. METHODS Four unique search terms were searched on Google across four English-speaking countries. We assessed the first 20 results of each search, including them if they contained CAM consumer health information for the treatment and/or management of arthritis. Eligible websites were assessed in duplicate using the DISCERN instrument, which consists of 16-items designed to assess quality. RESULTS Of total of 320 webpages, 239 were duplicates, and a total of 38 unique websites were deemed eligible and assessed using the DISCERN instrument. The mean summed DISCERN scores across all websites was 55.53 (SD = 9.37). The mean score of the overall quality of each website was 3.71 (SD = 0.63), thus the majority of websites are ranked as slightly above 'fair' quality. CONCLUSION Eligible websites generally received scores better than 'moderate' in terms of overall quality. Several shortcomings included a lack of transparency surrounding references used and underreporting of risks associated with treatment options. These results suggest that health providers should be vigilant of the variable quality of information their patients may be accessing online and educate them on how to identify high quality resources.
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Çınar Fİ, Sinan Ö, Yılmaz S, Bağçivan G, Aydoğan I, Yalçın AG, Tekgöz E, Çınar M. Use of complementary and alternative medicine in patients with ankylosing spondylitis. Eur J Rheumatol 2020; 8:20-26. [PMID: 33196421 DOI: 10.5152/eurjrheum.2020.20111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/19/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Some studies have shown that the use of complementary and alternative medicine (CAM) is common in patients with chronic painful conditions, such as ankylosing spondylitis (AS). This study aimed to determine the prevalence and types of CAM usage in patients with AS and to evaluate the impact of treatment adherence and beliefs about medicines on CAM usage. METHODS This study has a descriptive design. A total of 140 patients with AS were included. The treatment adherence of the patients was evaluated using the Morisky Green Levine Medication Adherence Scale. The Beliefs about Medicines Questionnaire (BMQ-T) was used to assess patients' beliefs about medicines. RESULTS Previous or current CAM usage was stated by 40% of the patients. It has been found that CAM usage was significantly high (p<0.05) in patients who were married, older, and diagnosed at older ages. The difference between patients' beliefs about medicines and CAM usage was not statistically significant (p>0.05). The BMQ-T scores were significantly different in terms of the patients' treatment adherence (p<0.05). CONCLUSION This study showed that approximately half of the patients with AS were using 1 CAM method. Furthermore, medication adherence and patients' beliefs about medicines did not have any impact on CAM usage, but the patients' beliefs about medicines affected treatment adherence.
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Affiliation(s)
- Fatma İlknur Çınar
- Department of Internal Medicine Nursing, University of Health Sciences Turkey, Gülhane Faculty of Nursing, Ankara, Turkey
| | - Özlem Sinan
- Department of Nursing, Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Turkey
| | - Sedat Yılmaz
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gülhane Faculty of Medicine, Ankara, Turkey
| | - Gülcan Bağçivan
- Department of School of Nursing, Koç University, İstanbul, Turkey
| | - Işıl Aydoğan
- Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ayşe Gül Yalçın
- Division of Rheumatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Emre Tekgöz
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gülhane Faculty of Medicine, Ankara, Turkey
| | - Muhammet Çınar
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gülhane Faculty of Medicine, Ankara, Turkey
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Determination of Use of Alternative Medicine Methods in Patients With Ankylosing Spondylitis. Holist Nurs Pract 2020; 36:175-182. [PMID: 32282562 DOI: 10.1097/hnp.0000000000000386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to examine complementary and alternative medicine (CAM) use among patients with ankylosing spondylitis (AS) who had or who had not received treatment with biological agents; the study also aimed to determine the types of CAM methods used by these patients. This is a comparative and cross-sectional study. This research was conducted at a rheumatology outpatient clinic of a university hospital in Turkey. A total of 120 patients who had (n = 60) and had not (n = 60) received therapy with biological agents participated in this study. A patient identification form and a questionnaire prepared by the researchers were used to collate the study data. This study found that the most commonly used method among patients who did not receive biological therapy was thermal facilities, at a rate of 28.3%; and that the most commonly used method among patients who did receive biological therapy was the use of thermal facilities, at a rate of 25%. No significant difference was found between patients who had received and patients who had not received biological therapy in terms of age and disease duration. Information was provided by health professionals to the patients concerning frequently used CAM modalities.
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Kavadar G, Eroğlu Demir S, Aytekin E, Akbal Y. Use of traditional and complementary medicine for musculoskeletal diseases. Turk J Med Sci 2019; 49:809-814. [PMID: 31064168 PMCID: PMC7018349 DOI: 10.3906/sag-1509-71] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background/aim We aimed to determine the prevalence of traditional and complementary medicine (TCM) use among patients with musculoskeletal disorders (MSDs) and to examine the methods used, frequency, and experienced benefits of therapies; the reasons for using TCM; and the sources of information about therapies. We also compared demographic characteristics of users and nonusers of TCM. Materials and methods The descriptive study was conducted with 839 patients who attended the physical therapy and rehabilitation units of 3 public hospitals between September 2014 and March 2015. A self-administered questionnaire including demographic characteristics, medical history, and details of TCM use was applied. Results Of the 839 individuals in the study (592 female, 247 male; mean age 48.9 ± 13.0 years), 35.4% reported using TCM. There was no significant statistical difference between users and nonusers in terms of age, gender, body mass index, socioeconomic status, or educational level (P > 0.05). The disease duration of TCM users was significantly higher than that of nonusers (P < 0.05). The most commonly used TCM methods were balneotherapy (31%), herbal therapies (30%), wet cupping (22.2%), and massage-manipulation methods (21.2%). Of TCM users, 75.1% were satisfied. Conclusion The prevalence of TCM use and satisfaction levels are high in patients with MSDs. Physicians should be well informed about TCM methods and raise the awareness of patients to prevent improper use of TCM.
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Affiliation(s)
- Gülis Kavadar
- Department of Physical Medicine and Rehabilitation, Bahçeşehir Liv Hospital, İstinye University, İstanbul, Turkey
| | - Saliha Eroğlu Demir
- Department of Physical Medicine and Rehabilitation, Rumeli Hospital, İstanbul, Turkey
| | - Ebru Aytekin
- Department of Physical Medicine and Rehabilitation, İstanbul Education and Research Hospital, Health Sciences University,İstanbul, Turkey
| | - Yıldız Akbal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmiâlem Vakıf University, İstanbul, Turkey
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DeSalvo JC, Skiba MB, Howe CL, Haiber KE, Funk JL. Natural Product Dietary Supplement Use by Individuals With Rheumatoid Arthritis: A Scoping Review. Arthritis Care Res (Hoboken) 2019; 71:787-797. [PMID: 29975014 DOI: 10.1002/acr.23696] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/03/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Natural product dietary supplements (NDS), defined as non-mineral, non-vitamin, ingested, natural product-derived, substances, are the most frequently used complementary and alternative medicine modality in the US, with musculoskeletal disease being the most frequent reason for their use. Because NDS usage is frequently unreported, and patients with RA may be at higher risk for NDS-related side effects due the underlying nature of the disease and frequent use of complex pharmaceutical regimens, a scoping review of the literature was undertaken to examine population-based patterns of NDS use for RA self-management. METHODS Using guidelines for scoping reviews, Allied and Complementary Medicine, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, Embase, Ovid/Medline, and Web of Science databases were searched to identify references presenting primary data related to the prevalence or patterns of use of NDS in RA populations. RESULTS Twenty-three studies, which were published between 1980 and 2015 and conducted in 11 countries, met the inclusion criteria. The overall prevalence of NDS use in patients with RA was 47% worldwide and did not differ by geographic region. On average, 47% of patients found NDS to be effective and 13% reported adverse side effects, with only 30% informing their physicians about the use of NDS, which in a majority of cases were used concomitantly with RA pharmaceuticals. Marine oils, glucosamine, vinegar, and chondroitin were among the most commonly reported NDS worldwide. CONCLUSION Given the apparent communication gap between patients and providers regarding NDS use and higher potential risks associated with this usage in RA, ongoing surveillance of population-based practices may help facilitate RA management and direct future NDS research.
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Arıkan H, Duman D, Kargın F, Ergin G, Horne R, Karakurt S, Eryüksel E. Author's Reply. Turk Thorac J 2018; 19:232. [PMID: 30455996 DOI: 10.5152/turkthoracj.2018.181826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hüseyin Arıkan
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Dildar Duman
- Department of Pulmonology University of Health Sciences, Süreyyapaşa Chest Diseases and Cheast Surgery Training and Research Hospital, İstanbul, Turkey
| | - Feyza Kargın
- Department of Pulmonology University of Health Sciences, Süreyyapaşa Chest Diseases and Cheast Surgery Training and Research Hospital, İstanbul, Turkey
| | - Gülbin Ergin
- Department of Physiotherapy and Rehabilitation, Lefke European University Faculty of Health Sciences, Lefka, Cyprus
| | - Rob Horne
- UCL School of Pharmacy, Centre for Behavioural Medicine, University College London, United Kingdom
| | - Sait Karakurt
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Emel Eryüksel
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
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Hamre HJ, Pham VN, Kern C, Rau R, Klasen J, Schendel U, Gerlach L, Drabik A, Simon L. A 4-year non-randomized comparative phase-IV study of early rheumatoid arthritis: integrative anthroposophic medicine for patients with preference against DMARDs versus conventional therapy including DMARDs for patients without preference. Patient Prefer Adherence 2018; 12:375-397. [PMID: 29588576 PMCID: PMC5859899 DOI: 10.2147/ppa.s145221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND While disease-modifying antirheumatic drugs (DMARDs) are a mainstay of therapy for rheumatoid arthritis (RA), some patients with early RA refuse DMARDs. In anthroposophic medicine (AM), a treatment strategy for early RA without DMARDs has been developed. Preliminary data suggest that RA symptoms and inflammatory markers can be reduced under AM, without DMARDs. PATIENTS AND METHODS Two hundred and fifty-one self-selected patients aged 16-70 years, starting treatment for RA of <3 years duration, without prior DMARD therapy, participated in a prospective, non-randomized, comparative Phase IV study. C-patients were treated in clinics offering conventional therapy including DMARDs, while A-patients had chosen treatment in anthroposophic clinics, without DMARDs. Both groups received corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). Primary outcomes were intensity of RA symptoms measured by self-rating on visual analog scales, C-reactive protein, radiological progression, study withdrawals, serious adverse events (SAE), and adverse drug reactions in months 0-48. RESULTS The groups were similar in most baseline characteristics, while A-patients had longer disease duration (mean 15.1 vs 10.8 months, p<0.0001), slightly more bone destruction, and a much higher proportion of women (94.6% vs 69.7%, p<0.0001). In months 0-12, corticosteroids were used by 45.7% and 81.6% (p<0.0001) and NSAIDs by 52.8% and 68.5% (p=0.0191) of A- and C-patients, respectively. During follow-up, both groups not only had marked reduction of RA symptoms and C-reactive protein, but also some radiological disease progression. Also, 6.2% of A-patients needed DMARDs. Apart from adverse drug reactions (50.4% and 69.7% of A- and C-patients, respectively, p=0.0020), none of the primary outcomes showed any significant between-group difference. CONCLUSION Study results suggest that for most patients preferring anthroposophic treatment, satisfactory results can be achieved without use of DMARDs and with less use of corticosteroids and NSAIDs than in conventional care. LIMITATION Because of the non-randomized study design, with A-patients choosing anthroposophic treatment, one cannot infer how this treatment would have worked for C-patients.
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Affiliation(s)
- Harald J Hamre
- Institute for Applied Epistemology and Medical Methodology at the Witten/Herdecke University, Freiburg, Germany
- Correspondence: Harald J Hamre, Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Zechenweg 6, 79111 Freiburg, Germany, Tel +49 761 1560 307, Fax +49 761 6125 6125, Email
| | - Van N Pham
- Institute of Statistics in Medicine, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Christian Kern
- Department of Integrative Medicine, Asklepios Westklinikum, Hamburg, Germany
| | - Rolf Rau
- Department of Rheumatology, Evangelisches Fachkrankenhaus Ratingen, Ratingen, Germany
| | - Jörn Klasen
- Department of Integrative Medicine, Asklepios Westklinikum, Hamburg, Germany
| | - Ute Schendel
- Department of Rheumatology, m&i-Fachklinik Bad Pyrmont, Bad Pyrmont, Germany
| | - Lars Gerlach
- Department of Internal Medicine and Gastroenterology, Filderklinik, Filderstadt, Germany
| | - Attyla Drabik
- Institute of Statistics in Medicine, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ludger Simon
- Department of Internal Medicine and Gastroenterology, Filderklinik, Filderstadt, Germany
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Lahiri M, Santosa A, Teoh LK, Clayton JA, Lim SY, Teng GG, Cheung PPM. Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis. Int J Rheum Dis 2017; 20:567-575. [DOI: 10.1111/1756-185x.13091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Manjari Lahiri
- Department of Medicine; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- Division of Rheumatology; University Medicine Cluster; National University Health System; Singapore Singapore
| | - Amelia Santosa
- Department of Medicine; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- Division of Rheumatology; University Medicine Cluster; National University Health System; Singapore Singapore
| | - Lay Kheng Teoh
- Division of Rheumatology; University Medicine Cluster; National University Health System; Singapore Singapore
| | - Jane A. Clayton
- Department of Medicine; Ng Teng Fong General Hospital; Singapore Singapore
| | - Sheen Yee Lim
- Department of Medicine; Ng Teng Fong General Hospital; Singapore Singapore
| | - Gim Gee Teng
- Department of Medicine; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- Division of Rheumatology; University Medicine Cluster; National University Health System; Singapore Singapore
| | - Peter P. M. Cheung
- Department of Medicine; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- Division of Rheumatology; University Medicine Cluster; National University Health System; Singapore Singapore
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Yang L, Sibbritt D, Adams J. A critical review of complementary and alternative medicine use among people with arthritis: a focus upon prevalence, cost, user profiles, motivation, decision-making, perceived benefits and communication. Rheumatol Int 2016; 37:337-351. [DOI: 10.1007/s00296-016-3616-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 11/17/2016] [Indexed: 12/11/2022]
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Huang MC, Pai FT, Lin CC, Chang CM, Chang HH, Lee YC, Sun MF, Yen HR. Characteristics of traditional Chinese medicine use in patients with rheumatoid arthritis in Taiwan: A nationwide population-based study. JOURNAL OF ETHNOPHARMACOLOGY 2015; 176:9-16. [PMID: 26481605 DOI: 10.1016/j.jep.2015.10.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/07/2015] [Accepted: 10/12/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Large-scale study of traditional Chinese medicine (TCM) usage among patients with rheumatoid arthritis (RA) is lacking. The aim of this study is to evaluate the TCM usage among RA patients in Taiwan. MATERIALS AND METHODS We examined the "registry for catastrophic illness patient dataset" of the National Health Insurance Research Database (NHIRD; n=23 million people) in Taiwan. Patients (n=25,263) newly diagnosed as RA in 2001-2009 were included and then followed-up until the end of 2011. Based on the medical utilization, they were further categorized into TCM users (n= 6891; 27.3%) and non-TCM users (n=18,372; 72.7%). The demographic data and core prescription patterns of the TCM users were analyzed. RESULTS Compared to non-TCM user, TCM users were younger (mean age: 49.6 versus 54.0 years), had a higher female/male ratio (82.7%/17.3% versus 74.1%/25.9%), resided in more urbanized area. Herbal remedies were the most commonly used therapeutic approach (76.4%), followed by combining acupuncture (21.1%). The frequency of outpatient visits in TCM users was higher across all disease categories except circulatory system. The most commonly prescribed formula and herb was Shang-Jong-Shiah-Tong-Yong-Tong-Feng-Wan and Rhizoma Corydalis, respectively. The analysis of core pattern revealed that Dang-Gui-Nian-Tong-Tang, Shu-Jing-Huo-Xie-Tang, Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, Myrrha and Olibanum, were among the most frequently used combinations. RA patients who had anxiety and depression, allergic rhinitis, osteoporosis, menstrual disorder, and menopausal syndrome were prone to have more TCM visits compared to non-TCM users. CONCLUSIONS Our population-based study revealed the high prevalence and specific usage patterns of TCM in the RA patients in Taiwan. The information could be used for further pharmacological investigation and clinical trials.
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Affiliation(s)
- Ming-Cheng Huang
- Graduate Institute of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Fu-Tzu Pai
- Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Che-Chen Lin
- Health Data Management Office, China Medical University Hospital, Taichung 404, Taiwan
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hen-Hong Chang
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Yu-Chen Lee
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Graduate Institute of Acupuncture Science, China Medical University, Taichung 404, Taiwan
| | - Mao-Feng Sun
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Hung-Rong Yen
- Graduate Institute of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
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