Arthritis Care Res (Hoboken). Author manuscript; available in PMC 2014 Apr 7.
Published in final edited form as:
PMCID: PMC3977347
NIHMSID: NIHMS568543
The publisher's final edited version of this article is available free at Arthritis Care Res (Hoboken)
Abstract
Objective.
Racial/ethnic
differences with regard to complementary and alternative medicine (CAM)
use have been reported in the US. However, specific details of CAM use
by African Americans with rheumatoid arthritis (RA) are lacking.
Methods.
Data
were collected from African Americans with RA enrolled in a multicenter
registry regarding the use of CAM, including food supplements, topical
applications, activities, and alternative care providers. Factors
associated with CAM use by sex and disease duration were assessed using t-test, Wilcoxon’s rank sum test, chi-square test, and logistic regression analyses.
Results.
Of
the 855 participants, 85% were women and mean age at enrollment was 54
years. Overall, ever using any of the CAM treatments, activities, and
providers was 95%, 98%, and 51%, respectively (median of 3 for number of
treatments, median of 5 for activities, and median of 1 for providers).
Those with longer disease duration (>2 years) were significantly
more likely (odds ratio >2.0, P < 0.05) to use raisins
soaked in vodka/gin, to take fish oils, or to drink alcoholic beverages
for RA treatment than those with early disease. As compared to men,
women were significantly (P < 0.05) more likely to
pray/attend church, write in a journal, and use biofeedback, but were
less likely to smoke tobacco or topically apply household oils for
treatment of RA.
Conclusion.
CAM
use was highly prevalent in this cohort, even in individuals with early
disease. Health care providers need to be aware of CAM use as some
treatments may potentially have interactions with conventional
medicines. This could be important within this cohort of African
Americans, where racial disparities are known to affect access to
conventional care.
INTRODUCTION
Rheumatoid
arthritis (RA) is a chronic multisystem autoimmune disease associated
with severe morbidity if untreated. Despite early detection and
availability of treatments to slow disease progression, no definitive
cure exists for RA. Current treatment modalities often have side effects
that may affect quality of life (1). Additionally, RA also has a significant impact on emotional and social well-being (2).
These factors are potential contributing factors to use of treatments
in place of (alternative) or in addition (complementary) to conventional
medications.
In the US, complementary and alternative
medicine (CAM) use has been increasing in general and for arthritis,
including RA. The prevalence of CAM use in RA patients has been reported
to vary from 20% to 86% (3-6). The 2007 National Health Interview Survey (NHIS) (3)
reported that 4 of 10 US adults had used CAM therapy in the past 12
months. Between 2002 and 2007, the relative increase in CAM use
(including prayer for health reasons) was 14.2% (4).
The
2002 and 2007 NHIS revealed a clear pattern of CAM use among different
racial/ethnic groups, with non-Hispanic whites and Asian Americans being
more likely to use CAM than African Americans and Hispanics (3-5).
With regard to prayer, African Americans were more likely to pray for
health reasons than non-Hispanic whites. However, such details regarding
CAM use in African Americans with RA are lacking due to low
representation of African Americans in RA studies. Also, much of the CAM
research in arthritis has been focused on individuals with longstanding
disease (7-9) and data on those with early disease are lacking.
The
results regarding sex differences with regard to CAM use in RA patients
have been mixed. Some studies report higher CAM use by women (6,10,11), while others report no significant sex differences (7,12). Arcury et al (8)
reported that women were less likely to drink liquor (whiskey) and more
likely to use religion as a remedy for their arthritis-related
symptoms. Such sex differences, which could be due to differential
disease activity, are of clinical significance, reflecting sex-specific
health behaviors.
The purpose of this study was
to describe the prevalence of CAM use with regard to various
treatments, activities, and providers using a cohort of African
Americans with RA from the southern US. The study also examined
potential differences by sex and disease duration with regard to overall
and specific CAM use.
