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A survey of traditional Chinese medicine use among rheumatoid arthritis patients: a claims data–based cohort study

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Abstract

Introduction/objectives

Traditional Chinese medicine (TCM) is commonly used for symptom relief in patients with chronic diseases. Nevertheless, large-scale surveys focusing on the utilization of TCM among patients with rheumatoid arthritis (RA) are limited, especially in Taiwan, where TCM is highly popular. This cohort study aimed to describe the utilization of TCM and determine the factors related to TCM usage among RA patients.

Method

A national health insurance database was used to identify 6532 newly diagnosed RA patients aged between 20 and 70 years, together with 12,246 subjects without RA matched by sex, age, and index year between 2000 and 2010. Incidence density of TCM use and its related factors was calculated by the Poisson regression model.

Results

Findings indicated that RA patients experienced higher incidence density of TCM use than non-RA patients, with an adjusted incidence density ratio of 1.30 (95% confidence interval = 1.21–1.36). Multivariate analysis showed that RA patients who were female, were young, had high monthly income, had high Charlson-Deyo comorbidity index scores, and lived in the highly urbanized area with high TCM density were more likely to use TCM services. The top three reasons for seeking TCM services were diseases of the musculoskeletal system and connective tissue, the respiratory system, and the digestive system.

Conclusions

The findings allow healthcare providers to identify the pattern of TCM use and characterize the factors that affect TCM utilization. Further research is required to fully address the efficiency and safety of TCM in treating RA patients.

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Acknowledgements

The study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, and managed by National Health Research Institutes.

Role of authors

All the authors approved the contents of the submitted article. Conceived and designed the experiments: LMC, YCC, TTY. Analyzed the data: TTY. Contributed reagents/materials/analysis tools: TTY, CLM, LH, LMC. Wrote the paper: TTY, LH. Final approval of manuscript: LMC, LH, CLM, LNS, YCC, TTY.

Funding

This research was supported by Dalin Tzuchi Hospital (Grant Number DTCRD103(2)-E-05).

Author information

Author notes

  1. Ming-Chi Lu, Hanoch Livneh and Lei-Mei Chiu contributed equally to this work.

Authors and Affiliations

  1. Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan

    Ming-Chi Lu & Ning-Sheng Lai

  2. School of Medicine, Tzu Chi University, 701 Jhongyang Road Section 3, Hualien, 97004, Taiwan

    Ming-Chi Lu & Ning-Sheng Lai

  3. Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA

    Hanoch Livneh

  4. Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan

    Lei-Mei Chiu

  5. Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan

    Chia-Chou Yeh

  6. School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, 701 Jhongyang Road Section 3, Hualien, 97004, Taiwan

    Chia-Chou Yeh

  7. School of Chinese Medicine, Chin Medical, Taichung, 40402, Taiwan

    Chia-Chou Yeh

  8. Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan

    Tzung-Yi Tsai

  9. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan

    Tzung-Yi Tsai

  10. Department of Nursing, Tzu Chi University of Science and Technology, 880 Chien-Kuo Road Section 2, Hualien, 62247, Taiwan

    Tzung-Yi Tsai

Authors
  1. Ming-Chi Lu
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  2. Hanoch Livneh
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  3. Lei-Mei Chiu
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  4. Ning-Sheng Lai
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  5. Chia-Chou Yeh
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  6. Tzung-Yi Tsai
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Corresponding author

Correspondence to Tzung-Yi Tsai.

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Ethics approval

This study was approved by the local institutional review board and ethics committee of Buddhist Dalin Tzu Chi Hospital, Taiwan (No. B10004021-2).

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The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or National Health Research Institutes.

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Lu, MC., Livneh, H., Chiu, LM. et al. A survey of traditional Chinese medicine use among rheumatoid arthritis patients: a claims data–based cohort study. Clin Rheumatol 38, 1393–1400 (2019). https://doi.org/10.1007/s10067-018-04425-w

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  • DOI: https://doi.org/10.1007/s10067-018-04425-w

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