Complementary and alternative medicine use by osteoporosis clinic patients
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We describe complementary and alternative medicine use (CAM) in 360 patients attending osteoporosis clinics. Of these patients, 57% were CAM users. Predictors of CAM use included lower mental quality of life, younger age and higher education. Less than half of CAM use was disclosed to physicians, despite potential adverse interactions.
The prevalence of complementary and alternative medicine (CAM) use in osteoporosis clinics is not known. The objective of this study was to describe the pattern of CAM use in this population.
We performed a cross-sectional study of 360 patients attending academic osteoporosis clinics in Toronto, Canada in 2001. Subjects completed a self-administered questionnaire on CAM use. Health-related quality of life (HQL) was measured with the Short-Form 36v2. Comparative statistics and logistic regression were performed to identify sociodemographic, HQL and clinical correlates of CAM use.
More than 80% of participants were women, Caucasian and had at least a high school education. Of subjects, 57% used CAM in the previous year. Only 44% of CAM use was disclosed to a medical doctor. CAM users and non-users did not differ in clinical characteristics such as bone mineral density, level of comorbidity and fracture history. In univariate analysis, CAM users were less satisfied with conventional medicine. However, when we explored patient satisfaction, comorbidities and sociodemographic as predictors for CAM use, the multivariable analyses showed that lower mental HQL, younger age, and post-secondary education were the only significant predictors. We identified 35 cases in which the utilization of CAM supplements could possibly exacerbate existing medical conditions.
Patients attending osteoporosis clinics frequently use CAM. Conceptually, the predictors of use identified in this study may fit into a socio-behavioral model that helps explain why people turn to CAM. Physicians may need to elicit a history of CAM use more vigilantly so as to better screen for possible adverse clinical interactions.
KeywordsAlternative medicine Bone diseases metabolic Drug interactions Quality of life
The authors are indebted to Ms. Cherry Mendoza and Ms. Susanne Stewart for their assistance in administering the questionnaire, Ms. Kathryn Herridge for obtaining patient information for us, Ms. Irene Ho for her assistance with the ethics applications, and Ms. Donna Cheung, Mr. Adrian Lau and Ms. Judy Lew for data collection and data entry. The authors would also like to thank the CAM practitioners who provided information on common alternative bone treatments.
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