Osteoporosis International

, Volume 18, Issue 11, pp 1547–1556 | Cite as

Complementary and alternative medicine use by osteoporosis clinic patients

  • C. A. K. Y. Chong
  • N. Diaz-Granados
  • G. A. Hawker
  • S. Jamal
  • R. G. Josse
  • A. M. Cheung
Original Article

Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Alternative medicine Bone diseases metabolic Drug interactions Quality of life 

References

  1. 1.
    Millar WJ (1997) Use of alternative health care practitioners by Canadians. Can J Public Health 88:154–158PubMedGoogle Scholar
  2. 2.
    Eisenberg DM, Davis RB, Ettner SL et al (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280:1569–1575PubMedCrossRefGoogle Scholar
  3. 3.
    Tindle HA, Davis RB, Phillips RS et al (2005) Trends in use of complementary and alternative medicine by US adults: 1997–2002. Altern Ther Health Med 11:42–49PubMedGoogle Scholar
  4. 4.
    Verhoef MJ, Hagen N, Pelletier G et al (1999) Alternative therapy use in neurologic diseases: use in brain tumor patients. Neurology 52:617–622PubMedGoogle Scholar
  5. 5.
    Pioro-Boisset M, Esdaile JM, Fitzcharles MA (1996) Alternative medicine use in fibromyalgia syndrome. Arthritis Care Res 9:13–17PubMedCrossRefGoogle Scholar
  6. 6.
    Ganguli SC, Cawdron R, Irvine EJ (2004) Alternative medicine use by Canadian ambulatory gastroenterology patients: secular trend or epidemic? Am J Gastroenterol 99:319–326PubMedCrossRefGoogle Scholar
  7. 7.
    Eisenberg DM, Kessler RC, Foster C et al (1993) Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 328:246–252PubMedCrossRefGoogle Scholar
  8. 8.
    MacLennan AH, Wilson DH, Taylor AW (1996) Prevalence and cost of alternative medicine in Australia. Lancet 347:569–573PubMedCrossRefGoogle Scholar
  9. 9.
    Sirois FM, Gick ML (2002) An investigation of the health beliefs and motivations of complementary medicine clients. Soc Sci Med 55:1025–1103PubMedCrossRefGoogle Scholar
  10. 10.
    Astin JA (1998) Why patients use alternative medicine: results of a national study. JAMA 279:1548–1553PubMedCrossRefGoogle Scholar
  11. 11.
    Seidl MM, Stewart DE (1998) Alternative treatments for menopausal symptoms. Systematic review of scientific and lay literature. Can Fam Physician 44:1299–1308PubMedGoogle Scholar
  12. 12.
    Kam IW, Dennehy CE, Tsourounis C (2002) Dietary supplement use among menopausal women attending a San Francisco health conference. Menopause 9:72–78PubMedCrossRefGoogle Scholar
  13. 13.
    Daniel W (1999) Biostatistics: A Foundation for Analysis in the Health Sciences, 7th edn. John Wiley Sons, John Wiley Sons: New YorkGoogle Scholar
  14. 14.
    (2001) Population Counts, Land Area, Population Density and Population Rank, for Canada, Provinces and Territories, and Census Subdivisions (Municiplaities), 2001 Census. Statistics CanadaGoogle Scholar
  15. 15.
    National Center for Complementary and Alternative Medicine. (2007) CAM Basics. Available at: http://nccam.nih.gov/health/whatiscam/. Accessed February 15, 2007
  16. 16.
    Burstein HJ, Gelber S, Guadagnoli E et al (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340:1733–1739PubMedCrossRefGoogle Scholar
  17. 17.
    Moore AD, Petri MA, Manzi S et al (2000) The use of alternative medical therapies in patients with systemic lupus erythematosus. Trination Study Group. Arthritis Rheum 43:1410–1418PubMedCrossRefGoogle Scholar
  18. 18.
    Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRefGoogle Scholar
  19. 19.
    Hopman WM, Towheed T, Anastassiades T et al (2000) Canadian normative data for the SF-36 health survey. Canadian Multicentre Osteoporosis Study Research Group. CMAJ 163:265–271PubMedGoogle Scholar
  20. 20.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383PubMedCrossRefGoogle Scholar
  21. 21.
    Chaudhry S, Jin L, Meltzer D (2005) Use of a self-report-generated Charlson Comorbidity Index for predicting mortality. Med Care 43:607–615PubMedCrossRefGoogle Scholar
  22. 22.
    Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedCrossRefGoogle Scholar
  23. 23.
    Tenenhouse A, Joseph L, Kreiger N et al (2000) Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int 11:897–904PubMedCrossRefGoogle Scholar
  24. 24.
    (2001) Median total income, by family type, by census metropolitan area. Statistics CanadaGoogle Scholar
  25. 25.
    Yue QY, Jansson K (2001) Herbal drug curbicin and anticoagulant effect with and without warfarin: possibly related to the vitamin E component. J Am Geriatr Soc 49:838PubMedCrossRefGoogle Scholar
  26. 26.
    Corrigan JJ Jr, Ulfers LL (1981) Effect of vitamin E on prothrombin levels in warfarin-induced vitamin K deficiency. Am J Clin Nutr 34: 1701–1705PubMedGoogle Scholar
  27. 27.
    Corrigan JJ Jr, Marcus FI (1974) Coagulopathy associated with vitamin E ingestion. JAMA 230:1300–1301PubMedCrossRefGoogle Scholar
  28. 28.
    Monauni T, Zenti MG, Cretti A et al (2000) Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes 49:926–935PubMedCrossRefGoogle Scholar
  29. 29.
    Adams ME (1999) Hype about glucosamine. Lancet 354:353–354PubMedCrossRefGoogle Scholar
  30. 30.
    Schelling JR (2000) Fatal hypermagnesemia. Clin Nephrol 53:61–65PubMedGoogle Scholar
  31. 31.
    This P, De La Rochefordiere A, Clough K et al (2001) Phytoestrogens after breast cancer. Endocr Relat Cancer 8:129–134PubMedCrossRefGoogle Scholar
  32. 32.
    Glazier MG, Bowman MA (2001) A review of the evidence for the use of phytoestrogens as a replacement for traditional estrogen replacement therapy. Arch Intern Med 161:1161–1172PubMedCrossRefGoogle Scholar
  33. 33.
    Miller LG (1998) Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 158:2200–2211PubMedCrossRefGoogle Scholar
  34. 34.
    Ernst E, Harkness E (2001) Spinal manipulation: a systematic review of sham-controlled, double-blind, randomized clinical trials. J Pain Symptom Manage 22:879–889PubMedCrossRefGoogle Scholar
  35. 35.
    Monostory K, Vereczkey L, Levai F, Szatmari I (1998) Ipriflavone as an inhibitor of human cytochrome P450 enzymes. Br J Pharmacol 123:605–610PubMedCrossRefGoogle Scholar
  36. 36.
    Alexandersen P, Toussaint A, Christiansen C, Devogelaer JP, Roux C, Fechtenbaum J, Gennari C, Reginster JY (2001) Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 285:1482–1488PubMedCrossRefGoogle Scholar
  37. 37.
    Hsiao AF, Wong MD, Kanouse DE et al (2003) Complementary and alternative medicine use and substitution for conventional therapy by HIV-infected patients. J Acquir Immune Defic Syndr 33:157–165PubMedCrossRefGoogle Scholar
  38. 38.
    Gagnon EM, Recklitis CJ (2003) Parents’ decision-making preferences in pediatric oncology: the relationship to health care involvement and complementary therapy use. Psychooncology 12:442–452PubMedCrossRefGoogle Scholar
  39. 39.
    Arcury TA, Bell RA, Snively BM et al (2006) Complementary and alternative medicine use as health self-management: rural older adults with diabetes. J Gerontol B Psychol Sci Soc Sci 61:S62–S70PubMedGoogle Scholar
  40. 40.
    Andersen R, Newman JF (1973) Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc. 51:95–124PubMedCrossRefGoogle Scholar
  41. 41.
    Schwartz CE, Laitin E, Brotman S et al (1999) Utilization of unconventional treatments by persons with MS: is it alternative or complementary? Neurology 52:626–629PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • C. A. K. Y. Chong
    • 1
  • N. Diaz-Granados
    • 1
  • G. A. Hawker
    • 2
  • S. Jamal
    • 3
  • R. G. Josse
    • 3
  • A. M. Cheung
    • 1
    • 4
    • 5
  1. 1.Division of General Internal Medicine and Clinical EpidemiologyUniversity Health Network and Mount Sinai Hospital, University of TorontoTorontoCanada
  2. 2.Division of Rheumatology, Department of MedicineWomen’s College Hospital, University of TorontoTorontoCanada
  3. 3.Division of Endocrinology, Department of MedicineSt. Michael’s Hospital, University of TorontoTorontoCanada
  4. 4.Division of Endocrinology, Department of MedicineUniversity Health Network and Mount Sinai Hospital, University of TorontoTorontoCanada
  5. 5.TorontoCanada

Personalised recommendations