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Prevalence and Factors Associated with Concomitant Chinese Medicine Use by Rheumatoid Arthritis Patients in A Multi-Ethnic Asian Population

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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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Author information

Authors and Affiliations

  1. Duke-NUS Medical School, Singapore, Singapore

    You-yi Huang, Julian Thumboo &  Kok Yong Fong

  2. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    You-yi Huang, Julian Thumboo &  Kok Yong Fong

  3. Medicine Academic Clinical Program, Division of Medicine, Singapore General Hospital, Singapore, Singapore

    Xiao-hui Xin

  4. Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore

    Rehena Sultana

Authors
  1. You-yi Huang
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  2. Xiao-hui Xin
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  3. Rehena Sultana
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  4. Julian Thumboo
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  5. Kok Yong Fong
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Contributions

Huang YY, Thumboo J and Yong FK designed, conceived and revised the study. Huang YY and Xin XH carried out the survey, analysis and drafting. Rehena S analysed and interpreted the data. All authors have read and approved this manuscript.

Corresponding author

Correspondence to Kok Yong Fong.

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Huang, Yy., Xin, Xh., Sultana, R. et al. Prevalence and Factors Associated with Concomitant Chinese Medicine Use by Rheumatoid Arthritis Patients in A Multi-Ethnic Asian Population. Chin. J. Integr. Med. 28, 223–228 (2022). https://doi.org/10.1007/s11655-021-3494-3

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  • DOI: https://doi.org/10.1007/s11655-021-3494-3

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