The CAM category used the most by those in both areas was “nutritional supplements, vitamins, or herbal therapies.” The South Chicago group reported a greater use of CAM strategies, specifically relaxation techniques and massage, though the difference in use was not significant. Their overall satisfaction with use of CAM therapies was also higher. The use of professional CAM services (i.e., chiropractic service, naprapathy or manual therapy, and acupuncture) was low for the total sample, but use was significantly greater for those with at least a high school education. The findings from logistic regression analysis showed the factors that significantly predicted any CAM use: severity of joint pain (>6 on a 10-point scale), use of prescription medicine for joint pain, and fair to poor health status. The investigators designated these three predictors as proxies for arthritis severity.
The authors note that their findings are similar to those in clinic-based samples.1 While arthritis severity as measured by health status, joint pain, and use of prescribed medicine was a stronger predictor of CAM use than any of the study’s sociodemographic or cultural variables, it does not completely rule out the importance of understanding how these other variables affect CAM use. Self-management is important in any chronic condition such as arthritis.2 Learning appropriate self-management strategies that assist in dealing with the pain and function over time is especially important for those who have not sought treatment previously for a variety of reasons that may include mistrust of the medical system, lack of insurance, or limited financial resources.
Teaching about how to use CAM strategies is needed to assist individuals in self-managing their condition, and assessing the need for teaching is important. Careful attention should be given to those who have not been exposed to learning a variety of methods. For example, those who are older may not be familiar with using a variety of nonpharmacological strategies.3 As the population ages, it is likely that the burden of arthritis will grow, making age an important demographic variable to address.
References
- Rao JK, Kroenke K, et al. Rheumatology patients’ use of complementary therapies: results from a one-year longitudinal study. Arthritis Rheum. 2003;49:619-625.
- Lorig K, Ritter PL, Plant K. A disease-specific self-help program compared with a generalized chronic disease self-help program for arthritis patients. Arthritis Rheum. 2005;53:950-957.
- Davis GC, Cortez C, Rubin BR. Pain management in the older adult with rheumatoid arthritis or osteoarthritis. Arthritis Care Res. 1990;3:127-131.