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Perceived efficacy among patients of various methods of complementary alternative medicine for rheumatologic diseases

G.S. Breuer¹, H. Orbach², O. Elkayam³, Y. Berkun², D. Paran³, M. Mates¹, G. Nesher¹

¹Rheumatology Service, Department of Internal Medicine, Shaare-Zedek Medical Center and the Hebrew University Medical School, Jerusalem; ²Rheumatology Service, Bikur Cholim Hospital, Jerusalem; ³Department of Rheumatology, Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

ABSTRACT
Objective
The purpose of this cross-sectional survey was to obtain and analyze data on self-perceived efficacy of different types of complementary alternative medicine (CAM) by patients with various rheumatologic conditions.

Methods
Patients followed in rheumatology outpatient clinics were screened for the use of CAM. Patients reporting the use of CAM were asked to participate in face-to-face structured interviews, specifying the various CAM types they used, and grading their subjective impression of efficacy of each CAM type on a scale of 1-10.

Results
350 consecutive patients were screened and 148 reported using CAM. In general, homeopathy and acupuncture were the most commonly used CAM types (44% and 41% of the CAM users, respectively). The mean number of different CAM methods used by a CAM user was 1.9 ± 1.1. Patients with fibromyalgia used significantly more CAM methods (2.7 ± 1.4, p = 0.005). On patients’ self-perceived efficacy scale of 1-10, the mean score of the whole group was 5.3 ± 3.2. Acupuncture and homeopathy achieved significantly higher self-perceived efficacy scores in CAM users with spondylo-arthropathies and osteoarthritis, respectively, when compared to some of the other disease groups. Satisfaction was lowest among CAM users with rheumatoid arthritis, vasculitis and connective tissue diseases.

Conclusion
In general, CAM users were less than moderately satisfied with self-perceived efficacy of CAM therapies. However efficacy of specific CAM methods differed significantly among patients in different disease groups.

Key words
Alternative medicine, complementary medicine, acupuncture, homeopathy.

Please address correspondence to: Gideon Nesher, MD, Department of Internal Medicine, Rheumatology Service, Shaare-Zedek Medical Center, P.O.Box 3235, Jerusalem 91031, Israel.
E-mail: rheum@szmc.org.il