Use of complementary and alternative therapy among patients with rheumatoid arthritis and osteoarthritis.
ABSTRACT Aims and objectives. We wanted to assess the prevalence of complementary and alternative therapy use among patients suffering from rheumatoid arthritis or osteoarthritis in the Lebanese population and to determine the perceived efficacy and side effects of complementary and alternative therapy in the treatment of these diseases. Background. Complementary and alternative therapy has become popular among patients with chronic illnesses because of its widespread use. Rheumatoid arthritis and osteoarthritis are two diseases associated with severe pain, inflammation and limited activity. Although both are quite common in Lebanon, no studies were conducted in our country to portray complementary and alternative therapy use in their treatment. Design. Descriptive cross-sectional study. Methods. Conducted individualised questionnaire-based interviews among 250 adult patients, ranging between the ages of 20-90 years and diagnosed with either rheumatoid arthritis or osteoarthritis. The questionnaire included demographic information, clinical information, use of conventional therapies and complementary and alternative therapy, and the disease status before and after complementary and alternative therapy use. Results. Fifty-eight (23·2%) patients used complementary and alternative therapy in addition to their conventional medications in the treatment of either rheumatoid arthritis or osteoarthritis. Most herbal medicine users (63·8%) believed that complementary and alternative therapy was beneficial. The disease status measured by the intensity of pain, sleeping pattern and level of activities was significantly improved after using complementary and alternative therapy (p = 0·01). Forty-eight (82·75%) patients were using herbals as complementary and alternative therapy, 14 (24·1%) of whom have sought medical care because of potential concomitant drug-complementary and alternative therapy side effects. However, these side effects were not serious and reversible. Conclusion and recommendations. Although complementary and alternative therapy might have beneficial effects in rheumatoid arthritis and osteoarthritis, patients should be cautious about their use and should necessarily inform their health care providers about the consumption of any products other than their conventional medicines. Relevance to clinical practice. It is quite essential for health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing medical care to patients with arthritis.
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ABSTRACT: The objective of this study was to determine the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement in patients with knee osteoarthritis. The design and setting were a randomized controlled study at a university hospital in Bangkok, Thailand. One-hundred and seven (107) patients with primary knee osteoarthritis (OA) with pain score of > or =5 were randomized to receive ibuprofen 800 mg per day or C. domestica extracts 2 g per day for 6 weeks. The main outcomes were improvement in pain on level walking, pain on stairs, and functions of knee assessed by time spent during 100-m walk and going up and down a flight of stairs. The adverse events were also recorded. Fifty-two (52) and 55 patients were randomized to C. domestica extracts and ibuprofen groups, respectively. Baseline characteristics of the patients in both groups were not different. The mean scores of the aforementioned outcomes at weeks 0, 2, 4, and 6 were significantly improved when compared with the baseline values in both groups. There was no difference in those parameters between the patients receiving ibuprofen and C. domestica extracts, except pain on stairs (p = 0.016). No significant difference of adverse events between both groups was found (33.3% versus 44.2%, p = 0.36 in C. domestica extracts and ibuprofen groups, respectively). C. domestica extracts seem to be similarly efficacious and safe as ibuprofen for the treatment of knee OA.Journal of alternative and complementary medicine (New York, N.Y.) 09/2009; 15(8):891-7. · 1.69 Impact Factor
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ABSTRACT: Complementary medicine (CM) is more popular than ever before. Rheumatology patients seem particularly keen to try CM. In this paper, surveys on rheumatology patients' use of CM are reviewed. The issues of perceived effectiveness, safety and costs are also addressed. In addition surveys of doctors' attitudes towards CM in rheumatology are summarised. Fourteen surveys on patients' use of CM and three on patients' attitudes towards CM were found and analysed. The results imply that the prevalence of CM varies between 30% and nearly 100%. Overall, patients perceive CM as being moderately effective. The survey contains only few data on adverse events of CM as perceived by these patients; collectively they suggest that adverse events are uncommon. Data on costs are similarly sparse; they imply that expenditure for CM is rarely high. Physicians seem to be more sceptical about CM than are their patients. It is concluded that, on average, CM is frequently used by rheumatology patients. The patients' level of satisfaction with CM is often considerable and few adverse effects are being reported. On the basis of these findings, a rigorous investigation of the effectiveness, safety and costs of CM in rheumatology seems desirable.Clinical Rheumatology 02/1998; 17(4):301-5. · 2.04 Impact Factor
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ABSTRACT: Herbal medicines are mixtures of more than one active ingredient. The multitude of pharmacologically active compounds obviously increases the likelihood of interactions taking place. Hence, the likelihood of herb-drug interactions is theoretically higher than drug-drug interactions, if only because synthetic drugs usually contain single chemical entities. Case reports and clinical studies have highlighted the existence of a number of clinically important interactions, although cause-and-effect relationships have not always been established. Herbs and drugs may interact either pharmacokinetically or pharmacodynamically. Through induction of cytochrome P450 enzymes and/or P-glycoprotein, some herbal products (e.g. St John's wort) have been shown to lower the plasma concentration (and/or the pharmacological effect) of a number of conventional drugs, including cyclosporine, indinavir, irinotecan, nevirapine, oral contraceptives and digoxin. The majority of such interactions involves medicines that require regular monitoring of blood levels. To date there is less evidence relating to the pharmacodynamic interaction. However, for many of the interactions discussed here, the understanding of the mechanisms involved is incomplete. Taking herbal agents may represent a potential risk to patients under conventional pharmacotherapy.Fundamental and Clinical Pharmacology 03/2005; 19(1):1-16. · 1.99 Impact Factor