Complementary and Alternative Medicine Use by U.S. Adults with Self‐Reported Doctor‐Diagnosed Arthritis: Results from the 2012 National Health Interview Survey

Abstract

Background The use of complementary and alternative medicine (CAM) therapies have been reported for the management of arthritis. However, little is known about CAM use among adults with self‐reported doctor‐diagnosed arthritis. Objectives To determine (1) the prevalence and type of CAM use, (2) the difference in characteristics between CAM users and non‐CAM users, and (3) the factors related to CAM use, among U.S. adults with self‐reported doctor‐diagnosed arthritis. Design Secondary analysis of the 2012 National Health Interview Survey (NHIS) data. Setting The NHIS is a cross‐sectional survey that gathers health‐related data on the civilian, noninstitutionalized U.S. population. Participants The NHIS 2012 uses a complex, multistage sampling design and oversamples minorities to achieve population representation; it included 34 525 adults, with 7179 adults having arthritis. Methods Data were analyzed using Stata 15.1 survey syntax. The potential factors related to CAM use included sociodemographics and health‐related characteristics. Main Outcome Measurements CAM modalities were categorized into six groups: natural products, manipulative therapies, mind‐body therapies, special diets, movement therapies, and other practitioner‐based CAM modalities. Results Of the adults with arthritis, 2428 (weighted estimate of 36.2% of U.S. adult population) had used CAM within the last year. Adults with arthritis reported greater use of CAM than those without, particularly the use of natural products, manipulative therapies and other practitioner‐based CAM modalities. Factors associated with higher CAM use included being female, residing in regions other than the U.S. South, having a college degree or higher, reporting very good/excellent self‐rated health status, and having current symptoms of joint stiffness/pain. Conclusion As more than one‐third of U.S. adults with arthritis seek CAM therapies, open and nonjudgmental conversations between conventional medicine providers, CAM providers, and patients should be encouraged to ensure patient health care needs are being met. Level of Evidence III

Gender Differences in the Prevalence of Complementary and Alternative Medicine Utilization among Adults with Arthritis in the United States

“…In a cross-sectional study of adult patients with arthritis using the 2007 National Health Interview Survey (NHIS) data to investigate CAM use, a significant association between CAM use and gender was observed with women reporting higher utilization rate of CAM than their men's counterparts [11]. This was confirmed recently in the Zhang et al's studies using the 2012 NHIS data, where higher use of CAM among women was also noted [9, 10]. The higher utilization rate of CAM among women is believed to be due to its perceived benefits in improving the physical and mental wellbeing [10].…”

“…According to a study that was conducted using nationally representative data of the US population to explore the prevalence of CAM utilization among patients with chronic health conditions, arthritis patients were found to be the highest users of CAM in comparison to other chronic health conditions [8]. It is estimated that around 30–41% of adults with arthritis in the US are CAM users [9–12]. Various modalities of CAM are commonly used for the treatment of arthritis such as homeopathy, acupuncture, naturopathy, chiropractic or osteopathic manipulation, and massage [12–17].…”

“…The main predicting factors for CAM use among adults with arthritis were believed to be the lack of effectiveness of conventional therapy [18], joint pain, and poor functional status [12]. However, it is notable that women with arthritis are using CAM more commonly than their male counterparts [9, 11]. In a cross-sectional study of adult patients with arthritis using the 2007 National Health Interview Survey (NHIS) data to investigate CAM use, a significant association between CAM use and gender was observed with women reporting higher utilization rate of CAM than their men's counterparts [11].…”

The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis

“…One Canadian study found that 33.9% of patients with juvenile idiopathic arthritis used CAM therapies [13]. Several studies from the United States have estimated that 30-41% of adults with arthritis use CAM [14][15][16][17], while CAM use among youth with juvenile idiopathic arthritis has been found to be 72% [18]. Another study found that 40% of Australians who suffer from osteoarthritis use CAM [19].…”

Complementary medicine for the management of knee and hip osteoarthritis – A patient perspective

“…Current best practice recommendations for hip and knee OA include a holistic approach to diagnosis and care that may incorporate education and self-management, pharmacological and non- older adults with knee OA found that about one-third used at least one or more complementary medicines or therapies (CMTs) to manage their OA, but that such use was to some degree inconsistent with treatment guidelines (Yang, Dubé, Eaton, McAlindon, & Lapane, 2013). A recent US population-based study similarly found that more than one-third of adults with arthritis sought complementary care to manage their health, concluding that dialogues that foster open and nonjudgmental communication and sharing between conventional and complementary healthcare providers and patients should be encouraged, to facilitate best possible patient care (Zhang et al, 2019).…”