Association between physician–patient relationship and the use of complementary and alternative medicine in patients with rheumatoid arthritis
Revista Colombiana de Reumatología (English Edition), ISSN: 2444-4405, Vol: 28, Issue: 1, Page: 28-37
2021
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Metrics Details
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Article Description
Although complementary and alternative medicine (CAM) use among patients with rheumatic diseases is extensive, discussions regarding these treatments occur rarely in the rheumatology setting, directly affecting the physician–patient relationship (PPR). The aim of this study was to evaluate the association between patient-physician relationship and complementary and alternative medicine use. As secondary objectives, to describe the patient’s perspective towards CAM use and estimate the prevalence of CAM treatments used in patients with rheumatoid arthritis. A descriptive cross-sectional survey was conducted, in which CAM use and physician–patient relationship were assessed by self-reported validated questionnaires (I-CAM-Q and PDRQ-9, respectively). The study included a total of 246 outpatients of a tertiary care hospital. There were no significant differences between CAM users vs. non-users, or informers vs. non-informers in terms of physician–patient relationship measured by PDQR. The prevalence of CAM use at 3 and 12 months were 37.4% and 41.5%, respectively. The most frequent used CAM treatments were: chiropractice, acupuncture, and herbal products. A large majority (78.5%) of the patients expressed agreement to the discussion of CAM use with the rheumatologist, but only 31.3% of total CAM users did so because of fear of retaliation (54.4%). Despite the extensive practice of CAM among patients with rheumatoid arthritis, most patients did not discuss these treatments with their physicians. Associations were found between MCA use and a lower patient’s treatment satisfaction and between physician–patient communication about CAM practice and a higher patient’s treatment satisfaction. El uso de medicina complementaria y alternativa (MCA) en pacientes con enfermedades reumáticas es prevalente pero la comunicación con el reumatólogo suele ser deficiente, lo cual afecta a la relación médico-paciente (RMP). Evaluar la asociación entre el uso de MCA y la RMP en enfermos con artritis reumatoide. Como objetivos adicionales, describir la percepción del paciente sobre la comunicación con su reumatólogo respecto al uso de MCA y el patrón de uso de las diferentes modalidades terapéuticas. Estudio descriptivo de corte transversal. El uso de MCA y la RMP se evaluaron mediante auto aplicación de cuestionarios validados (I-CAM-Q y PDRQ-9 respectivamente). Se incluyeron a 246 pacientes ambulatorios de una institución de tercer nivel de atención. Se encontró asociación entre una mayor satisfacción con el tratamiento y el no usar) MCA y, entre el hecho de informar al reumatólogo sobre el uso de MCA con un mayor grado de acuerdo con el médico sobre el origen de los síntomas y mayor satisfacción con el tratamiento. Las modalidades más frecuentemente utilizadas fueron: quiropraxia, acupuntura y productos herbales. El 78.5% afirmaron estar de acuerdo con comunicar el uso de este tipo de medicación al reumatólogo, sin embargo, sólo el 31.3% lo notificó por temor a represalias (54.4%). Pese a la alta prevalencia de uso de MCA en nuestros pacientes, la mayoría no comunicaron al reumatólogo. Se encontró asociación entre el uso de MCA y una menor satisfacción del paciente con el tratamiento y entre la comunicación médico-paciente sobre la práctica de MCA, y una mejor satisfacción al tratamiento.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S2444440521000078; http://dx.doi.org/10.1016/j.rcreue.2020.06.008; https://linkinghub.elsevier.com/retrieve/pii/S2444440521000078; https://api.elsevier.com/content/article/PII:S2444440521000078?httpAccept=text/xml; https://api.elsevier.com/content/article/PII:S2444440521000078?httpAccept=text/plain; https://dul.usage.elsevier.com/doi/; https://dx.doi.org/10.1016/j.rcreue.2020.06.008
Elsevier BV
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