Complementary and Alternative Medicine usage in Minority Patients with Rheumatic Diseases

Purpose: Rheumatic diseases are among the most common health problems in the US. A worldwide review of rheumatology surveys reports high complementary and alternative medicine (CAM) use by these patients. Because Hispanic and African American adults are under-represented in arthritis-specific CAM-use studies, this study assessed an underserved urban sample of this population.

Methods: This mixed method study examined participants (n=109) in the Natural History of Rheumatic Disease in Minority Communities study in a northwest Washington, D.C. clinic. Face-to-face interviews were conducted using an Inventory of Complementary and Alternative Medicine Practices and additional CAM questions.

Results: Participants were predominantly female (n=82); African-American (n=40) and Hispanic (n=46); first generation, Central American, sub-populations. Seventy-one percent reported using CAM, 25% used more than 5 different modalities. The less acculturated, the more frequently CAM usage was reported. Half of participants reported spending $1-99/month, and 60.6% reported CAM use had not changed their use of standard therapies. Body mass index (BMI) ranged from 15.4-52.9; as BMI increased, CAM usage increased (Pearson's r=0.23). Diagnoses grouped according to autoimmune (i.e. lupus), inflammatory (i.e. rheumatoid), structural (i.e. osteoarthritis) or pain syndrome (i.e. fibromyalgia) conditions were significantly related (÷² p<0.05) to CAM usage. CAM usage was highest in pain syndromes (92%).

Conclusions: Because the effects of rheumatic disease may be modifiable with lifestyle changes, adults are using CAM to help manage chronic conditions. An integrative medicine approach including assessing current usage, encouraging cultural practices, and providing relevant information may encourage the safe, continued use of CAM in combination with allopathic medical approaches.