Online Program

Missed opportunity? CAM use is less in overweight and obese people with osteoarthritis of the knee

Monday, November 4, 2013

Kate L. Lapane, PhD, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Shibing Yang, PhD, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA
Rachel Jawahar, PhD Student, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA
Charles Eaton, MD MS, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI
Timothy McAlindon, MD, Department of Rheumatology, Boston, MA
Objectives: Obesity is associated with knee pain and is an independent predictor of incident knee osteoarthritis (OA); increased pain with movement often leads patients to adopt sedentary lifestyles to avoid pain. Detailed descriptions of pain management strategies by body mass index (BMI) level among OA patients are lacking. The objectives were to describe complementary and alternative (CAM) and conventional medication use by BMI level and identify correlates of CAM use by BMI level. Methods: Using Osteoarthritis Initiative baseline data, 2,675 patients with radiographic tibiofemoral OA in at least one knee were identified. Use of CAM therapies and conventional medications was determined by interviewers. Correlates included SF-12, CES-D, Western Ontario and McMaster Universities Osteoarthritis Index, and Knee injury and Outcomes in Osteoarthritis Score quality of life. Multinomial logistic regression models adjusting for sociodemographic and clinical factors provided estimates of the association between BMI levels and treatment use; binary logistic regression identified correlates of CAM use. Results: BMI was inversely associated with CAM use (45% users had BMI >= 35 kg/m2; 54% had BMI <=25 kg/m2), but positively associated with conventional medication use (54% users had BMI >= 35 kg/m2; 35.1% had BMI <=5 kg/m2). Those with BMI >= 30 kg/m2 were less likely to use CAM alone or in combination with conventional medications when compared to patients with BMI <=25 kg/m2. Conclusions: CAM use is common among people with knee OA but is inversely associated with BMI. Efforts to increase the use of effective CAM therapies for symptom management in OA among patients with BMI exceeding 30 kg/m2 is warranted.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Describe complementary and alternative medicine use in overweight and obese persons with osteoarthritis Compare compare types of CAM use by level of body mass index Evaluate the extent to which overweight/obese people with knee OA are potentially underusing CAM therapies that could alleviate symptoms of knee OA

Keyword(s): Alternative Medicine/Therapies, Treatment Patterns

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PI of a subcontract from the federal government to evaluate CAM use in the National Osteoarthritis Initiative.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Janssen Scientific Pain medications; Schizophrenia Independent Contractor (contracted research and clinical trials)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.