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

Abstract

Background Complementary medicines and therapies (CMT) are recommended in osteoarthritis (OA) treatment guidelines; however, there are few studies on CMT use in the community. The present study explored the use and perceptions of CMT for OA management in a New Zealand population. Methods Nineteen middle‐ to older‐aged adults with hip or knee OA, recruited from a public hospital research database, engaged in focus groups exploring CMT knowledge, factors influencing CMT use, and the role of medical professionals in the decision‐making process. Participants were organized into four groups, further to explore the impact of age or OA duration on CMT use. Results Thematic analysis resulted in five themes, consistent across all groups: participants' perceptions of CMT; reasons for taking CMT; reasons for not taking CMT; sources and credibility of CMT information; and medical professionals' role in CMT use. Participants indicated a range of CMT use, yet were unclear what defined a product as ‘CMT’. CMT use was influenced by symptom severity, previous experiences of themselves or trusted others, and perceived CMT effectiveness. General practitioners were identified as participants' preferred source of CMT information, owing to both their professional knowledge and lack of commercial gain from promoting CMT use. Conclusion Participants supported CMT for OA management, based on evidence and/or experience of effectiveness. Proactive general practitioner dialogue and subsidized CMT products recommended as part of a clinical treatment plan would encourage further CMT uptake. Additionally, the development of standardized CMT terminology would facilitate patient–doctor communication regarding CMT use and promote inter‐professional dialogue regarding multidisciplinary patient treatment.

Peoples' beliefs about their chronic hip pain and its care: a systematic review of qualitative studies. “I'm just getting old and breaking down”

“…For example, approximately 60% of studies informing the review finding “treatment failures” (review finding 4) were from primary care, hospital care (nonspecialist orthopaedic care), or the community. 1,14,69,70,106,109,117,118,122,124…”

“…For example, approximately 60% of studies informing the review finding "treatment failures" (review finding 4) were from primary care, hospital care (nonspecialist orthopaedic care), or the community. 1,14,69,70,106,109,117,118,122,124 We judged that most studies had few methodological limitations (Table 2). However, most studies did not adequately consider the relationship between participants and researchers.…”

“…However, most studies did not adequately consider the relationship between participants and researchers. 1,13,14,24,26,41,42,54,60,69,[82][83][84]93,96,105,107,112,117,121,124 This limitation impacted our GRADE confidence ratings for the review findings "surgery is inevitable" (theme 5) and "information and support were helpful" (subtheme of review finding 5) (see Table 4 and supplementary appendix 6, available at http://links. lww.com/PAIN/B726).…”

“…13,59,83,96 (In one example, a perceived lack of effective treatments led someone to explore complementary medicines). 69 There was contrasting data regarding physiotherapy: some people remained optimistic about physiotherapy despite experiencing little benefit from it (theme 4) 59,114,115 ; however, others expected little future benefit from physiotherapy and exercise because of experiencing poor outcomes with using them (theme 4). People with lateral hip pain 114 and people who agreed to participate in a physiotherapy intervention 59 appeared more optimistic about physiotherapy and exercise than those with severe hip osteoarthritis.…”

Diz Osteoartritli Kadınlarda Tamamlayıcı ve Destekleyici Uygulamanın Semptom ve Fonksiyonel Duruma Etkisi

“…ortaya çıkmaktadır. Bu durum hem hastaları hem de bakım verenleri semptomların yönetiminde farklı arayışlara yönlendirmiş ve bu amaçla tamamlayıcı ve destekleyici uygulama (TDU) uygulamaları kullanılmaya başlanmıştır (10)(11)(12).…”