Patient Attitudes Toward Western Medicine and the Future of Chinese Medicine for Spondyloarthritis

Abstract

Spondyloarthritis (SpA) and ankylosing spondylitis (AS) have a significant social and economic impact on ethnic Chinese patients. Western medicine, especially NSAIDs and disease-modifying anti-rheumatic drugs (DMARDs), are standard mainstream therapies for patients with SpA and AS. However, patient compliance with these medications is poor, due to the fear of side effects. In spite of their poor functional status and disease activity, less than 40% of AS patients are regularly treated. Complementary and alternative medicine (CAM) is very popular in Asian countries like China, Korea, Japan, India and Taiwan. A Korean survey in university hospital rheumatology clinics showed that 155 patients (68.5%) reported using at least one form of CAM during the previous 12 months. Herbal remedies and acupuncture were the most frequently used categories of CAM. Compared to conventional Western treatments, CAM is seen to have advantages in terms of a lower incidence of adverse reactions, greater patient choice, psychological comfort, and an increased quality of the patient/therapist relationship. Common symptoms treated by CAM were pain (80%), decreased functioning (43%), and lack of energy (24%). Tripterygium wilfordii Hook. f. (Lei Gong Teng), Tetrandrine (Tet), acupuncture and Tai Chi are some examples of potential Chinese medicine treatments for spondyloarthritis. CAM usage is a worldwide trend. However, further study, including basic research and well-designed clinical trials, is warranted. Patients should be instructed to discuss treatment strategies for their disease, and the use of CAM, with their rheumatologists.

<p>The Association Among Medication Beliefs, Perception of Illness and Medication Adherence in Ischemic Stroke Patients: A Cross-Sectional Study in China</p>

“…However, with these convenient access channels, all patients can simply buy prescriptions for themselves beyond the necessity, such as Traditional Chinese Medicine (TCM) which can create the belief that they are not worried about taking prescribed medicine. 44,45 The perception of ischemic stroke (overall score) was significantly associated with medication adherence in our results, which consistent with the predictive study in Thailand that showed that illness perceptions were significantly associated with and could predict medication adherence. 38 The study of key barriers to medication adherence in survivors of strokes and transient ischemic attacks revealed that the low perceived need for medications (the necessity of medicine) was not associated with medication adherence (OR: 1.230, 95% CI: 0.790 to 1.910, P = 0.36).…”

“…Compared to western treatment, Chinese people believe Traditional Chinese Medicine (TCM) to have more benefits in terms of lower side effects, more options, psychological comfort, and an increase in the quality of the relationship between patients and healthcare providers. 45 Thus, the point estimate about the necessity of the individual prescription among Chinese people could be due to opportunity, and further studies are needed to explore this finding further.…”