Use of Conventional and Nonconventional Treatments for Osteoarthritis in the Family Medicine Setting

Sleath, Betsy; Cahoon, William D.; Sloane, Philip D.; Callahan, Leigh F.

doi:10.1097/01.smj.0000308363.10237.54

Cited by 10 publications

(29 citation statements)

References 26 publications

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“…Our work extends similar reports based on the general US population [29,30], as well as persons with self-reported arthritis [13], to a population with radiographically confirmed knee OA. Our work is not consistent with other reports [14,17], however. Comparing results of CAM use across studies is challenging because researchers often use different definitions of CAM.…”

Section: Discussioncontrasting

confidence: 99%

“…Consistent with other studies [13], we found that CA used more biologically based supplements, especially glucosamine and chondroitin, and chiropractic services relative to AA. Also consistent with the literature [14,16,17], we found that AA used more spiritual and religious activities and topical agents relative to CA.…”

Section: Discussionsupporting

confidence: 91%

“…In our study, however, we found only 1% of AA and CA used this method. Another study reporting greater CAM use among AA relative to CA did not include massage and chiropractic service as CAM therapy [17]. Consistent with other studies [13], we found that CA used more biologically based supplements, especially glucosamine and chondroitin, and chiropractic services relative to AA.…”

Section: Discussionsupporting

confidence: 88%

“…AA may have developed healing traditions using herbs and other substances owing to lack of access to even rudimentary medical care [15]. It is also possible that differences in disease severity may have accounted for racial differences in the use of CAM therapies [16,17]. Similar to studies on CAM use, studies on racial differences in use of conventional medications for OA also yielded inconsistent results, with some studies [18,19], but not all [17], reporting greater use of conventional medications among CA relative to AA.…”

Section: Introductionmentioning

confidence: 99%

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Racial differences in symptom management approaches among persons with radiographic knee osteoarthritis

Yang

Jawahar

McAlindon

et al. 2012

BMC Complement Altern Med

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BackgroundThe extent to which racial differences exist in use of treatments for osteoarthritis (OA) is debatable. The purpose of this study was to describe the differences between African Americans (AA) and Caucasian Americans (CA) in using treatment approaches to manage symptoms among individuals with radiographic-confirmed knee OA.MethodsA cross-sectional study was conducted. Using data from the Osteoarthritis Initiative, we identified 508 AA and 2,075 CA with radiographic tibiofemoral OA in at least one knee. Trained interviewers asked questions relating to current OA treatments including seven CAM therapy categories—alternative medical systems, mind-body interventions, manipulation and body-based methods, energy therapies, and three types of biologically based therapies, as well as conventional medications. We categorized participants as: conventional medication only users, CAM only users, users of both and users of neither. Multinomial logistic regression models adjusting for sociodemographics and clinical/functional factors provided estimates of the association between race and treatment use.ResultsOverall, 16.5% of AA and 24.2% of CA exclusively used CAM to treat OA, 25.0% of AA and 23.8% of CA used CAM in conjunction with conventional medications, and 24.8% of AA and 14.6% of CA exclusively used conventional medications. After control for sociodemographic and clinical factors, AA were less likely than CA to use CAM therapies alone (adjusted odds ratio (OR) of using CAM alone relative to no CAM or conventional treatments: 0.68, 95% confidence interval (CI): 0.48–0.96) or with conventional medications (adjusted OR relative to no CAM or conventional treatments: 0.59, 95%CI: 0.42–0.83). However, no differences in use of conventional medications alone were observed after adjustment of covariates.ConclusionCAM use is common among people with knee OA, but is less likely to be used by AA relative to CA. For effective CAM therapies, targeted outreach to underserved populations including education about benefits of various CAM treatments and providing accessible care may attenuate observed disparities in effective CAM use by race.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Racial differences in symptom management approaches among persons with radiographic knee osteoarthritis

Yang

Jawahar

McAlindon

et al. 2012

BMC Complement Altern Med

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“…8 Currently, there are no curative therapies for OA and clinical guidelines recommend both pharmacological and non-pharmacological methods to relieve symptoms. 9,10 CAM use is common among OA patients 11,12 perhaps due to ineffective pain management or adverse effects associated with conventional medicine 13,14 or because of the patients’ own health beliefs. 15 …”

Section: Introductionmentioning

confidence: 99%

Longitudinal Use of Complementary and Alternative Medicine Among Older Adults With Radiographic Knee Osteoarthritis

Yang

Dubé

Eaton

et al. 2013

Clinical Therapeutics

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Background Osteoarthritis (OA) accounts for more mobility issues in older adults than any other disease. OA is a chronic and often painful disease for which there is no cure. Cross-sectional studies have shown that older adults frequently use complementary and alternative medicine (CAM) and arthritis is the most common reason for CAM use. While previous research has profiled the sociodemographic and clinical characteristics of CAM users, few have provided information on variation in CAM use over time and most only considered use of any CAM, which was often a mixture of heterogeneous therapies. Objectives This study sought to describe the longitudinal patterns of CAM use among older adults with knee OA, and to identify correlates/predictors of different commonly-used CAM therapies. Methods The Osteoarthritis Initiative included 1,121 adults aged 65 years and above with radiographic tibiofemoral OA in one or both knees at baseline. Annual surveys captured current use of conventional therapies and 25 CAM modalities (grouped into 6 categories) for joint pain or arthritis at baseline and during the 4-year follow-up. We assessed longitudinal use of CAM modalities by summing the number of visits with participants reporting use of each modality. Correlates of CAM use under consideration included sociodemographic indicators, body mass index, overall measures of mental and physical wellbeing, and clinical indices of knee OA. Generalized estimation equations provided adjusted odds ratio estimates and 95% confidence intervals. Results Nearly one third of older adults reported using ≥ one CAM modality for treating OA at all assessments. With the exception of glucosamine and chondroitin (18%), few were persistent users of other CAM modalities. One in five of those using NSAIDs or glucosamine/chondroitin were using them concurrently. Adjusted models showed: 1) adults aged ≥75 years were less likely to use dietary supplements than those aged between 65 and 75 years; 2) persons with more severe knee pain or stiffness reported more CAM use; 3) better knee-related physical function was correlated with more use of chiropractic/massage; 4) older adults with more comorbidities were less likely to report use of dietary supplements. Conclusion Patterns of CAM use are, to some extent, inconsistent with current guidelines for OA treatment. Evaluating the potential risks and benefits in older adults from commonly-used CAM modalities, with or without combination use of conventional analgesics, is warranted.

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Patterns and Correlates of Self‐Management Strategies for Osteoarthritis‐Related Pain Among Older Non‐Hispanic Black and Non‐Hispanic White Adults

Johnson

Sibille

Cardoso

et al. 2021

Arthritis Care & Research

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Objective Knee osteoarthritis (OA) is a leading source of pain and disability among older adults. Self‐management (SM) strategies are recommended to manage OA symptoms. Sociodemographic and clinical characteristics, along with other factors, may influence SM utilization rate. This study sought to examine the prevalence and correlates of SM use for pain among non‐Hispanic Black patients (NHB) and non‐Hispanic White patients (NHW) older adults with or at risk for knee OA. Methods A secondary data analysis was conducted on the Understanding Pain and Limitations in Osteoarthritic Disease multisite observational study, which included NHB (n = 104) and NHW (n = 98) community‐dwelling older adults with or at risk for knee OA. Participants completed measures of sociodemographics, pain SM use, coping, and clinical and experimental pain. Results Clinical and experimental pain were significantly greater among NHBs compared to NHWs. There were no significant differences in use of total SM by ethnicity/race. Interestingly, multiple linear regression revealed that clinical and experimental pain indices, as well as coping, number of pain sites, age, and sex were differentially associated with total SM use between NHBs and NHWs. There were significant ethnicity/race by type of pain management interaction effects for pain measures. Conclusion SM is common among older adults with or at risk for knee OA pain, and the prevalence of SM does not differ by ethnicity/race, but many guideline‐recommended interventions for OA are underutilized. Importantly, different factors were associated with the use of SM, highlighting distinct biopsychosocial mechanisms contributing to SM use in NHBs and NHWs.

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Use of Conventional and Nonconventional Treatments for Osteoarthritis in the Family Medicine Setting

Abstract: Providers should make sure to ask patients about all treatments they are using for their osteoarthritis.

Cited by 10 publications

References 26 publications

Racial differences in symptom management approaches among persons with radiographic knee osteoarthritis

Racial differences in symptom management approaches among persons with radiographic knee osteoarthritis

Longitudinal Use of Complementary and Alternative Medicine Among Older Adults With Radiographic Knee Osteoarthritis

Patterns and Correlates of Self‐Management Strategies for Osteoarthritis‐Related Pain Among Older Non‐Hispanic Black and Non‐Hispanic White Adults

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