E047 Utilization of complementary and alternative medicine in patients with rheumatological conditions at Kenyatta National Hospital
Authors: Juma Kismat M , Oyoo George O , Kalman Eugene G 
Published: April 2024

Abstract

Background/Aims
The utilization of complementary and alternative medicine (CAM) has recently increased, especially among patients with rheumatic diseases, particularly those experiencing pain and mobility limitations. CAM use poses potential risks, such as drug interactions and adherence to conventional medicine. This study aimed to determine the prevalence of CAM use and evaluate the reasons and determinants among patients with rheumatological diseases who attended the rheumatology outpatient clinic at Kenyatta National Hospital (KNH).

Methods
In this cross-sectional descriptive study, patients with a confirmed diagnosis of rheumatic disease were enrolled at the rheumatology outpatient clinic of KNH. Consecutive sampling technique was employed to select patients. Data collection utilized two validated tools: the self-administered NAFKAM International - CAM-Questionnaire (I-CAM-Q) for assessing the prevalence and primary reasons for CAM utilization and the SF-36 questionnaire to assess the quality of life. CAM use was determined as a percentage of all study participants. Health-related quality of life (HRQOL) was assessed using the SF-36 questionnaire, and the results were compiled to established norms. Mean scores and standard deviations were calculated for each SF-36 subscale, and patients’ overall health-related quality of life was categorized as either good or poor based on a 50% cut-off score. To determine the association between CAM use and socio-demographic factors, as well as HRQOL, the Chi-square test was used, with statistical significance set at a p-value of &lt; 0.05.

Results
A total of 151 patients, predominantly female (137), with a median age of 45 (IQR 31.5-56.5) years, participated in the study. The prevalence of CAM use was 55.6%. Among the CAM modalities, vitamins/minerals (94%), prayer for health (80.9%), and herbs/herbal products (69%) were the most frequently used. The primary motivation for CAM utilization was to enhance overall well-being, followed by its adoption as an alternative or co-medication due to the high cost of conventional medicine. Dissatisfaction with conventional medicine emerged as the least common reason. CAM use was not influenced by age, gender, marital status, or level of education but was associated with parameters indicating poorer health, as evidenced by the mental component score and physical component score of SF-36.

Conclusion
The study highlights a significant prevalence of CAM use among patients with rheumatic diseases, indicating a noteworthy trend in healthcare choices. This suggests that many individuals with severe conditions may seek CAM as an adjunctive approach to managing their health. Alternatively, CAM usage might interfere with adherence to conventional medication, potentially exacerbating disease severity. Healthcare professionals should be vigilant in recognizing CAM usage and assessing whether it is preferred over conventional medicine, facilitating informed decisions and patient-centered care. This research contributes valuable insights into the complex landscape of healthcare choices among patients with rheumatological diseases, shedding light on the importance of holistic healthcare management.

Disclosure
K.M. Juma: None. G.O. Oyoo: None. E.G. Kalman: None.