THU0650 COMPLEMENTARY AND ALTERNATIVE MEDICINE IN RHEUMATOLOGY: A SURVEY OF ITS USE FOR COMMON RHEUMATOLOGICAL CONDITIONS AMONG MULTI-ETHNIC PATIENTS IN LEICESTERSHIRE
Authors: Chris Sabu Tharakan, Nutchaya Ungcharoen, Jessy Sabu, Arumugam Moorthy
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> The use of complementary and alternative medicine (CAM) is common in patients with chronic disease.<sup>1</sup> However, the usage of CAMs among patients with rheumatological conditions has been understudied. A significant proportion of primary care trusts are now providing therapies such as acupuncture and osteopathy to some of the 9 million users of CAMs in the United Kingdom (UK).<sup>2</sup> As the NHS serves a varied patient populace, it is important to appreciate the perceptions and utilisation of CAM amongst multi-ethnic groups. <h3>Objectives:</h3> To identify the different types CAMs utilised by Rheumatology patients. To identify Rheumatology patients' views towards the role and use of CAMs in managing their condition(s). To identify locations where patients receive CAM and to determine patient's spending practices. <h3>Methods:</h3> A cross-sectional survey on CAMs, and its use for common rheumatological conditions was conducted among multi-ethnic patients in Leicestershire, UK, through convenience sampling. The initial questionnaire was created by a multi-disciplinary input, with a patient-centred focus. Thereafter 10 questionnaires were piloted and revised accordingly. The data subsequently underwent statistical analyses. <h3>Results:</h3> A total of 107 patients completed the survey over a 3-month period with a response rate of 90%. Most of the respondents (91.8%) were over the age of 35 (age range 19 to 78 years, mean age 50.512.8SD). Among the respondents, 66% were women and 34% were men. 72.9% were of white British or European ethnicity and 20.6% of South Asian ethnicity (17.8% Indian and 2.8% Pakistani). Majority of the patients (66.4%) had rheumatoid arthritis (RA), followed by psoriatic arthritis (11.2%) and ankylosing spondylitis (4.7%). The respondent demographics were consistent with known epidemiology of common rheumatological conditions, with a higher prevalence among women than in men (female-to-male ratio of 3:1 in RA). 31.8% used CAM for managing symptoms related to their condition(s). Almost half of these respondents (41.2%) used CAM products and/or practices daily, with up to 64.7% spending between £10- £100. The majority of respondents (82.4%) received CAM therapy within the UK, followed by India (17.6%). Commonly used CAM products include: ginger (35.3%), fish oil supplements (32.4%), turmeric (32.4%) and cannabidiol (CBD) oil (23.5%). The most common CAM therapies were acupuncture (44.1%), yoga (14.7%), chiropractice (14.7%), meditation (2.9%) and stretch-fit (2.9%). Many respondents (64.7%) used more than one product and/or practice. 60% of the respondents that used CAMs had RA. 9 out of 34 (26.5%) respondents found CAM therapies to be beneficial for their condition(s), with seven (20.6%) finding it to be useful for pain control/relief. Up to 17.8% of all respondents, including those with no prior experience of CAM, perceived potential benefits. However, 65.4% reported neutral views towards CAM. <h3>Conclusion:</h3> In our local multi-ethnic population, it is evident that a notable proportion of patients have utilised CAM to supplement the management of their condition. Healthcare professionals need to be aware of the CAMs available, particularly when informing and treating their patients. Effective communication is required in this area to maintain patient's confidence and safety. Further qualitative research should consider the reasons for the use of CAMs. <h3>References:</h3> [1] Metcalfe A, Williams J, McChesney J, Patten S, Jetté N. Use of complementary and alternative medicine by those with a chronic disease and the general population - results of a national population-based survey. BMC Complementary and Alternative Medicine. 2010;10(1) [2] Verkek R. The Alliance for Natural Health International e-alert number 333. 2017. <h3>Disclosure of Interests:</h3> Chris Sabu Tharakan: None declared, Nutchaya Ungcharoen: None declared, Jessy Sabu: None declared, Arumugam Moorthy Speakers bureau: Speaker fee from Abbvie, Novartis.