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Complementary and alternative medicine use in patients with gout: a longitudinal observational study
Estee Chan1, Meaghan E House, Keith J Petrie
1From the *Department of Rheumatology, Auckland District Health Board, and Departments of †Medicine and ‡Psychological Medicine, University of Auckland, Auckland; and §Department of Medicine, University of Otago Wellington, Wellington, New Zealand.
Background:
Complementary and alternative medicine (CAM) is frequently used by patients with arthritis.
Objectives:
The objectives of this study were to determine the frequency and type of CAM used for gout, to understand the clinical and psychological factors associated with CAM use in people with gout, and to determine whether patients using CAM have different clinical outcomes over 1 year.
Methods:
A total of 276 patients with gout for less than 10 years' duration were recruited into a longitudinal observational study. Complementary and alternative medicine information including frequency, type, and cost of therapies were recorded at baseline. Gout disease activity (including flare frequency, tophus count, Health Assessment Questionnaire II, and serum urate) was assessed at baseline and after 1 year.
Results:
Complementary and alternative medicine use was reported by 23.9% of patients. A diverse range of CAM was used, most commonly dietary supplements and vitamins. Patients using CAM reported higher levels of concern about their gout but did not differ from those not taking CAM with respect to age, sex, years of formal education, ethnicity, illness perceptions, or gout disease activity measures at baseline or after 1 year. Total costs at baseline related to gout therapy were higher in the CAM users compared with those not using CAM (mean [SD] cost per month NZ $35.7 [NZ $69.0] vs NZ $7.1 [NZ $22.8]; P = 0.001).
Conclusions:
Complementary and alternative medicine use is not uncommon in patients with gout, albeit less than is reported in other rheumatic diseases. Inquiry about CAM use should be incorporated into the clinical assessment of patients with gout, to develop treatment plans that best suit the individual patient's health beliefs.
