The use of alternative medical therapies in patients with systemic lupus erythematosus. Trination Study Group.
OBJECTIVE
As part of an ongoing study of health resource utilization and diminished productivity in patients with systemic lupus erythematosus (SLE), the use of alternative medical therapies was assessed.


METHODS
A cohort of 707 patients with SLE from 3 countries completed questionnaires on demographics, social support, health status (using the Short Form 36 health survey), satisfaction with health care, health resource utilization (conventional resources and alternative therapies), and time losses in labor market and non-labor market activities. Annual direct and indirect costs (1997 Canadian dollars) were calculated and compared for users and nonusers of alternative medical therapies.


RESULTS
Among the 707 patients, 352 (49.8%) were found to use alternative therapies and at similar rates across Canada, the United States, and the United Kingdom. Users were younger and better educated than nonusers, exhibited poorer levels of self-rated health status and satisfaction with medical care, and had minimal to no objective evidence of worse disease (according to the revised Systemic Lupus Activity Measure instrument). The mean of log direct medical costs for conventional resources was higher for users of select alternative therapies compared with nonusers. In a logistic regression, neither the number of alternative therapies used nor the individual therapy increased the probability of incurring indirect costs.


CONCLUSIONS
The use of alternative medical therapies is common in patients with SLE. Users of many alternative medical therapies accrue greater conventional medical costs compared with nonusers. The use of alternative medical therapy may be a marker for care-seeking behavior associated with higher consumption of conventional medical resources in the absence of demonstrable additional morbidity and should be considered in future cost analyses of patients with SLE.
Moore
A D
AD
McGill University Health Centre, Montreal, Quebec, Canada.
Petri
M A
MA
Manzi
S
S
Isenberg
D A
DA
Gordon
C
C
Senécal
J L
JL
St Pierre
Y
Y
Joseph
L
L
Penrod
J
J
Fortin
P R
PR
Sutcliffe
N
N
Goulet
J R
JR
Choquette
D
D
Grodzicky
T
T
Esdaile
J M
JM
Clarke
A E
AE
D000328:Adult; D002170:Canada; D015331:Cohort Studies; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006113:United Kingdom; D014481:United States