title: Use of alternative medicines by patients with OA that adversely interact with commonly prescribed medications.
abstract: Owing to the increasing prevalence, patient interest, and high risk of adverse effects associated with use of complementary and alternative medicine (CAM), investigation of this issue in an orthopaedic population is warranted. The objectives of this study were to (1) identify the prevalence of CAM use, (2) assess the level of communication between patients and physicians regarding CAMs, (3) uncover reasons for nondisclosure, and (4) identify potentially harmful interactions between CAMs and conventional therapy. We conducted a cross-sectional observational study among patients being treated in orthopaedic surgical clinics for osteoarthritis (OA). Of the 373 participants, 42.9% reported taking one or more CAMs, and 40.6% admitted their surgeons were unaware of their alternative therapy use. Reasons for nondisclosure included, the patient thought: (1) it was not important (29.7%); (2) the surgeon would not be interested (13.5%); and (3) their surgeon would not know about CAMs (8.2%). Twenty-two of 281 patients (7.8%) were taking alternative medicines that could interact with their blood pressure medication, 28.6% were taking anticoagulant/antiplatelet medication and also taking a CAM that could interact, and 5.9% were taking conventional pain medications along with a CAM that potentially could interact. Orthopaedic surgeons should make it part of their consultation to inquire about CAM use.
  
  
  METHODS
  Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Faculty of Health Sciences, Elborn College, The University of Western Ontario, London, ON, Canada.
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Marsh
authors.forename: Christine
authors.initials: C
authors.lastname: Hager
authors.forename: Tom
authors.initials: T
authors.lastname: Havey
authors.forename: Sheila
authors.initials: S
authors.lastname: Sprague
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
authors.forename: Dianne
authors.initials: D
authors.lastname: Bryant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D000529:Complementary Therapies; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D041743:Herb-Drug Interactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010003:Osteoarthritis / Q000188:drug therapy*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D028321:Plant Preparations / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D012651:Self Medication; D011795:Surveys and Questionnaires; D014342:Truth Disclosure
chemical_list: D000700:Analgesics; D000925:Anticoagulants; D000959:Antihypertensive Agents; D028321:Plant Preparations; D010975:Platelet Aggregation Inhibitors