Use of alternative medicines by patients with OA that adversely interact with commonly prescribed medications.
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.
Marsh
Jacquelyn
J
Faculty of Health Sciences, Elborn College, The University of Western Ontario, London, ON, Canada.
Hager
Christine
C
Havey
Tom
T
Sprague
Sheila
S
Bhandari
Mohit
M
Bryant
Dianne
D
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
D000700:Analgesics; D000925:Anticoagulants; D000959:Antihypertensive Agents; D028321:Plant Preparations; D010975:Platelet Aggregation Inhibitors