title: Characterisation of complementary and alternative medicine use and its impact on medication adherence in inflammatory bowel disease.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) use among inflammatory bowel disease (IBD) patients is common. We characterised CAM utilisation and assessed its impact on medical adherence in the IBD population.
  
  
  OBJECTIVE
  To characterise CAM utilisation and assess its impact on medical adherence in the IBD population.
  
  
  METHODS
  Inflammatory bowel disease patients recruited from an out-patient clinic at a tertiary centre were asked to complete a questionnaire on CAM utilisation, conventional IBD therapy, demographics and communication with their gastroenterologist. Adherence was measured using the self-reported Morisky scale. Demographics, clinical characteristics and self-reported adherence among CAM and non-CAM users were compared.
  
  
  RESULTS
  We recruited prospectively 380 IBD subjects (57% Crohn's disease; 35% ulcerative colitis, and 8% indeterminate colitis). The prevalence of CAM use was 56% and did not significantly vary by type of IBD. The most common reason cited for using CAM was ineffectiveness of conventional IBD therapy (40%). The most popular form of CAM was probiotics (53%). CAM users were younger than non-CAM users at diagnosis (21.2 vs. 26.2, P < 0.0001) and more likely than non-CAM users to have a University-level education or higher (75% vs. 62% P = 0.006). There was no overall difference in adherence between CAM and non-CAM users (Morisky score: 1.0 vs. 0.9, P = 0.26).
  
  
  CONCLUSIONS
  The use of complementary and alternative medicine is widely prevalent among IBD patients, and is more frequent among those with experience of adverse effects of conventional medications. From this cross-sectional analysis, complementary and alternative medicine use does not appear to be associated with reduced overall adherence to medical therapy.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: A V
authors.initials: AV
authors.lastname: Weizman
authors.forename: E
authors.initials: E
authors.lastname: Ahn
authors.forename: R
authors.initials: R
authors.lastname: Thanabalan
authors.forename: W
authors.initials: W
authors.lastname: Leung
authors.forename: K
authors.initials: K
authors.lastname: Croitoru
authors.forename: M S
authors.initials: MS
authors.lastname: Silverberg
authors.forename: A Hillary
authors.initials: AH
authors.lastname: Steinhart
authors.forename: G C
authors.initials: GC
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult