title: Assessment of use of complementary alternative medicine and its impact on quality of life in the patients attending rheumatology clinic, in a tertiary care centre in India.
abstract: OBJECTIVE
  Complementary and alternative medicine (CAM) has witnessed an increase in use in recent times in rheumatological conditions and is expected to have impact on the quality of life (QOL). We had planned to conduct this study to investigate the extent of use of CAM and its effect on QOL of patients at a tertiary care center.
  
  
  METHODS
  Ethics committee approval was obtained. Sixty patients suffering from osteoarthritis (OA) and rheumatoid arthritis (RA) were enrolled as per the selection criteria, after obtaining their informed consent. Each patient was interviewed for CAM use/non-use, and Western Ontario and McMaster Universities (WOMAC) (modified) index for QOL was recorded by the study personnel.
  
  
  METHODS
  The normality was checked by using Kolmogorov-Smirnov test. Descriptive statistics was performed and Mann-Whitney U-test was used to compare the QOL of CAM users and non-users.
  
  
  RESULTS
  Of the 60 patients enrolled with OA (10) and RA (50), 58% (35/60) used CAM. Ayurveda and massage therapy were the commonest [80% (28/35)], followed by yoga asana [34% (12/35)] and homoeopathy [20% (7/35)]. It was observed that combinations of therapies were used too. Nearly half [49% (17/35)] of the CAM users were on self-prescribed medication and 71% (25/35) of them did not inform the physician of CAM use. The QOL of CAM users (WOMAC score: 56.31 ± 6.82) was better than that of CAM non-users (WOMAC score: 60.16 ± 4.02) (P value 0.01).
  
  
  CONCLUSIONS
  Patients with RA frequently used CAM and QOL improvised with CAM use. We observed that self-administration of CAM was common and this was not informed to the treating physician.
authors.affiliation: Department of Infectious Diseases, Maharashtra University of Health Sciences, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, India.
authors.forename: M P
authors.initials: MP
authors.lastname: Jadhav
authors.forename: P M
authors.initials: PM
authors.lastname: Jadhav
authors.forename: P
authors.initials: P
authors.lastname: Shelke
authors.forename: Y
authors.initials: Y
authors.lastname: Sharma
authors.forename: M
authors.initials: M
authors.lastname: Nadkar
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000628:therapy*; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010003:Osteoarthritis / Q000453:epidemiology / Q000628:therapy*; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care; D016896:Treatment Outcome