title: Self-reported use of natural health products among rheumatology patients: A cross-sectional survey.
abstract: To describe the self-reported use of natural health products (NHPs) and identify characteristics that predict selected NHP use in rheumatology patients.
  
  
  
  We conducted a cross-sectional survey of consecutive rheumatology patients in two major clinics in Edmonton, Alberta. Survey items included demographic data, rheumatologic diagnoses, prescribed medications, NHPs, and information regarding patients' use of NHPs. Selected NHPs of interest - defined to include joint-specific products, oils with putative joint benefits, and other non-vitamin, non-mineral products - were classified by 2 reviewers. The characteristics of selected NHP users and non-users were compared using chi-squared and ANOVA tests, followed by multivariable-adjusted logistic regression.
  
  
  
  1063 patients completed the survey (response rate = 36%, mean age 53 [sd 15], 70% female). 36% of respondents reported using one or more of a wide range of selected NHPs (mean 1.8, range 1-9). The most common source of NHP recommendations for selected NHP users were physicians (42%). Significant predictors of selected NHP use were: being female (aOR 1.41, 95%CI [1.05-1.90], p = 0.02), having a post-secondary degree (aOR 1.60 [1.15-2.22], p = 0.005), and the number of non-rheumatic medications (aOR 1.08 [ 1.00-1.15], p = 0.03) and NSAIDs (aOR 1.32 [1.06, 1.63], p = 0.01). Similar findings were observed among only inflammatory arthritis patients.
  
  
  
  Our study confirms the frequent use of selected NHPs, possibly to mitigate persistent symptoms of rheumatologic illness. Rheumatologists appear to be trusted sources of advice and recommendations on NHP use and should provide balanced counselling for their patients.
authors.affiliation: Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alta, Canada.
authors.forename: Jill J
authors.initials: JJ
authors.lastname: Hall
authors.affiliation: Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta, Canada.
authors.forename: Tharindri D
authors.initials: TD
authors.lastname: Dissanayake
authors.affiliation: Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta, Canada.
authors.forename: Darren
authors.initials: D
authors.lastname: Lau
authors.affiliation: Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta, Canada.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000188:drug therapy*; D012219:Rheumatology; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: arthritis; complementary therapies; natural health product; rheumatoid arthritis