Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice

Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice

Gingold, M. Buchbinder, R. Cohen, M. Hall, S. Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice Internal Medicine Journal 32: 208-214, 2002.

Abstract

 

BACKGROUND:
Over 80% of rheumatoid arthritis (RA) patients have used some type of complementary medicine (CM) at some time. Little is known about RA patients’ perceptions of the efficacy, hazards and costs associated with CM use relative to physician-prescribed medicine. These data may be helpful in better understanding patients’ needs and in improving their care.
AIMS:
To determine the prevalence and features of CM use among RA patients attending a community-based private rheumatology practice. CM was defined as treatment that was initiated by the patient, excluding treatment that had been prescribed or specifically recommended by their doctor. telephone-administered questionnaire was used to survey a stratified random sample of 200 RA patients who had attended the practice within the preceding year. The main outcome measures were: (i) CM use in the past year, (ii) patient expenditure on CM, (iii) patients’ perceptions of CM and (iv) characteristics of patients using CM.
RESULTS:
One hundred and six patients responded (response rate 53%) and 101 completed the interview. Seventy-four patients (73.3%) had used some form of CM in the past year. There were 68 (67.3%) patients who had utilized complementary therapies and 32 patients (31.7%) who had consulted a complementary practitioner for their RA. The most commonly used treatments were dietary (64 instances) and behavioural/cognitive therapies (45 instances). Prescription medicine was considered more beneficial than either form of CM, and users and non-users of CM held a similar perception of the efficacy of prescription medicine. The median amount spent on RA treatment per month was $A7 (range 0-91) for complementary treatments, $A26 (1-270) for complementary practitioners and $A7 (0-80) for prescription medicine. Women were more likely to have consulted a CM practitioner (OR = 1.5; 95% CI: 1.2-1.9), as were patients who were not receiving a pension (OR = 1.7; 95% CI: 1.1-2.6).
CONCLUSIONS:
This study confirmed that CM use is prevalent among RA patients attending a community-based private rheumatology practice. Despite lesser perceived benefit, patients spent at least as much money on CM as they did on prescription medicine. These findings suggest that there are other factors motivating the use of alternative treatments.

Yoga for improving sleep quality and quality of life in older adults

Yoga for improving sleep quality and quality of life in older adults

Halpern, J., Cohen, M., Kennedy, G., Reece, J., Cahan, K., Baharav, A., (2014) Yoga for improving sleep quality and quality of life in older adults. Alternative Therapies in Health and Medicine 20(3):37-46

Abstract

 

CONTEXT:
The aging process is associated with physiological changes that affect sleep. In older adults, undiagnosed and untreated insomnia may cause impaired daily function and reduced quality of life (QoL). Insomnia is also a risk factor for accidents and falls that are the main cause of accidental deaths in older adults and, therefore, is associated with higher morbidity and mortality rates in older populations.
OBJECTIVES:
The research team aimed to (1) examine the efficacy of a yoga intervention (YI) for the treatment of insomnia in older adults, (2) determine the ability of yoga to enhance the QoL of older adults, and (3) establish the applicability of yoga practice for older people in a Western cultural setting.
DESIGN:
A waiting-list controlled trial. Settings • The study took place in Jerusalem, Israel, from 2008-2009.
PARTICIPANTS:
Participants were older men and women (age ≥ 60 y) with insomnia.
INTERVENTION:
The YI group participated in 12 wk of classes, held 2 ×/wk, incorporating yoga postures, meditative yoga, and daily home practice of meditative yoga.
OUTCOME MEASURES:
The study used self-report assessments of sleep quality using the following: (1) sleep quality-the Karolinska Sleepiness Scale (KSS), the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI), and daily sleep and practice logs; (2) mood states-the Depression Anxiety Stress Scale long form (DASS-42) and the Profile of Mood States short form (POMS-SF); (3) a health survey (SF-36); and (4) mobile at-home sleep studies.
RESULTS:
Compared with controls, the YI group showed significant improvements in a range of subjective factors, including overall sleep quality; sleep efficiency; sleep latency and duration; self-assessed sleep quality; fatigue; general well-being; depression; anxiety; stress; tension; anger; vitality; and function in physical, emotional, and social roles.
CONCLUSIONS:
Yoga was shown to be safe and improved sleep and QoL in a group of older adults with insomnia. Outcomes depended on practice compliance.