Complementary and alternative medicine

May 01, 2007, 4:00am

Use of complementary and alternative medicine (CAM) was investigated in groups of patients with psoriasis or rosacea via a structured, physician-administered questionnaire. The results showed more psoriasis patients compared with rosacea patients had tried CAM. Motivations for use differed in the two groups. Patients were unaware of potential side effects.

Key Points

Curiosity was the second most common reason why patients in both groups tried CAM - it was listed as the motivating factor by 37 percent of psoriasis patients and 23 percent of rosacea patients. Only a small minority of the patients who tried a CAM did so because of concern about side effects of the medications they were using.

At the 65th Annual Meeting of the American Academy of Dermatology (AAD), Maeve A. McAleer, M.D., and Frank C. Powell, M.D., reported the findings from a study they undertook to evaluate the use and knowledge of CAM among patients with rosacea and psoriasis. In face-to-face interviews, Dr. McAleer administered a structured questionnaire to consecutive patients seen in the outpatient clinic with a diagnosis of rosacea (59 patients) or psoriasis (103 patients).

The results showed the proportion of patients who had used CAM was about 2.5-fold higher in the psoriasis group compared with rosacea patients, 54 percent versus 22 percent, respectively.

Motivating factors for trying CAM also differed between the two groups. Whereas 50 percent of the psoriasis patients had turned to CAM because they felt their conventional treatment was not working, the appeal of natural treatment was cited by 38 percent of the rosacea patients as the reason for using CAM. Only 23 percent of rosacea patients said they tried CAM because conventional treatments lacked efficacy.

None of the patients in the study were aware of any potential side effects of CAM and while 94 percent thought it would be important for their treating physician to know they were using such a modality, only 58 percent indicated they would spontaneously discuss it with their dermatologist.

"Based on these data, we surmise that rosacea patients may use CAM less frequently than psoriasis patients because they are relatively more satisfied with available conventional treatments. However, failure to disclose use of CAM appears to be a common problem among all patients," says Dr. McAleer, dermatology registrar.

"Our study also found that one out of eight patients who tried a CAM had a 'bad reaction.' That experience highlights the potential adverse effects of these agents and the importance of asking patients directly about use of CAM because of their potential to interact with concomitant drugs and disease states."

The study was undertaken recognizing the increasing popularity of CAM and to address the lack of published data on its use by rosacea patients. The investigators noted that there are previous studies of CAM use by psoriasis patients and also reports relating to atopic dermatitis patients.

"Overall, the previous psoriasis studies showed that about two-thirds of patients had tried CAM, and those data are consistent with the findings in our study," Dr. McAleer says.

DEMOGRAPHICS

The questionnaire also gathered information on the patients' demographic and social characteristics and disease history.

In both groups, a range of disease types and severities were represented, and
the populations were about equally divided among men and women. The psoriasis patients were younger, on average, than the rosacea patients (mean age 45 vs. 57 years) and also had a longer history of their disease (mean duration 18 vs. 9 years). However, no conclusions can be drawn from the collected data about the profile of a typical patient who tries CAM, Dr. McAleer says.

"Although we are a regional treatment center, our catchment area is largely an inner city population. Since the majority of our patients have a similar sociodemographic background, it is not possible in this study to accurately determine if certain patient features are associated with CAM use," Dr. McAleer says.

CONTINUED CAM USE

Among the rosacea and psoriasis patients, only 20 percent of patients who had ever used CAM were still using it.

Reports on types of CAM tried showed a wide variety had been used by patients in both groups. Herbal products were the most frequently tried type of CAM by the rosacea and psoriasis patients.