Top

BMC Complementary Medicine and Therapies

Published in:

Open Access 01-12-2021 | Systemic Lupus Erythematosus | Research article

Factors associated with the use of complementary therapies in Taiwanese patients with systemic lupus erythematosus: a cross-sectional study

Authors: Ming-Chi Lu, Hui-Chin Lo, Hsiu-Hua Chang, Chia-Wen Hsu, Malcolm Koo

Published in: BMC Complementary Medicine and Therapies | Issue 1/2021

Abstract

Background

This study aimed to investigate the prevalence of and the factors associated with the regular use of complementary therapies for Taiwanese patients with systemic lupus erythematosus (SLE).

Methods

In this cross-sectional study, 351 patients with SLE were consecutively recruited from a regional hospital in southern Taiwan from April to August 2019. Demographic and clinical information, including the use of different types of complementary therapies, was ascertained using a self-constructed questionnaire. Disease-specific quality of life was measured using the Lupus Quality of Life (LupusQoL) questionnaire. SLE disease activity was assessed using the rheumatologist-scored Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Factors associated with the regular use of complementary therapies were evaluated using multiple logistic regression analyses.

Results

Of the 351 patients with SLE, 90.3% were female, and 60.1% were ≥ 40 years of age. The prevalence of the regular use of any type of complementary therapy was 85.5%. The five most popular types of complementary therapy used were (1) fitness walking or strolling, (2) Buddhist prayer or attending temple, (3) vitamin consumption, (4) calcium supplementation, and (5) fish oil supplementation. Multiple logistic regression analyses revealed that the significant and independent factors associated with the regular use of complementary therapies in patients with SLE were age ≥ 40 years (adjusted odds ratio [aOR] 2.76, p = 0.013), nonoverweight or nonobesity (aOR 0.29, p = 0.004), engagement in vigorous exercise in the past year (aOR 4.62, p = 0.002), a lower SLEDAI-2 K score (aOR 0.90, p = 0.029), and a lower score in the physical health domain of the LupusQoL (aOR 0.57, p = 0.001).

Conclusions

A high prevalence of complementary therapy use in Taiwanese patients with SLE was observed. Rheumatologists should routinely ask patients about their use of supplements to minimize the risk of interaction with medical therapy.

Available only for authorised users

Lisnevskaia L, Murphy G, Isenberg D. Systemic lupus erythematosus. Lancet. 2014;384:1878–88.CrossRefPubMed

Stojan G, Petri M. Epidemiology of systemic lupus erythematosus: an update. Curr Opin Rheumatol. 2018;30:144–50. https://doi.org/10.1097/BOR.0000000000000480.CrossRefPubMedPubMedCentral

Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W. The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology (Oxford). 2017;56:1945–61. https://doi.org/10.1093/rheumatology/kex260.CrossRef

Yeh KW, Yu CH, Chan PC, Horng JT, Huang JL. Burden of systemic lupus erythematosus in Taiwan: a population-based survey. Rheumatol Int. 2013;33(7):1805–11. https://doi.org/10.1007/s00296-012-2643-6.CrossRefPubMed

Lee YH, Choi SJ, Ji JD, Song GG. Overall and cause-specific mortality in systemic lupus erythematosus: an updated meta-analysis. Lupus. 2016;25(7):727–34. https://doi.org/10.1177/0961203315627202.CrossRefPubMed

Elera-Fitzcarrald C, Fuentes A, González LA, Burgos PI, Alarcón GS, Ugarte-Gil MF. Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions. Expert Rev Clin Immunol. 2018;14(11):915–31. https://doi.org/10.1080/1744666X.2018.1529566.CrossRefPubMed

Greco CM, Nakajima C, Manzi S. Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus. Curr Rheumatol Rep. 2013;15(11):378.CrossRefPubMedPubMedCentral

Shirato S. How CAM helps systemic lupus erythematosus. Holist Nurs Pract. 2005;19(1):36–9. https://doi.org/10.1097/00004650-200501000-00009.CrossRefPubMed

Engebretson J. Alternative and complementary healing: implications for nursing. J Prof Nurs. 1999;15(4):214–23. https://doi.org/10.1016/S8755-7223(99)80007-6.CrossRefPubMed

10.

Moore AD, Petri MA, Manzi S, Isenberg DA, Gordon C, Senecal JL, et al. The use of alternative medical therapies in patients with systemic lupus erythematosus. Trination Study Group. Arthritis Rheum. 2000;43(6):1410–8.https://doi.org/10.1002/1529-0131(200006)43:6<1410::AID-ANR27>3.0.CO;2-U. CrossRefPubMed

11.

Alvarez-Nemegyei J, Bautista-Botello A. Complementary or alternative therapy use and health status in systemic lupus erythematosus. Lupus. 2009;18(2):159–63. https://doi.org/10.1177/0961203308095946.CrossRefPubMed

12.

Zörgő S, Peters GY, Mkhitaryan S. Attitudes underlying reliance on complementary and alternative medicine. Integr Cancer Ther. 2020;19:1534735420910472. https://doi.org/10.1177/1534735420910472.CrossRefPubMedPubMedCentral

13.

Jones E, Nissen L, McCarthy A, Steadman K, Windsor C. Exploring the use of complementary and alternative medicine in cancer patients. Integr Cancer Ther. 2019;18:1534735419846986. https://doi.org/10.1177/1534735419846986.CrossRefPubMedPubMedCentral

14.

Raosoft. Sample Size Calculator. http://www.raosoft.com/samplesize.html. Accessed 18 Mar 2021.

15.

Koo M, Chang YY, Lee MH, Huang CF, Chen SC, Yeh YC. Factors associated with the use of complementary and alternative medicine in middle-aged adults and elderly. Taiwan Geriatr Gerontol. 2011;6(1):29–42. https://doi.org/10.29461/TGG.201102.0003.CrossRef

16.

Hsu MC, Creedy D, Moyle W, Venturato L, Tsay SL, Ouyang WC. Use of complementary and alternative medicine among adult patients for depression in Taiwan. J Affect Disord. 2008;111(2–3):360–5. https://doi.org/10.1016/j.jad.2008.03.010.CrossRefPubMed

17.

Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40:1725. https://doi.org/10.1002/art.1780400928.CrossRefPubMed

18.

Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86. https://doi.org/10.1002/art.34473.CrossRefPubMedPubMedCentral

19.

McElhone K, Abbott J, Shelmerdine J, Bruce IN, Ahmad Y, Gordon C, et al. Development and validation of a disease-specific health-related quality of life measure, the LupusQol, for adults with systemic lupus erythematosus. Arthritis Rheum. 2007;57(6):972–9. https://doi.org/10.1002/art.22881.CrossRefPubMed

20.

Wang SL, Wu B, Leng L, Bucala R, Lu LJ. Validity of LupusQoL-China for the assessment of health related quality of life in Chinese patients with systemic lupus erythematosus. PLoS One. 2013;8(5):e63795. https://doi.org/10.1371/journal.pone.0063795.CrossRefPubMedPubMedCentral

21.

Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29(2):288–91.PubMed

22.

Chin CY, Chen YH, Wu SC, Liu CT, Lee YF, Tsai MY. Complementary and alternative medicine use in breast cancer patients at a medical center in Taiwan: a cross-sectional study. Integr Cancer Ther. 2020;19:1534735420983910. https://doi.org/10.1177/1534735420983910.CrossRefPubMedPubMedCentral

23.

Chang MY, Liu CY, Chu MC, Wu TM, Chen ML, Chu ML. Conditions for the use of complementary and alternative medicine in Taiwan: a nationwide survey analysis for 2011. Taiwan J Public Health. 2013;32(1):85–99. https://doi.org/10.6288/TJPH2013-32-01-11.CrossRef

24.

Chang MY, Liu CY, Chen HY. Changes in the use of complementary and alternative medicine in Taiwan: a comparison study of 2007 and 2011. Complement Ther Med. 2014;22(3):489–99. https://doi.org/10.1016/j.ctim.2014.03.001.CrossRefPubMed

25.

Yeh ML, Lin KC, Chen HH, Wang YJ, Huang YC. Use of traditional medicine and complementary and alternative medicine in Taiwan: a multilevel analysis. Holist Nurs Pract. 2015;29(2):87–95. https://doi.org/10.1097/HNP.0000000000000071.CrossRefPubMed

26.

O'Dwyer T, Durcan L, Wilson F. Exercise and physical activity in systemic lupus erythematosus: a systematic review with meta-analyses. Semin Arthritis Rheum. 2017;47(2):204–15. https://doi.org/10.1016/j.semarthrit.2017.04.003.CrossRefPubMed

27.

Narayanasamy A, Narayanasamy M. The healing power of prayer and its implications for nursing. Br J Nurs. 2008;17(6):394–8. https://doi.org/10.12968/bjon.2008.17.6.28907.CrossRefPubMed

28.

Yodchai K, Dunning T, Savage S, Hutchinson AM. The role of religion and spirituality in coping with kidney disease and haemodialysis in Thailand. Scand J Caring Sci. 2017;31(2):359–67. https://doi.org/10.1111/scs.12355.CrossRefPubMed

29.

Garrow D, Egede LE. National patterns and correlates of complementary and alternative medicine use in adults with diabetes. J Altern Complement Med. 2006;12(9):895–902. https://doi.org/10.1089/acm.2006.12.895.CrossRefPubMed

30.

Alnahdi MA, Alsulayhim AK, Bin Salem AH, Masuadi E, Al MY. Patterns and outcomes of complementary and alternative medicine use among adult patients with multiple sclerosis. Cureus. 2020;12(10):e10825. https://doi.org/10.7759/cureus.10825.CrossRefPubMedPubMedCentral

31.

Tippens K, Marsman K, Zwickey H. Is prayer CAM? J Altern Complement Med. 2009;15:435–8. https://doi.org/10.1089/acm.2008.0480.CrossRefPubMedPubMedCentral

32.

Robles B, Upchurch DM, Kuo T. Comparing complementary and alternative medicine use with or without including prayer as a modality in a local and diverse United States jurisdiction. Front Public Health. 2017;5:56. https://doi.org/10.3389/fpubh.2017.00056.CrossRefPubMedPubMedCentral

33.

Kamen D, Aranow C. Vitamin D in systemic lupus erythematosus. Curr Opin Rheumatol. 2008;20(5):532–7. https://doi.org/10.1097/BOR.0b013e32830a991b.CrossRefPubMed

34.

Amital H, Szekanecz Z, Szücs G, Dankó K, Nagy E, Csépány T, et al. Serum concentrations of 25-OH vitamin D in patients with systemic lupus erythematosus (SLE) are inversely related to disease activity: is it time to routinely supplement patients with SLE with vitamin D? Ann Rheum Dis. 2010;69(6):1155–7. https://doi.org/10.1136/ard.2009.120329.CrossRefPubMed

35.

Minami Y, Sasaki T, Arai Y, Kurisu Y, Hisamichi S. Diet and systemic lupus erythematosus: a 4 year prospective study of Japanese patients. J Rheumatol. 2003;30(4):747–54.PubMed

36.

Sha Y, Rui Z, Dong Y, Wei X, Zhou Y, Ye X, et al. Total serum calcium level is negatively correlated with systemic lupus erythematosus activity. Dose-response. 2020;18(2):1559325820926764. https://doi.org/10.1177/1559325820926764.CrossRefPubMedPubMedCentral

37.

Mendoza-Pinto C, Rojas-Villarraga A, Molano-González N, Jiménez-Herrera EA, León-Vázquez ML, Montiel-Jarquín Á, et al. Bone mineral density and vertebral fractures in patients with systemic lupus erythematosus: a systematic review and meta-regression. PLoS One. 2018;13(6):e0196113. https://doi.org/10.1371/journal.pone.0196113.CrossRefPubMedPubMedCentral

38.

Mok CC, Birmingham DJ, Leung HW, Hebert LA, Song H, Rovin BH. Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis. Rheumatology (Oxford). 2012;51(4):644–52. https://doi.org/10.1093/rheumatology/ker212.CrossRef

39.

Bucher HC, Hengstler P, Schindler C, Meier G. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med. 2002;112(4):298–304. https://doi.org/10.1016/s0002-9343(01)01114-7.CrossRefPubMed

40.

Yazdany J, Pooley N, Langham J, Nicholson L, Langham S, Embleton N, et al. Systemic lupus erythematosus; stroke and myocardial infarction risk: a systematic review and meta-analysis. RMD Open. 2020;6(2):e001247. https://doi.org/10.1136/rmdopen-2020-001247.CrossRefPubMedPubMedCentral

41.

Duarte-García A, Myasoedova E, Karmacharya P, Hocaoğlu M, Murad MH, Warrington KJ, et al. Effect of omega-3 fatty acids on systemic lupus erythematosus disease activity: a systematic review and meta-analysis. Autoimmun Rev. 2020;19(12):102688. https://doi.org/10.1016/j.autrev.2020.102688.CrossRefPubMed

42.

Arriens C, Hynan LS, Lerman RH, Karp DR, Mohan C. Placebo-controlled randomized clinical trial of fish oil's impact on fatigue, quality of life, and disease activity in systemic lupus Erythematosus. Nutr J. 2015;14:82. https://doi.org/10.1186/s12937-015-0068-2.CrossRefPubMedPubMedCentral

43.

Grzywacz JG, Suerken CK, Neiberg RH, Lang W, Bell RA, Quandt SA, et al. Age, ethnicity, and use of complementary and alternative medicine in health self-management. J Health Soc Behav. 2007;48(1):84–98. https://doi.org/10.1177/002214650704800106.CrossRefPubMed

44.

Upchurch DM, Rainisch BW. The importance of wellness among users of complementary and alternative medicine: findings from the 2007 National Health Interview Survey. BMC Complement Altern Med. 2015;15:362. https://doi.org/10.1186/s12906-015-0886-y.CrossRefPubMedPubMedCentral

45.

Alvarez-Nemegyei J, Bautista-Botello A, Dávila-Velázquez J. Association of complementary or alternative medicine use with quality of life, functional status or cumulated damage in chronic rheumatic diseases. Clin Rheumatol. 2009;28(5):547–51. https://doi.org/10.1007/s10067-008-1082-y.CrossRefPubMed

46.

Metcalfe A, Williams J, McChesney J, Patten SB, Jetté N. Use of complementary and alternative medicine by those with a chronic disease and the general population--results of a national population based survey. BMC Complement Altern Med. 2010;10:58. https://doi.org/10.1186/1472-6882-10-58.CrossRefPubMedPubMedCentral

47.

Kohl WK, Dobos G, Cramer H. Conventional and complementary healthcare utilization among US adults with cardiovascular disease or cardiovascular risk factors: a nationally representative survey. J Am Heart Assoc. 2020;9(9):e014759. https://doi.org/10.1161/JAHA.119.014759.CrossRefPubMedPubMedCentral

48.

Astin JA. Why patients use alternative medicine: results of a national study. JAMA. 1998;279(19):1548–53. https://doi.org/10.1001/jama.279.19.1548.CrossRefPubMed

49.

Gough M. A couple-level analysis of participation in physical activity during unemployment. SSM Popul Health. 2017;3:294–304. https://doi.org/10.1016/j.ssmph.2017.03.001.CrossRefPubMedPubMedCentral

50.

Shin JY, Kim SY, Park B, Park JH, Choi JY, Seo HG, et al. Predictors of complementary and alternative medicine use in cancer care: results of a nationwide multicenter survey in Korea. Evid Based Complement Alternat Med. 2012;2012:212386. https://doi.org/10.1155/2012/212386.CrossRefPubMedPubMedCentral

51.

Shinto L, Yadav V, Morris C, Lapidus JA, Senders A, Bourdette D. Demographic and health-related factors associated with complementary and alternative medicine (CAM) use in multiple sclerosis. Mult Scler. 2006;12(1):94–100. https://doi.org/10.1191/1352458506ms1230oa.CrossRefPubMed

52.

Busato A, Dönges A, Herren S, Widmer M, Marian F. Health status and health care utilisation of patients in complementary and conventional primary care in Switzerland--an observational study. Fam Pract. 2006;23(1):116–24. https://doi.org/10.1093/fampra/cmi078.CrossRefPubMed

53.

Velicer CM, Ulrich CM. Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review. J Clin Oncol. 2008;26(4):665–73. https://doi.org/10.1200/JCO.2007.13.5905.CrossRefPubMed

54.

Jors K, Büssing A, Hvidt NC, Baumann K. Personal prayer in patients dealing with chronic illness: a review of the research literature. Evid Based Complement Alternat Med. 2015;2015:927973. https://doi.org/10.1155/2015/927973.CrossRefPubMedPubMedCentral

55.

Gu C, Zhao R, Zhang X, Gu Z, Zhou W, Wang Y, et al. A meta-analysis of secondary osteoporosis in systemic lupus erythematosus: prevalence and risk factors. Arch Osteoporos. 2019;15(1):1. https://doi.org/10.1007/s11657-019-0667-1.CrossRefPubMed

56.

Gold DT. The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone. 1996;18(3 Suppl):185S–9S. https://doi.org/10.1016/8756-3282(95)00500-5.CrossRefPubMed

Title: Factors associated with the use of complementary therapies in Taiwanese patients with systemic lupus erythematosus: a cross-sectional study
Authors: Ming-Chi Lu
Hui-Chin Lo
Hsiu-Hua Chang
Chia-Wen Hsu
Malcolm Koo
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Systemic Lupus Erythematosus
Published in: BMC Complementary Medicine and Therapies / Issue 1/2021
Electronic ISSN: 2662-7671
DOI: https://doi.org/10.1186/s12906-021-03416-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Factors associated with the use of complementary therapies in Taiwanese patients with systemic lupus erythematosus: a cross-sectional study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Norwogonin attenuates hypoxia-induced oxidative stress and apoptosis in PC12 cells

Taohuajing reduces oxidative stress and inflammation in diabetic cardiomyopathy through the sirtuin 1/nucleotide-binding oligomerization domain-like receptor protein 3 pathway

Administration of hydro-alcoholic extract of spinach improves oxidative stress and inflammation in high-fat diet-induced NAFLD rats

Acculturation and use of traditional medicine among African migrant women in Sydney: a mixed method study

Immunomodulatory and anti-inflammatory effects of Phellinus linteus mycelium

Anti-inflammatory and antitumor activities of the chloroform extract and anti-inflammatory effect of the three diterpenes isolated from Salvia ballotiflora Benth