Randomized Controlled Trial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2015; 21(12): 3663-3670
Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3663
Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease
Réme Mountifield, Jane M Andrews, Antonina Mikocka-Walus, Peter Bampton
Réme Mountifield, Peter Bampton, Department of Gastroenterology and Hepatology, Flinders Medical Centre, South Australia 5042, Australia
Jane M Andrews, IBD Service, Department of Gastroenterology and Hepatology and School of Medicine, University of Adelaide at Royal Adelaide Hospital, South Australia 5042, Australia
Réme Mountifield, Jane M Andrews, Peter Bampton, Flinders University of South Australia, South Australia 5042, Australia
Antonina Mikocka-Walus, School of Nursing and Midwifery, University of South Australia, South Australia 5042, Australia
Author contributions: Mountifield R was involved in conception, design, seeking ethical approval, data acquisition and analysis, data interpretation, manuscript drafting and modification and preparation of the final paper; Andrews JM and Bampton P were involved in planning the study; Bampton P in maintaining the FMC database; and both Andrews JM and Bampton P in data interpretation and revising the manuscript; and Mikocka-Walus A assisted with data entry and analysis.
Ethics approval: This study was approved by Flinders Clinical Research Ethics Committee on behalf of SA subjects and Menzies School of Health Human Research Ethics Committee for Darwin subjects.
Informed consent: All study participants provided informed consent prior to study enrolment.
Conflict-of-interest: Réme Mountifield has received speaker fees from Ferring, AstraZeneca, and Janssen; Jane M Andrews has been an advisory board consultant for Abbvie, Schering-Plough, Ferring, Fresenius-Kabi, Janssen, Takeda, Hospira and has consulted for Orphan and Shire; Jane M Andrews also received research funding from Abbvie and Janssen and received speaker fees from Abbvie, Astra Zeneca, MSD, Fresenius Kabi, Janssen, Orohan, Nycomed, Ferring, Takeda and Shire; Antonina Mikocka Walus has received speaker fees from MSD pharmaceuticals; Peter Bampton has no conflict of interest to disclose.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Réme Mountifield, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia. ramonreme@adam.com.au
Telephone: +61-8-82045511 Fax: +61-8-82723580
Received: September 9, 2014
Peer-review started: September 10, 2014
First decision: November 14, 2014
Revised: December 24, 2014
Accepted: January 21, 2015
Article in press: January 21, 2015
Published online: March 28, 2015
Processing time: 201 Days and 17.8 Hours
Abstract

AIM: To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts.

METHODS: A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis.

RESULTS: In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001).

CONCLUSION: In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.

Keywords: Complementary medicine; Alternative therapy; Therapy; Inflammatory bowel disease; Patient-Doctor Communication; Medication adherence

Core tip: Complementary medicine use is widespread in inflammatory bowel disease, and potentially deleterious to treatment outcomes. Whilst demographic and clinical predictors of complementary and alternative therapy (CAM) are well established, attitudinal influences are under explored. This study demonstrates that the specific aspect of patient doctor relationship most influencing CAM use is quality of doctor communication. The other newly identified predictor of CAM use is its use by family and friends. This finding enables valuable insight suggesting that in the absence of good doctor communication, inflammatory bowel disease patients seek advice from unqualified sources such as family and friends.