A pilot study of complementary and alternative medicine use in patients with fibromyalgia syndrome

Fibromyalgia syndrome (FMS) is a complex disorder, with primary symptoms of sleep disturbances, pain, and fatigue. FMS is one of the most common reasons for patient visits to a rheumatologist. Previous studies have suggested that complementary and alternative medicine (CAM) use in patients with rheumatic diseases is common, but such data specific to FMS patients is limited. Objective: The following study sought to describe the prevalence of CAM use in a primary care practice of patients with FMS and assess whether these patients discuss CAM use with their physician, physician-extender, and/or pharmacist. Methods: A one-group cross-sectional survey design was implemented in a large, community-based, private physician practice of patients diagnosed with FMS. A self-administered questionnaire was distributed during clinic visits. It solicited information related to demographic characteristics; FMS-specific health background; whether CAM use had been discussed with a health care provider; and the «ever-use» of common types of CAM. Respondents returned the questionnaire via US mail in a postage-paid, self-addressed envelope. Results: A total of 115 surveys were distributed with 54 returned for analysis (47% completion rate). The sample was predominantly female, well educated and had a mean age of 55.6 years. All respondents were White. Most respondents (92.6%) reported using some type of CAM. Exercise (92.2%), chiropractic treatment (48.1%), lifestyle and diet (45.8%), relaxation therapy (44.9%), and dietary and herbal supplements (36.5%) were most commonly reported CAM therapies «ever-used» by respondents. Dietary and herbal supplements with the highest prevalence of «ever-use» were magnesium (19.2%), guaifenesin (11.5%), and methylsulfonylmethane (MSM) (9.6%). Respondents most commonly discussed CAM with the clinic rheumatologist and the primary care physician (53.7% and 38.9%, respectively). Only 14.8% of respondents discussed CAM with a pharmacist. However, a significantly higher proportion of respondents who «ever-used» dietary and herbal supplements discussed CAM with a pharmacist compared to those who never used dietary and herbal supplements (chi square=6.03, p=0.014). Conclusion: This pilot study suggests that CAM use is common in patients diagnosed with FMS. Compared to other healthcare providers, respondents were least likely to discuss CAM with a pharmacist. However, respondents who used dietary and herbal supplements were more likely to discuss CAM with a pharmacist compared to those who did not, suggesting the potential influence of pharmacist intervention (AU)

El síndrome de fibromialgia (SFM) es un desorden complejo, con síntomas primarios de alteraciones del sueño, dolor y fatiga. SFM es una de las razones más frecuentes por las que los pacientes visitan al reumatólogo. Estudios previos han sugerido que es frecuente el uso de la medicina complementaria y alternativa (MCA) en pacientes con enfermedades reumáticas, pero tales datos relativos a SFM son escasos. Objetivo: El siguiente estudio trató de describir la prevalencia de uso de MCA en atención primaria en pacientes con SFM y evaluar si estos pacientes comentan la MCA con sus médicos, o con sus auxiliares médicos y/o con el farmacéutico. Métodos: Se empleó un diseño de investigación transversal de un grupo de pacientes diagnosticados de SFM de un gran consultorio privado de un médico. Durante las horas de visita, se distribuyó un cuestionario auto-administrado. Solicitaba información relacionada con las características demográficas; antecedentes sanitarios específicos del SFM; si se había discutido la posibilidad de usar MCA con el profesional de la salud; y el uso «alguna vez» de los tipos frecuentes de MCA. Los respondentes retornaban el cuestionario por correo en un sobre pre-pagado. Resultados: Se distribuyeron un total de 115 encuestas con 54 devueltas para análisis (47% cumplimentación). La muestra era predominantemente mujeres, bien educadas y con una media de edad de 55,6 años. Todos los respondentes eran blancos. La mayoría (92,6%) comunicaban usar algunos tipos de MCA. Los más frecuentemente comunicados como los que habían usado «alguna vez» eran ejercicio (92,2%), tratamiento quiropráctico (48,1%), estilos de vida y dieta (45,8%), terapia de relajación (44,9%), suplementos dietéticos y herbales (36,5%). Los suplementos dietéticos y plantas medicinales con una prevalencia más alta fueron magnesio (19,2%), guaifenesina (11,5%) y metilsulfonilmetano (9,6%). Los respondentes discutieron normalmente el uso de MCA con el reumatólogo y el médico de atención primaria (53,7% y 38,9%, respectivamente). Sólo el 14,8% de los respondentes lo había discutido con un farmacéutico. Sin embargo, una proporción mayor de respondentes que habían usado «alguna vez» suplementos dietéticos y plantas medicinales discutieron el uso de MCA con el farmacéutico que aquellos que nunca los habían usado (chi cuadrado=6.03, p=0.014). Conclusión: Este estudio piloto sugiere que la medicina complementaria y alternativa se usa frecuentemente en pacientes diagnosticados de SFM. Comparados con otros profesionales de la salud, los respondentes discutían menos su MCA con el farmacéutico. Sin embargo, los que habían usado suplementos dietéticos y plantas medicinales discutían más fácilmente sobre su MCA con el farmacéutico que los que no los habían usado nunca, lo que apunta al posible papel del farmacéutico en este campo (AU)

A pilot study of complementary and alternative medicine use in patients with fibromyalgia syndrome.

UNLABELLED: Fibromyalgia syndrome (FMS) is a complex disorder, with primary symptoms of sleep disturbances, pain, and fatigue. FMS is one of the most common reasons for patient visits to a rheumatologist. Previous studies have suggested that complementary and alternative medicine (CAM) use in patients with rheumatic diseases is common, but such data specific to FMS patients is limited. OBJECTIVE: The following study sought to describe the prevalence of CAM use in a primary care practice of patients with FMS and assess whether these patients discuss CAM use with their physician, physician-extender, and/or pharmacist. METHODS: A one-group cross-sectional survey design was implemented in a large, community-based, private physician practice of patients diagnosed with FMS. A self-administered questionnaire was distributed during clinic visits. It solicited information related to demographic characteristics; FMS-specific health background; whether CAM use had been discussed with a health care provider; and the "ever-use" of common types of CAM. Respondents returned the questionnaire via US mail in a postage-paid, self-addressed envelope. RESULTS: A total of 115 surveys were distributed with 54 returned for analysis (47% completion rate). The sample was predominantly female, well educated and had a mean age of 55.6 years. All respondents were White. Most respondents (92.6%) reported using some type of CAM. Exercise (92.2%), chiropractic treatment (48.1%), lifestyle and diet (45.8%), relaxation therapy (44.9%), and dietary and herbal supplements (36.5%) were most commonly reported CAM therapies "ever-used" by respondents. Dietary and herbal supplements with the highest prevalence of "ever-use" were magnesium (19.2%), guaifenesin (11.5%), and methylsulfonylmethane (MSM) (9.6%). Respondents most commonly discussed CAM with the clinic rheumatologist and the primary care physician (53.7% and 38.9%, respectively). Only 14.8% of respondents discussed CAM with a pharmacist. However, a significantly higher proportion of respondents who "ever-used" dietary and herbal supplements discussed CAM with a pharmacist compared to those who never used dietary and herbal supplements [chi square=6.03, p=0.014]. CONCLUSION: This pilot study suggests that CAM use is common in patients diagnosed with FMS. Compared to other healthcare providers, respondents were least likely to discuss CAM with a pharmacist. However, respondents who used dietary and herbal supplements were more likely to discuss CAM with a pharmacist compared to those who did not, suggesting the potential influence of pharmacist intervention.

Status and recommendations for self-care instruction in US colleges and schools of pharmacy, 2006.

Teachers of pharmacy self-care courses have met annually since 1998 at the Nonprescription Medicines Academy (NMA) held in Cincinnati, Ohio. During these meetings, self-care faculty members discuss methods of enhancing the teaching of self-care in US colleges and schools of pharmacy. Self-care courses are taught using a variety of methods and content is woven into pharmacy curricula in many different ways. This manuscript sets forth the current state of self-care instruction in pharmacy curricula including the recommended core curriculum, instructional methodologies, course mechanics, existing standards, and assessment and curricular placement, and makes recommendations for the future.

Constructing a self-care curriculum.

The purpose of this paper is to describe the unique challenges presented by a dynamic marketplace when designing a self-care curriculum. As manufacturers seek to satisfy consumer demand and increase market product shares, rapid changes occur with brand name extensions and prescription to nonprescription switches. The US Food and Drug Administration's continuous process of approving ingredients (monographs) add to this changing environment. Thus, developing learning outcomes beyond drug knowledge becomes critical. Learning outcomes must also address the multifaceted nature of self-care, including the development of skills in patient assessment (triage) and education. Determining which content areas to be covered can be difficult when consumer demand and marketplace changes are considered. For example, consumer use of dietary and herbal supplements forces pharmacists to have some basic knowledge of safety and efficacy regarding these products. Ultimately, given the dynamic, multifaceted nature of self-care, developing life-long learning skills/attitudes in students may be the most important outcome necessary for a self-care curriculum.