CAM therapies among primary care patients using opioid therapy for chronic pain

被引：64
作者：
Fleming S. [1 ]
Rabago D.P. [2 ]
Mundt M.P. [2 ]
Fleming M.F. [2 ]
机构：
[1] Bastyr University, Seattle
[2] Department of Family Medicine, University of Wisconsin, Madison
来源：
BMC Complementary and Alternative Medicine | / 7卷 / 1期
关键词：
Chronic Pain; Chronic Pain Patient; Massage Therapy; Osteopathic Manipulative Treatment; Chronic Opioid Therapy;
D O I：
10.1186/1472-6882-7-15
中图分类号：
学科分类号：
摘要：
Background: Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. Method: A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Results: Patients were treated for a variety of pain problems including low back pain (38.4%), headaches (9.9%), and knee pain (6.5%); the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248), chiropractic treatment (17.8%, n = 162), acupuncture (7.6%, n = 69), yoga (6.1%, n = 55), herbs and supplements (6.8%, n = 62), and prolotherapy (5.9%, n = 54). CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8%) and prolotherapy (87.7%), whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. Conclusion: This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied. © 2007 Fleming et al; licensee BioMed Central Ltd.
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