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Use of Complementary Therapies for Arthritis among Patients of Rheumatologists

Jaya K. Rao, MD, MHS; Kimberly Mihaliak, BS; Kurt Kroenke, MD; John Bradley, MD; William M. Tierney, MD; and Morris Weinberger, PhD
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From Roudebush Veterans Affairs Medical Center, Indiana University School of Medicine, and Regenstrief Institute for Health Care, Indianapolis, Indiana.

Acknowledgments: The authors thank the following rheumatologists, who allowed recruitment of their patients for this study: Drs. Mary Rochelle Jacobs and Steven Hugenberg, Division of Rheumatology, Indiana University School of Medicine, Indianapolis, Indiana; Dr. David Batt, Arthritis Care Center, Indianapolis, Indiana; Dr. Douglas Smith, Rheumatology Associates, Indianapolis, Indiana; and Dr. James Ehlich, Eastside Rheumatology, Indianapolis, Indiana. They also thank Maureen Reindl, BS, for assistance with patient recruitment and data collection and Lorrie Mamlin, MPH, for assistance with statistical analyses. This work is dedicated to the memory of Koppaka Visweswara Rao, PhD, DSc, who inspired and encouraged this study.

Grant Support: By the Commonwealth Fund, New York, New York (no. 97066), and the Health Services Research Career Development Program, Department of Veterans Affairs (Drs. Rao and Weinberger). Dr. Rao was a 1996 Picker/Commonwealth Faculty Scholar in Patient-Centered Care.

Requests for Reprints: Jaya K. Rao, MD, MHS, Health Services Research and Development (152), Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC 27705.

Current Author Addresses: Dr. Rao: Health Services Research and Development (152), Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC 27705.

Ms. Mihaliak and Dr. Weinberger: Health Services Research and Development (11H), Roudebush Veterans Affairs Medical Center, 1481 West 10th Street, Indianapolis, IN 46202.

Drs. Kroenke and Tierney: Regenstrief Institute for Health Care, RG-6, 1001 West 10th Street, Indianapolis, IN 46202.

Dr. Bradley: Rheumatology Department, Wishard Hospital M-200, 1001 West 10th Street, Indianapolis, IN 46202.

Ann Intern Med. 1999;131(6):409-416. doi:10.7326/0003-4819-131-6-199909210-00003
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Complementary and alternative medicine (CAM) has recently attracted national attention in the United States because of its widespread use, associated costs, and unknown effects. A population-based survey (1) indicated that 4 out of 10 Americans used CAM for chronic conditions in 1997 and made an estimated 629 million visits to practitioners of alternative medicine, far exceeding the 388 million visits that were made to primary care physicians during the same year. In addition, the total out-of-pocket expenditures related to CAM use in 1997 were an estimated $27 billion; this figure is comparable to the out-of-pocket expenditures for all physician services (1).

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