Kai Sun1,2, Jackie Szymonifka3,4, Henghe Tian3,4, Yaju Chang3,4, Jennifer C Leng3,4, Lisa A Mandl3,4. 1. From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA. kai.sun@duke.edu. 2. K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine. kai.sun@duke.edu. 3. From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA. 4. K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine.
Abstract
OBJECTIVE: Chinese Americans are a fast-growing immigrant group with more severe rheumatic disease manifestations than whites and often a strong cultural preference for traditional Chinese medicine (TCM). We aimed to examine TCM use patterns and association with patient-reported outcomes (PRO) among Chinese American rheumatology patients. METHODS: Chinese Americans actively treated for systemic rheumatic diseases were recruited from urban Chinatown rheumatology clinics. Data on sociodemographics, acculturation, clinical factors, and TCM use (11 modalities) were gathered. Self-reported health status was assessed using Patient Reported Outcomes Measurement Information System (PROMIS) short forms. TCM users and nonusers were compared. Factors independently associated with TCM use were identified using multivariable logistic regression. RESULTS: Among 230 participants, median age was 57 years (range 20-97), 65% were women, 71% had ≤ high school education, 70% were on Medicaid insurance, 47% lived in the United States for ≥ 20 years, and 22% spoke English fluently. Half used TCM in the past year; these participants had worse self-reported anxiety, depression, fatigue, and ability to participate in social roles and activities compared with nonusers. In multivariable analysis, TCM use was associated with belief in TCM, female sex, ≥ 20 years of US residency, reporting Western medicine as ineffective, and shorter rheumatic disease duration. CONCLUSION: Among these Chinese American rheumatology patients, TCM users had worse PRO in many physical and mental health domains. TCM use may be a proxy for unmet therapeutic needs. Asking about TCM use could help providers identify patients with suboptimal health-related quality of life who may benefit from targeted interventions.
OBJECTIVE: Chinese Americans are a fast-growing immigrant group with more severe rheumatic disease manifestations than whites and often a strong cultural preference for traditional Chinese medicine (TCM). We aimed to examine TCM use patterns and association with patient-reported outcomes (PRO) among Chinese American rheumatologypatients. METHODS: Chinese Americans actively treated for systemic rheumatic diseases were recruited from urban Chinatown rheumatology clinics. Data on sociodemographics, acculturation, clinical factors, and TCM use (11 modalities) were gathered. Self-reported health status was assessed using Patient Reported Outcomes Measurement Information System (PROMIS) short forms. TCM users and nonusers were compared. Factors independently associated with TCM use were identified using multivariable logistic regression. RESULTS: Among 230 participants, median age was 57 years (range 20-97), 65% were women, 71% had ≤ high school education, 70% were on Medicaid insurance, 47% lived in the United States for ≥ 20 years, and 22% spoke English fluently. Half used TCM in the past year; these participants had worse self-reported anxiety, depression, fatigue, and ability to participate in social roles and activities compared with nonusers. In multivariable analysis, TCM use was associated with belief in TCM, female sex, ≥ 20 years of US residency, reporting Western medicine as ineffective, and shorter rheumatic disease duration. CONCLUSION: Among these Chinese American rheumatologypatients, TCM users had worse PRO in many physical and mental health domains. TCM use may be a proxy for unmet therapeutic needs. Asking about TCM use could help providers identify patients with suboptimal health-related quality of life who may benefit from targeted interventions.
Entities:
Keywords:
ASIAN-AMERICANS; CHINESE TRADITIONAL MEDICINE; PATIENT-REPORTED OUTCOME MEASURES; RHEUMATOLOGY
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