Usage of complementary therapies in rheumatology: a systematic review.

Complementary medicine (CM) is more popular than ever before. Rheumatology patients seem particularly keen to try CM. In this paper, surveys on rheumatology patients' use of CM are reviewed. The issues of perceived effectiveness, safety and costs are also addressed. In addition surveys of doctors' attitudes towards CM in rheumatology are summarised. Fourteen surveys on patients' use of CM and three on patients' attitudes towards CM were found and analysed. The results imply that the prevalence of CM varies between 30% and nearly 100%. Overall, patients perceive CM as being moderately effective. The survey contains only few data on adverse events of CM as perceived by these patients; collectively they suggest that adverse events are uncommon. Data on costs are similarly sparse; they imply that expenditure for CM is rarely high. Physicians seem to be more sceptical about CM than are their patients. It is concluded that, on average, CM is frequently used by rheumatology patients. The patients' level of satisfaction with CM is often considerable and few adverse effects are being reported. On the basis of these findings, a rigorous investigation of the effectiveness, safety and costs of CM in rheumatology seems desirable.