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Willingness of emergency department patients with musculoskeletal complaints to participate in complementary and alternative medicine research

Published online by Cambridge University Press:  21 May 2015

Riyad B. Abu-Laban ,
Catherina A. van Beek ,
Jeffrey A. Quon  and
Joseph Wu
Riyad B. Abu-Laban*
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital, Division of Emergency Medicine, University of British Columbia, Vancouver, BC
Catherina A. van Beek
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital, Division of Emergency Medicine, University of British Columbia, Vancouver, BC
Jeffrey A. Quon
Affiliation:
Cambie Chiropractic Centre, Vancouver, BC, and the Department of Health Care and Epidemiology, University of BritishColumbia
Joseph Wu
Affiliation:
The Integral Chinese Medicine and Acupuncture Research Foundation, Vancouver, BC
*
Department of Emergency Medicine, Vancouver General Hospital, 855 West 12th Ave., Vancouver BC V5Z 1M9; 604 875-4111 x62181, fax 604 875-4872, [email protected]

Abstract

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Background:

The emergency department (ED) is a unique potential location for recruitment into studies of complementary and alternative medicine (CAM) therapies. We sought to determine the stated willingness of ED patients with musculoskeletal complaints to participate in CAM research for their presenting problem, and to determine the characteristics of this population.

Methods:

The study was carried out in the ED of Vancouver General Hospital weekdays between 10 am and 6 pm from Oct. 16, 2000, to Nov. 21, 2000. All adults who presented with musculoskeletal complaints involving the spine, upper extremity or lower extremity, unless they had pain severe enough to impair their ability to answer questions or unless there was a language or other communication barrier, were approached by a research nurse. If it was learned that they had already been assessed by an emergency physician, they were eliminated as potential study participants. After being presented background information by the research nurse, consenting patients were asked a series of standardized questions during a 15-minute private interview prior to their assessment by an emergency physician.

Results:

Of 107 eligible patients, 93 participated (87%). Most symptoms began on the day of presentation (44%) or in the previous week (41%). The mean age of those studied was 38 years, and 56% were male. Most presenting problems involved the ankle/foot (29%), multiple sites (19%), the lumbosacral region (14%) or the wrist/hand (14%). Seventy-six percent of patients had utilized CAM previously during their lives, and 13% were currently using CAM for their presenting problem. The majority of patients stated an informed hypothetical willingness to enroll in a CAM study of the following therapies: traditional Chinese medicine 74% (69/93: 95% confidence interval [CI] 64.1%–82.7%); chiropractic 70% (65/93: 95%CI 59.5%–79.0%); and other CAM therapies 92% (86/93: 95%CI 85.1%–96.9%). Of patients asked, 99% stated they would comply with 4 to 6 weeks of outpatient follow-up, and 70% stated they would participate in a placebo-controlled study. Logistic regression modeling, performed for secondary purposes, indicated that willingness to participate in traditional Chinese medicine or chiropractic research was independent of age, sex, educational status, pain severity or prior exposure to the modality of interest.

Conclusions:

ED patients with musculoskeletal complaints have a high stated willingness to participate in CAM research, even if this involves outpatient follow-up or a placebo-controlled design. ED-based CAM research appears feasible and should be pursued.

Keywords

alternative medicinechiropracticemergency medicineemergency careemergency servicemedicine traditional Chinesemusculoskeletal systemmusculoskeletal abnormalities
Type
Em Advances • Innovations en MU
Information
Canadian Journal of Emergency Medicine , Volume 4 , Issue 6 , November 2002 , pp. 401 - 407
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

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