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The Relationship between Complementary and Alternative Medicine and Disease Related Concerns in Patients with Inflammatory Bowel Disease: A Mixed Methods Approach

Background: Complementary and alternative medicine (CAM) is common used by patients with inflammatory bowel disease (IBD) and they use CAM in an attempt to achieve improvement and well-being. Research has shown that IBD affects health related quality of life (HRQOL) and several aspects influenced it, such as disease activity, insufficient efficacy and side effects from treatments. Disease related concerns can also affect the HRQOL. There is little information about Swedish patients with IBD and the association between their diseases related concerns and CAM use.

Aim: To explore the possible association between disease related concerns and CAM use in IBD patients and to get a deeper understanding of IBD patients disease related concerns.

Methods: A total of 645 IBD patients from 12 different outpatient IBD clinics, were enrolled and asked to answer two questionnaires; a study specific questionnaire concerning CAM use, disease and demographic data and the Rating Form of Inflammatory Bowel Disease Patients' Concerns (RFIPC) questionnaire. The questionnaire also contains an open question "Is there anything more that concerns you?” which the patients answer in their own words.

Results: Of the participants, 313 used CAM and expressed more concerns in 15 of the 25 RFIPC items compared to patients who did not do so/non-users. CAM use was related to younger age and female gender. The open question revealed that IBD had a major impact on everyday life and that IBD patients' worry concerned: The family and self, the burden of disease and associated factors.

Conclusion: It seems important for healthcare professional to be aware that IBD patients using CAM had more disease related concerns compared with non-users and IBD affects the whole life, especially the family and the self.


Annelie Lindberg RN, Bjöörn Fossum RNT, Per Karlen, Olle Broström, Lena Oxelmark RN

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