Experiences with Complementary and Integrative Health Among People with Rheumatoid Arthritis and Systemic Lupus Erythematosus: A Qualitative Study.

Abstract

OBJECTIVE Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are chronic immune-mediated inflammatory diseases often complicated by persistent pain and fatigue despite cutting edge pharmacological treatments. Lifestyle medicine (LM) and complementary and integrative health (CIH) offer adjuvant therapies with potential to alleviate these symptoms, but little is known about patients' experiences with these modalities. METHODS This qualitative study explored the use of LM and CIH among English- and Spanish-speaking patients with RA and SLE. We conducted five focus groups using an original semistructured interview guide to examine participants' experiences with, and barriers to using, LM and CIH. Group discussions were recorded, transcribed verbatim, translated, and analyzed in a multi-step iterative process to identify frequencies and thematic trends. RESULTS Thirty-nine participants with RA or SLE discussed using LM and CIH modalities to manage their disease in 130 mentions. Diet was the most frequently discussed lifestyle modality with participants noting specific foods that exacerbated or alleviated symptoms. Traditional Chinese Medicine (TCM) and natural products were the most discussed CIH approaches, and participants expressed a strong interest in exploring additional complementary modalities to mitigate symptoms. The primary barriers to using LM and CIH were uncertainty regarding safe and effective practices and high out-of-pocket expenses. CONCLUSION Patients with RA and SLE are highly interested in using LM and CIH to manage their conditions, but many are unsure which adjunctive treatment approaches are safe and effective. More research on LM and CIH modalities is needed to facilitate clear, evidence-based answers to these common patient questions.