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R Buchbinder

Publications and source records attributed to R Buchbinder.

56 records · Page 4Linked to original sources
PubMedDate not supplied

Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice.

BACKGROUND: Over 80% of rheumatoid arthritis (RA) patients have used some type of complementary medicine (CM) at some time. Little is known about RA patients' perceptions of the efficacy, hazards and costs associated with CM use relative to physician-prescribed medicine. These data may be helpful in better understanding patients' needs and in improving their care. AIMS: To determine the prevalence and features of CM use among RA patients attending a community-based private rheumatology practice. CM was defined as treatment that was initiated by the patient, excluding treatment that had been prescribed or specifically recommended by their doctor. telephone-administered questionnaire was used to survey a stratified random sample of 200 RA patients who had attended the practice within the preceding year. The main outcome measures were: (i) CM use in the past year, (ii) patient expenditure on CM, (iii) patients' perceptions of CM and (iv) characteristics of patients using CM. RESULTS: One hundred and six patients responded (response rate 53%) and 101 completed the interview. Seventy-four patients (73.3%) had used some form of CM in the past year. There were 68 (67.3%) patients who had utilized complementary therapies and 32 patients (31.7%) who had consulted a complementary practitioner for their RA. The most commonly used treatments were dietary (64 instances) and behavioural/cognitive therapies (45 instances). Prescription medicine was considered more beneficial than either form of CM, and users and non-users of CM held a similar perception of the efficacy of prescription medicine. The median amount spent on RA treatment per month was $A7 (range 0-91) for complementary treatments, $A26 (1-270) for complementary practitioners and $A7 (0-80) for prescription medicine. Women were more likely to have consulted a CM practitioner (OR = 1.5; 95% CI: 1.2-1.9), as were patients who were not receiving a pension (OR = 1.7; 95% CI: 1.1-2.6). CONCLUSIONS: This study confirmed that CM use is prevalent among RA patients attending a community-based private rheumatology practice. Despite lesser perceived benefit, patients spent at least as much money on CM as they did on prescription medicine. These findings suggest that there are other factors motivating the use of alternative treatments.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Most commonly used methods of detecting spinal subluxation and the preferred term for its description: a survey of chiropractors in Victoria, Australia.

PURPOSE: To determine the most commonly used diagnostic methods for detecting the spinal entity that chiropractors adjust/manipulate and the preferred term for describing this entity. DESIGN: Postal survey (self-completed questionnaire). SETTING: Victoria, Australia. PARTICIPANTS: All 554 chiropractors registered May 30, 1994, with the Chiropractors and Osteopaths Registration Board of Victoria. MAIN OUTCOME MEASURES: Frequency of use and opinion with respect to reliability of 16 specific methods, measured on a 7-point, Likert-type scale [never used (1) to always used (7) and very unreliable (1) to very reliable (7), respectively]; the respondent's preferred term for describing the spinal entity that chiropractors adjust/manipulate. RESULTS: The response rate was 85%. The most commonly used method was static palpation (mean score 6.6 +/- 1.1). Seven other methods, including pain description of the patient, orthopedic tests, motion palpation, visual posture analysis, leg length discrepancy, neurological tests and plain static X-rays had mean scores greater than 4.0. All of these methods, as well as functional X-ray views and kinesiological muscle testing, were considered reliable, with mean reliability scores greater than 4.0. Motion palpation was regarded as the most reliable method (mean reliability score 5.9 +/- 1.2). Seventy-five different terms for describing the spinal entity were named by 440 respondents. "Subluxation" was included in the preferred term of 294 respondents (67%), 46 included "dysfunction" (11%), 35 included "fixation" (8%) and 20 included "manipulable" (4.5%). CONCLUSION: Chiropractors commonly use a variety of methods to identify the spinal entity that they manipulate. There is no consensus as to the preferred term for describing this entity.

Chiropractic↗