Regional variations in the use of complementary and alternative medicines for inflammatory bowel disease patients in Italy:an IG-IBD study.

AbstractBackground and aim: Complementary and alternative medicines (CAM) are being usedincreasingly by patients with Crohn's disease (CD) and ulcerative colitis (UC). We aimed toassess the prevalence and usage of CAM in different geographical areas of Italy and possiblepredictors of their use.Methods and materials: A structured questionnaire, administered to outpatients, attending8 general hospitals and 9 tertiary referral centres, was completed by 2011 patients (909 CD, 1087UC and 15 indeterminate colitis). 583 patients lived in the North, 659 in Central Italy and 769 in theSouth.Results: CAM users were 475 (23.6%) with no regional differences in their distribution. Usagecorrelated significantly with female gender (p=0.030), higher education (p=0.021), hospitalization rates (p=0.000), extra-intestinal complications (p=0.000), non-adherence to conventionaltreatments (p=0.054), adverse reactions to conventional treatments (p=0.000), and activedisease (p=0.007); 5-ASA usage was associated with a more limited use of CAM (p=0.005). Dietarychanges or supplements and prayer were significantly more frequently reported in South, whileNorthern Italian patients more frequently used homeopathy, herbal medicines and physicalexercises. Patients in Central Italy adopted an intermediate behavior. CAM use ameliorated thepatient's general well-being according to two thirds of the users. Costs were higher for Northernpatients than in Central or Southern Italy.Conclusion: One in four IBD patients in Italy use CAM. More money is spent on CAM in NorthernItaly. Regional differences emerged as regards the type of CAM but not in terms of diseasefeatures, frequency of and reasons for CAM use, or perceived effects