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Use of and satisfaction with complementary and alternative medicine in four chronic diseases: a cross-sectional study
M S Bhalerao1, P M Bolshete, B D Swar
1Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai 400012, Maharashtra, India. Department of Clinical Pharmacology.
Background:
We assessed the extent of use of complementary and alternative medicine (CAM) by patients with four chronic diseases-epilepsy, HIV, rheumatoid arthritis (RA) and diabetes mellitus (DM)-at a tertiary care, teaching hospital of allopathic medicine in India. We also assessed patients' satisfaction with CAM.
Methods:
Adults attending the outpatient clinics for epilepsy, HIV, RA and DM who took CAM were recruited over a period of 16 weeks. After obtaining written informed consent, they were administered the 'Treatment Satisfaction Questionnaire for Medication' (TSQM)TM to assess satisfaction in domains such as effectiveness, no side-effect, convenience and global satisfaction.
Results:
Of the 4664 patients screened, 1619 (34.7%) were using CAM and 650 (40%) of them consented to participate. The extent of use of CAM was 63% in patients with DM, 42.7% in RA, 26.2% in HIV and 7.7% in epilepsy. Ayurveda 57.1% (95% CI 53.27-60.89) was the most frequently used CAM. Satisfaction in terms of effectiveness and global satisfaction was highest among patients with HIV (69.4% and 69.2%, respectively) and least among those who had RA (56.6% and 54.1%, respectively). High scores were reported to 'no side-effect' domain in all the four diseases. The proportion of physicians who were aware about their patients' using CAM was 100% in patients with RA, 95% in HIV, 74% in epilepsy and 29% in DM.
Conclusion:
A large proportion of patients with four chronic diseases reporting to a hospital of allopathic medicine in India were also using CAM and were satisfied with its use. Given the potential interaction of CAM with allopathic medicines, a history of use of CAM should be elicited in clinical practice.