Bhalerao M S, Bolshete P M, Swar B D, Bangera T A, Kolhe V R, Tambe M J, Wade M P, Bhowate S D, Sonje U B, Gogtay N J, Thatte U M
Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai 400012, Maharashtra, India. Department of Clinical Pharmacology.
Natl Med J India. 2013 Mar-Apr;26(2):75-8.
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.
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.
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.
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.
我们在印度一家三级医疗、西医教学医院评估了癫痫、艾滋病毒、类风湿性关节炎(RA)和糖尿病(DM)这四种慢性病患者使用补充和替代医学(CAM)的程度。我们还评估了患者对补充和替代医学的满意度。
在16周的时间里招募了在门诊治疗癫痫、艾滋病毒、类风湿性关节炎和糖尿病且使用补充和替代医学的成年人。在获得书面知情同意后,对他们进行“药物治疗满意度问卷”(TSQM)TM 评估,以评估在有效性、无副作用、便利性和总体满意度等方面的满意度。
在筛查的4664名患者中,1619名(34.7%)正在使用补充和替代医学,其中650名(40%)同意参与。糖尿病患者使用补充和替代医学的比例为63%,类风湿性关节炎患者为42.7%,艾滋病毒患者为26.2%,癫痫患者为7.7%。阿育吠陀疗法占57.1%(95%可信区间53.27 - 60.89),是最常用的补充和替代医学。艾滋病毒患者在有效性和总体满意度方面的满意度最高(分别为69.4%和69.2%),类风湿性关节炎患者最低(分别为56.6%和54.1%)。在所有四种疾病中,“无副作用”方面的得分都很高。知晓患者使用补充和替代医学的医生比例在类风湿性关节炎患者中为100%,艾滋病毒患者中为95%,癫痫患者中为74%,糖尿病患者中为29%。
在印度一家西医医院就诊的患有四种慢性病的患者中,很大一部分也在使用补充和替代医学,并且对其使用感到满意。鉴于补充和替代医学与西医药物之间可能存在相互作用,临床实践中应了解患者使用补充和替代医学的病史。