Use of Traditional, Complementary and Alternative Medicine (TCAM)

Abstract

ABSTRACT

Background Stroke is major public health concern worldwide due to its significant motility and morbidity. Lack of comprehensive rehabilitation care and chronic consequences of stroke, long-term care by using Traditional, Complementary and Alternative Medicine, here after referred to as TCAM, is very common in stroke patients. Stroke patients’ own sense of severity and functional limitation has been proven to be essential in effective rehabilitation care. However, association between patients’ self-reported severity and choice of TCAM has not been still documented. Therefore, the purpose of this study is to study the customs of TCAM use among stroke patients according to their perceived severity. Moreover, the prevalence, pattern, characteristics of TCAM users and predictors of TCAM use are also study to discover patients’ needs. Method A cross-sectional study was conducted among (310) stroke rehabilitation patients attending outpatient clinics of National Rehabilitation Hospital, Yangon, Myanmar. Data was collected by face-to-face interview with structured questionnaires, containing (35) items after getting informed consent from each patient. Descriptive analysis was done and both univariate and multivariable analysis were used to determine the TCAM use among stroke patients according to their different characteristics. Results Study revealed that (218, 70.3%) of stroke patients used traditional, complementary and alternative medicine for their symptom management (122, 55.96%). The main reason for using these treatments was their belief on integrated treatment (93, 42.66%). Stroke patients’ self-reported severity as less severe used high TCAM (p< 0.01). Moreover, presence of high blood pressure (p< 0.01), having some problem in walking (p< 0.01), self-care (p< 0.05) and usual activities (p< 0.01), feeling moderate anxiety (p< 0.01) were significantly associated with higher TCAM usage. But patients without self-reported pain used more traditional, complementary and alternative medicine (p< 0.01). TCAM use were more frequent among female patients (OR=3.4, 95% CI= 1.18-6.36, p< 0.001), presence of delay medical care due to cost(OR=3.09, 95% CI= 1.65-5.8, p< 0.001), presence of hypertension(OR=3.24, 95% CI= 1.64-6.42, p< 0.001), presence of moderate anxiety(OR=6.46, 95% CI= 1.74-10.25, p< 0.001), receiving physiotherapy (< 4 times/ week) (OR=2.47, 95% CI= 1.2-5.06, p< 0.001), and disagree with the effectiveness of physiotherapy(OR=1.94, 95% CI= 1.01-3.74, p< 0.001). About (70%) of users received their treatments from neither healthcare professionals nor traditional medicine practitioners. Most of the respondents (235, 92.89%) did not inform to their physicians about use of these treatments because their physicians did not ask (92, 30%). Conclusion Significant proportion of stroke patients is using TCAM because of their belief in the effectiveness of combined treatments. Also their self-perception on severity of stroke and functional status determine choice of treatment. Therefore, physicians need to assess patients’ own perception on disease status for implementation of effective rehabilitation. Moreover, the majority of TCAM users are taking non-practitioner based TCAM therapies and they have never informed to their physician. Hence, physicians should be aware of TCAM use among their patients.

Key words: Traditional, complementary and alternative medicines (TCAM), stroke