June 2015, Volume 65, Issue 6

Original Article

The reasons for using and not using alternative medicine in Khorramabad women, west of Iran

Azadeh Khansari  ( MSc, Razi Herbal Medicine Research Center, Iran. )
Ghaffar Ali Mahmoudi  ( Forensic Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. )
Vahid Almasi  ( Clinical Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. )
Nahid Lorzadeh  ( Department of Gynaecology, Lorestan University of Medical Sciences, Khorramabad, Iran. )

Abstract

Objective: To evaluate reasons for using and not using alternative medicines.
Methods: The cross-sectional study was conducted in 2009 on women over 18 years of age in Khorramabad, Iran. The subjects were selected by using cluster and simple random sampling method. The data were recorded in a questionnaire that involved questions about the subjects\' age, marital status, their opinions on their general health, and advantages and disadvantages of conventional and alternative medicine.
Results: Of the 1600 women initially selected, 1551(97%) represented the final sample. The mean age of the participants was 35.04±10.71 years. Overall, 435(28%) spoke of disadvantages of alternative medicine; 277(18%) about the advantages of alternative medicine; 523(34%) about the advantages of conventional treatments; and 316(20%) about the disadvantages of conventional treatments. The most prevalent reason for not using the conventional treatments was the cost factor in 159(50.3%). Trust in physicians 328(62.7%) and distrust in alternative medicine therapists 317(73%) were the most prevalent reasons for using conventional treatments and not using alternative medicine.
Conclusion: Similar studies should be done on the reasons for using and not using each medication of alternative medicines separately.
Keywords: Alternative medicine, Complementary medicine, Side effects. (JPMA 65: 623; 2015).


Introduction

Alternative medicine is defined as various medical practices that are not generally considered parts of conventional medicine. The use of alternative medicine is prevalent around the world.1 Alternative medicine is being used for the treatment of a wide variety of disorders, such as diabetes,2 multiple sclerosis,3 dyslipidaemia4 and chronic pain.5 The use of alternative medicine has increased in recent years. The increasing use is based on some beliefs that may be true or not. For example, many individuals believe that alternative medicine has no side effects. It has been reported that many herbal medicines have adverse effects6 and some of them can be carcinogenic.7 The aim of this study was to evaluate some reasons for using alternative medicines. Understanding the reasons can help us understand the opinion of the people about alternative medicine.


Subjects and Methods

The cross-sectional study was done in 2009 on women over 18 years of age in Khorramabad, western Iran, The subjects were selected using cluster and simple random sampling methods. Khorramabad was divided into 8 clusters and in each cluster, 200 women were selected randomly. The subjects were approached at their respective homes and were interviewed face-to-face. The questionnaire consisted of questions about the subjects\' age, marital status, and their opinions on general health, and advantages and disadvantages of conventional and alternative medicines.


Results

Of the 1600 women initially selected, 1551(97%) formed the final sample. The mean age of the participants was 35.04±10.71 years. Of them, 111(7.16%), 528(34.04%), 463(29.85%), 259(16.69%), 131(8.45%), 45(2.9%) and 14(0.9%) were <20, 20-29, 30-39, 40-49, 50-59, 60-69 and >70 years of age respectively. Besides, 263(17%) participants were single and 1288(83%) were married. Of the participants, 132(8.51%), 122(7.87%), 588(37.91%), 526(33.91%) and 183(11.8) described their general health as excellent, good, moderate, and poor respectively.
Overall, 435(28%) spoke of disadvantages of alternative medicine; 277(18%) about the advantages of alternative medicine; 523(34%) about the advantages of conventional treatments; and 316(20%) about the disadvantages of conventional treatments (Table-1).

Further, 316(20.4%) people reported that they had used conventional treatments due to the disadvantages like side effects, cost, difference in physicians\' opinions and distrust in physicians, and 277(17.9%) had used alternative medicine due to advantages of alternative medicine like usefulness, out of habit, low side effects, being inexpensive and trust in the therapists. Of the participants, 523(33.7%) had used conventional treatments due to the advantages of conventional treatments, and 435(28%) had not used them due to disadvantages (Table-2).

The most prevalent reason for not using the conventional treatments was the cost factor in 159(50.3%). Trust in physicians 328(62.7%) and distrust in alternative medicine therapists 317(73%) were the most prevalent reasons for using conventional treatments and not using alternative medicine.


Discussion

In our study, the most prevalent reason for not using the conventional treatments was the cost of conventional treatments. Trust in physicians and distrust in alternative medicine therapists were the most prevalent reasons for using conventional treatments and not using alternative medicine respectively.
Of the participants, 61 said they had not used conventional treatments due to their side effects, and 11 said they had used conventional treatments due to their low side effects. In contrast, 78 had not used alternative medicine due to the side effects, and 66 had used alternative medicine due to their low side effects. In some studies the adverse effects of conventional medicine was one of the main reasons for using alternative medicine. One study declared that concern about the side effects of standard pharmacological therapies had been the most common reason for using alternative medicine in Italy.8 Another study reported that one of the two most common reasons for using complementary and alternative medicine by cancer patients in Turkey had been "the idea that it may be helpful; at least it\'s not harmful".9 Another study reported that the reason for using complementary and alternative medicine in 9.4% of Ghanaian cancer patients undergoing radiotherapy and chemotherapy had been their beliefs about the toxicity of conventional treatment.10 Also, it reported that 21.9% of them had used complementary and alternative medicine "based on faith and beliefs".10 But, another study reported that the reason of only 2% of the users of complementary and alternative medicine for using them had been dissatisfaction with conventional medicine.11 Also, it reported that the reason of 6% of the non-users of alternative medicine had been the fear of adverse events.11
It has also been reported that some reasons for using complementary and alternative medicines in Australia had been "works better or as good as conventional treatments", "fewer side effects than conventional treatments", "dissatisfaction with conventional treatments", "easier access than conventional treatments", "cheaper than conventional treatments".12 The most common reason for using complementary and alternative medicine in the Canadian patients with inflammatory bowel disease had been the ineffectiveness of conventional IBD therapy.13 The use of complementary and alternative medicine was more frequent in the inflammatory bowel disease patients with experience of adverse effects of conventional medications.13
One study declared that 20.13% of diabetic patients had used complementary medicine since they believed that conventional treatments did not help them, and 21.3% due to being expensive of conventional treatments.14 Similar to our findings, the high cost of conventional treatments is one of the main reasons for using alternative medicine.
One study reported that the most common reasons for not using alternative and complementary therapy had been the lack of knowledge and fear of interference with conventional therapies.15 Also, a study reported that the reason of 50.2% of non-users of complementary and alternative medicine had been not having enough information about them, and the reason of 4% of them had been the expensiveness of these medications.16 Concern about interactions between conventional treatment and complementary and alternative medicine, and concern about harmfulness of complementary and alternative medicine had been the reasons for not using these medications in 20% and 9% of participants of a study.17
There are some differences between the results of our study and similar studies. These differences may be due to the variety of alternative medications, different diseases of the participants, their different beliefs, different questionnaires, and little information about alternative medicine.


Conclusion

The most prevalent reason for not using the conventional treatments was the cost factor of conventional treatments. Similar studies shall be done about the reasons for using and not using each medication of alternative medicines separately. This can lead to obtaining more exact results.


Acknowledgment

We are grateful to Mr. Yadollah Pournia for editorial assistance.

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