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Sunday, 13 December 2015

Complementary and alternative medicine in Indian Parkinson's disease patients


Open Access
Original article

Open Access funded by Center for Food and Biomolecules, National Taiwan University
Under a Creative Commons license

Abstract

Use of complementary and alternative medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué) in Parkinson disease (PD) ranged 40–70%. The objective of this study was to determine the frequency, types and factors associated with the use of CAM in Indian PD patients. PD patients, fulfilling UKPD-Society brain-bank diagnostic-criteria, attending Movement-disorders clinic of a tertiary-care teaching hospital in India from 1st May to 15th December 2012 were enrolled. Information on socio-demographic, clinical data and treatment along with factors (source of information, benefits, harms, reason for use and cost) associated with CAM use were recorded. Out of 233 consecutive PD patients, 106 (46%) used CAM. Mean ± SD age of CAM users was 56 ± 11.2 years. Among CAM users, 72% were males, with mean age-onset 49 ± 11.16 years (P = 0.042) and 73% receiving levodopa therapy (p = 0.006). Longer duration PD, higher education (graduates and above), urban residence, and fairly good perceived health were other factors seen among CAM users. Reasons for using CAM were ‘feel good factor’ (73%), 9% took CAM due to side effects from allopathic-medicines. Commonly used CAM were Ayurvedic, homeopathic medicines, and acupuncture (針灸 zhēn jiǔ) [74/106 (70%)]. Median CAM cost in Indian Rupees (INR) was 1000/month (USD16, range: 0-400USD/month in year 2012). Almost half of PD patients use CAM. Three-quarters of Indian CAM using PD patients believe that CAM is harmless, using it at a substantial cost. CAM-users are educated, young, urban dwellers, longer duration PD and receiving levodopa. Commonly used CAM was Ayurvedic, Homeopathic medicines and acupuncture.

Graphical abstract

Keywords

  • Parkinson's disease;
  • Complementary and alternative medicine;
  • CAM;
  • Ayurveda;
  • Acupuncture

1. Introduction

Complementary and Alternative Medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué) are a group of management practices that are not part of conventional western medicine.1 In US, 40% of Parkinson's disease (PD) patients use some form of CAM during the course of their illness,2 while in Korea, it is as high as 76%.3 Though using it for long periods and with other medications, most patients are not aware of possible adverse effects and potential drug interactions with their use.4 Traditionally, CAM has been used by PD patients in China, India and Amazon-region in the form of herbal preparations containing anticholinergics, levodopa and MAO-B inhibitors.5 Different forms of CAM include ingestion or, application of preparations on surface of body, activities of different severity such as yoga, meditation, dance, music and exercise. Current study was undertaken on Indian PD patients at a tertiary care teaching hospital to determine frequency, types and factors associated, along with benefits, harms and cost of CAM in PD patients.