Abstract

Background: Use of complementary and alternative medicine (CAM) is more common in elderly patients due to the prevalence of various age-related chronic medical conditions. The pharmacokinetics and pharmacodynamics change with age and are different in the elderly as compared to a young adult. Non-disclosure of CAM usage voluntarily by the patients, along with the practice of poly-pharmacy for various comorbidities and concurrent use of modern medicine with CAM, makes this age group particularly prone to adverse effects of drugs and the drug–drug interactions. Use of CAM assumes further importance in the context of Indian elderly, due to the widespread belief in traditional medicines and easy over-the-counter availability of many prescription drugs in India. Aims and
Objective: The study was conducted to understand and analyze the knowledge, attitude, and perception of CAM usage specifically in elderly Indian patients, which to the best of our knowledge has yet not been assessed previously.
Materials and Methods: It was a descriptive cross-sectional study assessing a representative sample of 325 elderly patients over the age of 60 years. Data collection was done after face-to-face interview-based survey administered on a semi-structured questionnaire.
Results: The number of CAM users (65.5%) was significantly more than the non-users (P ≤ 0.05). In the age group between 60 and 69 years, 59% had used CAM, as compared to a significantly more number of 76% patients (P ≤ 0.05), in the age group above 70 years. The CAM practice in the elderly was not influenced significantly by gender, education, rural or urban background, and distance from the health-care facility of modern medicine system. CAM was the initial choice of therapy for 65.7% of the users. Ayurveda was the most popular practice (64.8%), followed by homeopathy (62.4%) with many patients using both the practices together. Use of CAM practices concomitantly with modern medicine was not considered unsafe by 56.8% of patients. The physicians of modern medicine did not ask 91.5% of elderly patients about CAM usage and 85.5% of patients did not volunteer any information on CAM usage unless asked for.
Conclusions: The study suggests the need to acknowledge and explore the high prevalence of CAM usage with increasing age in the Indian elderly, both to identify the irrational usage of CAM alone or in combination with the modern medicine system and to facilitate the integration of rational CAM practices in the mainstream medicine.