Usage of and cost of complementary/alternative medicine in diabetic patients.

The purposes of the present survey research in diabetic patients were 1) to determine characteristics of complementary/alternative medicine (CAM) use, 2) to identify factors related to CAM use such as sociodemographic, adverse effects, and quality of life, and 3) to determine differences between patients who used and did not use CAM. The data was collected through developed questionnaires and SF-36 scale Thai version. Samples were 159 diabetes patients over 18 years of age or older who came for treatment at Suppasitthiprasong Hospital, Ubon Ratchathani Province, Thailand. The results indicated that the prevalence of CAM use was rather high (47.8%). The most common types of CAM used were yoga/exercise (32.8%), unchanged form of herbal medicine (29.9%), and changed form herbal medicine (17.8%). The average expense of CAM use was dollar 8.58 per person per month. Thus, if the percentage of CAM use and the cost were true for other Thai diabetic patients throughout Thailand, CAM use expenditure for the whole country would be about dollar 915,250-1,545,750 per month, which is quite high for a small country like Thailand. Most patients (64.4%) who used CAM did not inform their doctors about their CAM use. Results also indicated that government official patients were more likely to use CAM than those of farmer patients significantly (p-value = 0.03, odds ratio = 12.11). In addition, the present study found that patients who had a higher income were more likely to use CAM than those of lower income patients significantly (p - value = 0.04, odds ratio = 1.01). However, other factors such as age, sex, marital status, level of education, health insurance coverage status, duration of time to treat, occurrence of adverse effects, and quality of life were not different between the patients who used CAM and who did not use CAM. Physicians should pay more attention to the CAM use of patients since they used CAM without informing physicians and some herbal medicines may cause hypoglycemia. However, the study results had some limitations to apply to other Thai populations since the sample were Suppasitthiprasong patients who may be different from other Thai populations in many ways such as their local culture, belief, and CAM use types and cost.

Usage of alternative medicine in cancer patients.

The purpose of this study was to find out the characteristics of alternative medicine (AM) use and factors related to its use such as expense, compliance, and quality of life in 180 cancer patients from Suppasitthiprasong Hospital and the Center of Cancer Prevention and Control in Ubon Ratchathani. Results from questionnaires indicated that 77% of cancer patients used AM, mostly herbal medicine either in altered or unaltered from, because they received advice from other persons and wanted to obtain extra treatment. Patients who used AM still maintained good compliance with their conventional treatment. However, 51.35% of patients were using both alternative and conventional medicine without telling their doctors. The mean expense for AM us was 451 Baht per patients per month. Thus, if the percentage of AM use and their costs are true for other Thai cancer patients throughout Thailand, AM use expenditure for the whole country would be about 112 millions Baht per month, which is quite high. After controlling for other factors, results also indicated that patients with low education (primary grade or lower) were significantly more likely to use AM than those patients with higher education (high school or higher) (OR = 0.04, p = 0.007). Unemployed patients were significantly more likely to use AM than those patients who were farmers (OR = 0.04, p = 0.007). Patients who suffered from side effects of conventional therapy were significantly more likely to use AM than patients who did not (OR = 3.05, p = 0.005). In addition, patients without problems with daily life due to cancer pain were significantly more likely to use AM than those who had no emotional problems (OR = 0.98, p = 0.004). However, there were no other differences in other dimensions of quality of life. There are some limitations in this study preventing generalization to other Thai people such as the lack of information concerning the patients’ diagnosis and stage of cancer, differences in cultures and belief, and the AM cost.