Complementary and alternative medicine in Indian Parkinson's disease patients

Abstract

Use of complementary and alternative medicine (CAM; 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 ( 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.

Keywords: Acupuncture; Ayurveda; CAM; Complementary and alternative medicine; Parkinson's disease.

Graphical abstract

Fig. 1

CAM (補充與替代醫學 bǔ chōng yǔ tì dài yī xué) modalities (n, percentage of CAM modalities).

Fig. 2

CAM* drugs (n, percentage of CAM modalities). * Complementary and Alternative Medicines.

Fig. 3

CAM* interventions (n, percentage of CAM modalities). * Complementary and Alternative Medicines.

Fig. 4

ROC of significant factors*. Area under ROC (Receiver Operating Characteristic Curve) curve = 0.8117, Correctly classified = 75.27%. * Factors included for ROC curve are: Age of onset, duration of PD, education status, residence of patients (urban or rural).