title: Study of association between use of complementary and alternative medicine and non-compliance with modern medicine in patients presenting to the emergency department.
abstract: BACKGROUND
  Complementary and alternative medicines (CAMs) are extensively used by the public. Noncompliance is an important cause of therapy failure.
  
  
  OBJECTIVE
  This study was done to determine prevalence of emergency admission due to noncompliance with modern medicine following switching over to CAM and to identify any significant association for CAM use among noncompliers.
  
  
  METHODS
  This cross-sectional study was conducted in the emergency unit of a tertiary healthcare institute.
  
  
  METHODS
  Demographic factors and system affected were compared between compliers and noncompliers. Prevalence, reasons and nature of noncompliance were determined. Age, gender, outcome, relation strength and potential preventability of noncompliance, precipitating and previous disease and noncompliant drugs were compared for significant association between CAM using and other noncompliers.
  
  
  METHODS
  Student's 't' test, Chi square test and odds ratio were used.
  
  
  RESULTS
  Of the 506 patients interviewed 168 (33%) were noncompliant. In 160 (95%) patients noncompliance was due to under-dosing. Lack of knowledge and CAM use constituted 144 (86%) noncompliance-related admissions. Thirty-three (7%) admissions were strongly related to noncompliance and CAM use. Age, gender, outcome, drug use and diseases except chronic obstructive pulmonary disease (COPD) and asthma showed no association while relation strength and potential preventability of emergency admission was less with CAM-using noncompliers. Noncompliance was observed for hypertension, diabetes, COPD and asthma, seizure disorder, tuberculosis and hemophilia besides hepatic and renal failure. The CAM noncompliers used CAM more for modern medicine incurable or unaffordable than curable diseases.
  
  
  CONCLUSIONS
  Advice for regular treatment and frequent monitoring can decrease CAM use-related noncompliance admissions.
authors.affiliation: Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh--160012, India. vishnujose@hotmail.com
authors.forename: V M
authors.initials: VM
authors.lastname: Jose
authors.forename: A
authors.initials: A
authors.lastname: Bhalla
authors.forename: N
authors.initials: N
authors.lastname: Sharma
authors.forename: D
authors.initials: D
authors.lastname: Hota
authors.forename: S
authors.initials: S
authors.lastname: Sivaprasad
authors.forename: P
authors.initials: P
authors.lastname: Pandhi
mesh_terms: D000328:Adult; D000529:Complementary Therapies; D004358:Drug Therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D016312:Treatment Refusal / Q000523:psychology