title: The influence of traditional and complementary and alternative medicine on medication adherence in Honduras.
abstract: BACKGROUND
  Adherence to medication is a worldwide problem and deserves country-specific attention. Honduras, like many other countries, has allopathic providers, traditional medicine (TM), and complementary and alternative medicine (CAM). Understanding a population's health behaviors is essential to satisfactory integration of these systems and successful patient care.
  
  
  OBJECTIVE
  The objective was to identify factors that influence medication adherence in Honduras.
  
  
  METHODS
  The research team administered a cross-sectional, 25-item questionnaire to various neighborhoods based on national demographic statistics in order to obtain a quota sample. Setting • The survey took place in Tegucigalpa, Honduras, Central America.
  
  
  METHODS
  The research team surveyed 614 Hondurans, aged ≥ 18 y, within the general population of Tegucigalpa, the largest and capital city of Honduras, in neighborhoods representing areas where primarily the lower and middle classes lived.
  
  
  METHODS
  The primary outcome measure was a modified Medication Adherence Report Scale (MARS). Results • The research team collected 610 surveys that had complete answers to questions about adherence (610/614, 99.3%) total complete responses to other items varied. The prevalence of use of TM was 62.8% (381/607). Nearly one-half, 47.3% (287/607), of all the respondents had used herbs or teas for health in the prior year, and 26.1% (159/607) of all respondents had received a sobada (therapeutic rubbing). Respondents with daily private spiritual devotions (OR = 0.610, P = .018) and diabetes (OR = 0.154, P = .004) were less likely to report low adherence. Receiving a sobada and a history of fever were independently associated with low adherence (OR = 1.718, P = .017 and OR = 2.226, P < .001, respectively).
  
  
  CONCLUSIONS
  Hondurans use both allopathic and TM. Although private spiritual devotion may help improve adherence to medication, only use of traditional massage therapy, the sobada, was associated with decreased adherence. Effective integration of alternative therapies in Central America will require proper counseling on how to combine multiple therapies to maximize the health benefits.
authors.forename: Michael Paul
authors.initials: MP
authors.lastname: Catalino
authors.forename: Reyna Maria
authors.initials: RM
authors.lastname: Durón
authors.forename: Julia Nancy
authors.initials: JN
authors.lastname: Bailey
authors.forename: Kenton Roy
authors.initials: KR
authors.lastname: Holden
mesh_terms: D000328:Adult; D000529:Complementary Therapies / Q000523:psychology* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008519:Medicine, Traditional / Q000523:psychology*; D012959:Socioeconomic Factors; D016903:Drug Monitoring