Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 1637  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
  Search
 
 :: Next article
 :: Previous article 
 :: Table of Contents
  
 RESOURCE Links
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::  Article in PDF (75 KB)
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 

  IN THIS Article
 ::  References

 Article Access Statistics
    Viewed5554    
    Printed118    
    Emailed3    
    PDF Downloaded794    
    Comments [Add]    
    Cited by others 7    

Recommend this journal


 


 
EXPERT'S COMMENTS
Year : 2007  |  Volume : 53  |  Issue : 2  |  Page : 85

Noncompliance with conventional medicine and use of complementary/alternative medicine


Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, United Kingdom

Correspondence Address:
E Ernst
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter EX2 4NT
United Kingdom
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.32204

Rights and Permissions




How to cite this article:
Ernst E. Noncompliance with conventional medicine and use of complementary/alternative medicine. J Postgrad Med 2007;53:85

How to cite this URL:
Ernst E. Noncompliance with conventional medicine and use of complementary/alternative medicine. J Postgrad Med [serial online] 2007 [cited 2019 Oct 13];53:85. Available from: http://www.jpgmonline.com/text.asp?2007/53/2/85/32204


Complementary/alternative medicine (CAM) stands out from all other areas of medicine in one characteristic: more surveys (about one every 1 days) are being published than in any other field. Many tell us very little new or worth knowing,[1] but every now and then a grain of wheat emerges from the chaff. In this issue, Jose et al report a survey from India which essentially suggests that noncompliance with conventional medicine could be related to the use of CAM.[2]

Noncompliance is a widespread, costly and life-threatening phenomenon.[3] For decades, researchers have, by and large unsuccessfully, tried to determine what causes noncompliance. Jose et al[2] show that CAM use could be an important factor. How could we explain this finding?

We know that CAM users tend to be critical about science and the establishment.[4] So this general attitude could also prevent patients from complying with mainstream prescriptions. But there could be more. Practitioners of CAM, as well as books, websites and newspaper articles on CAM have all been implicated in influencing patients such that they distrust conventional medicine.[5] These issues are difficult to investigate and systematic evidence is therefore scarce. The best-researched example by far is immunization.

There is good and plenty of evidence to show that some CAM practitioners (e.g., homeopaths, chiropractors, naturopaths and doctors of anthroposophical medicine) advise parents against immunization programs for their children.[6] In this situation, noncompliance represents a risk, not just for the child that might not get vaccinated but to the population as a whole. If non-vaccination happens on a sufficiently large scale, we as a population will lose our herd immunity. In this case, epidemics would return which we had long thought a thing of the past. We know that, in the UK, anti-immunization advice by CAM practitioners is one of the main reasons for children to remain unvaccinated.[7]

So, the initially somewhat amazing finding of Jose et al[2] does after all tie in with previous research. Nevertheless, I do think we need independent replication of their data and information from countries other than India. If such studies confirm the original result, we may have an important stone in the puzzle to better understand noncompliance. In any case, we should be vigilant and proactive about CAM use. We should ask our patients whether they consult CAM practitioners and, if so, we should make sure they are properly informed about the risk they may expose themselves to, if they listen to wrong advice.

 
 :: References Top

1.Ernst E. Prevalence surveys: To be taken with a pinch of salt. Complement Ther Clin Pract 2006;12:272-5.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Jose VM, Bhalla A, Sharma N, Hota D, Sivaprasad S, Pandhi P. Study of association between use of complementary and alternative medicine and non-compliance with modern medicine in patients presenting to the emergency department. J Postgrad Med 2007;53: 96-101.  Back to cited text no. 2    
3.Rasmussen JN, Chong A, Alter DA. Relationship between adherence to evidence-based pharmacology and long-term mortality after acute myocardial infarction. JAMA 2007;297:177-86.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Ernst E, Pittler MH, Wider B, Boddy K. The desktop guide to complementary and alternative medicine. 2nd ed. Elsevier Mosby: Edinburgh; 2006.  Back to cited text no. 4    
5.Ernst E. 'First, do no harm' with complementary and alternative medicine. Trends Pharmacol Sci 2007;28:48-50.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Schmidt K, Ernst E. Welcome to the lion's den - CAM therapists and immunisations. Focus Altern Complement Ther 2005;10:98-100.  Back to cited text no. 6    
7.Simpson N, Lenton S, Randall R. Potential refusal to have children immunized: Extent and reasons. BMJ 1995;310:227.  Back to cited text no. 7  [PUBMED]  



This article has been cited by
1 the use of complementary and alternative medicine by nurses
buchan, s. and shakeel, m. and trinidade, a. and buchan, d. and ah-see, k.
british journal of nursing. 2012; 21(11): 672-675
[Pubmed]
2 Complementary and alternative medicine use by otolaryngology patients: A paradigm for practitioners in all surgical specialties
Shakeel, M., Trinidade, A., Ah-See, K.W.
European Archives of Oto-Rhino-Laryngology. 2010; 267(6): 961-971
[Pubmed]
3 The use of complementary and alternative medicine by patients attending a general otolaryngology clinic: can we afford to ignore it?
Shakeel, M., Trinidade, A., Jehan, S., Ah-See, K.W.
American Journal of Otolaryngology - Head and Neck Medicine and Surgery. 2010; 31(4): 252-260
[Pubmed]
4 The use of complementary and alternative medicine by patients attending a general otolaryngology clinic: can we afford to ignore it?
Muhammad Shakeel,Aaron Trinidade,Shah Jehan,Kim W. Ah-See
American Journal of Otolaryngology. 2010; 31(4): 252
[Pubmed] | [DOI]
5 Use of complementary and alternative medicine by patients attending arhinology outpatient clinic
Newton, J.R., Santangeli, L., Shakeel, M., Ram, B.
American Journal of Rhinology and Allergy. 2009; 23(1): 59-63
[Pubmed]
6 Complementary and alternative medicine use among patients undergoing otolaryngologic surgery
Shakeel, M., Newton, J.R., Ah-See, K.W.
Journal of Otolaryngology - Head and Neck Surgery. 2009; 38(3): 355-361
[Pubmed]
7 Complementary and alternative medicine use by otolaryngology patients: a paradigm for practitioners in all surgical specialties
Muhammad Shakeel, Aaron Trinidade, Kim W. Ah-See
European Archives of Oto-Rhino-Laryngology. 2009;
[VIEW] | [DOI]



 

Top
Print this article  Email this article
Previous article Next article
Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow