Abstract
BackgroundTraditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia.MethodsA cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers purposively selected from Phnom Penh, Kampong Cham and Siem Reap. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. I-CAM-Q was used to measure TCAM use. A multivariate logistic regression model was constructed to identify factors associated with herbal medicine use.ResultsIn total, 1602 patients were included in this study, of whom 77.7% were female, and 51.2% were recruited from urban primary health centers with a mean age of 46.5 years (SD = 15.2). Of total, 27.0% reported at least one consultation with a TCAM provider in the past 12 months. The most common modality of TCAM used was herbal medicine (89%). Herbs were obtained at drug or folk stores (36.9%), from herbalists directly (28.5%) or from their own gardens (18.6%). Of herb users, 55.2% reported that herbs were somewhat helpful. After adjustment, herb users were significantly more likely to be female (AOR = 1.42, 95% CI = 1.12–2.67), have completed less schooling (AOR = 0.66, 95% CI = 0.45–0.96), were unemployed or homemakers (AOR = 0.23, 95% CI = 0.13–0.52) and have a gastrointestinal illness (AOR = 0.49, 95% CI = 0.39–0.62).ConclusionsHerbal medicines are broadly used among chronic disease patients in Cambodia. Understanding TCAM use in the general population will support health care practitioners and policy makers to make informed decisions about the use of TCAM. Integration of TCAM into the primary health system should be further explored.
Highlights
Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world
Our study examined the prevalence of and factors associated with TCAM use among patients with chronic diseases in primary healthcare settings in Cambodia
Our study found that herbal medicines are broadly used among patients with chronic diseases in Cambodia with nearly half of the population having used an herbal medicine in the last 12 months
Summary
Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. Traditional, complementary and alternative medicine (TCAM) has been a growing area of interest in recent years. In the WHO’s 2012 survey, countries around the world cited a paucity of adequate research as the most limiting factor in improving and integrating TCAM into their national healthcare system [1]. Other studies have indicated high rates of use in Malaysia (63.9%) and Thailand (52.5%) [4] These findings corroborate the results of a recent systematic review of TCAM literature, which found that the highest rates of TCAM use were in East Asian countries [5]. In a recent study of Cambodian refugees living in Long Beach, California, 34% of the respondents reported continued seeking of TCAM in addition to seeking western allopathic medical therapies [6], while the systematic review noted that, in the United Kingdom, United States and Canada, TCAM use in the general population ranged from 26% to 52% [5]
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