Roderick Salenga et al. /JAASP 1(2012) 16-24 RESEARCH PAPER Prevalence, perceptions and predictors of complementary and alternative medicine use in selected communities in the Philippines Vina R.A. Dahilig1 and Roderick L. Salenga1,* 1College of Pharmacy, University of the Philippines, Philippines. Keywords Abstract complementary medicine alternative The study examines the use of complementary and medicine alternative medicine among residents of selected rural community rural and urban communities in the Philippines urban community using the CAM Healthcare Model. Interviews were conducted on 146 respondents in Batangas, Correspondence Caloocan and Paraňaque using a structured Roderick Layug Salenga questionnaire that applies the RAND Short Form R.Ph., M.P.H. (SF) 36 and the Brief Illness Perception College of Pharmacy Questionnaire as measures of self-perceived health University of the status. A higher prevalence was observed among Philippines Philippines the rural respondents (68.4%) as compared with E-mail: their urban counterparts (51.5%). Users in both [email protected]. rural and urban areas perceived CAM as beneficial. Significant predictors of use included the type of community, an annual income of less than USD 10,500, more than 10 years of residence in the community, self-perceived health status in the Energy/Fatigue, Emotional Well-being and Pain scales in the SF 36, presence of chronic illness, and consultations to traditional faith healer for health issues. Since only about 27% of the variability in the odds of using CAM can be explained by the model, further studies investigating other predictors of use are recommended. Introduction Complementary and alternative Alternative Medicine (NIH-NCCAM) in medicine (CAM), as defined by the the United States, is a term for a National Institutes of Health- National group of diverse medical and health Center for Complementary and care systems, practices, and products 16 Roderick Salenga et al. /JAASP 1(2012) 16-26 that are not generally considered to Materials and Method be a part of conventional medicine. It encompasses a broad type of practice, Across sectional design was used to including, but not limited to, evaluate CAM use among adults in the aromatherapy, yoga, homeopathy, rural municipality of Mataas na Kahoy, prayer, meditation, acupuncture and Batangas and two urban communities treatment with herbs, vitamins and in Barangay Baesa 160 Zone 14 food supplements. The increasing District II in Caloocan City and in growth of global CAM use has already Barangay Don Bosco, Paraňaque City. been well documented in literature. In The setting was based on the the national survey in the United definition of rurality and urbanity of a States, for example, CAM use community from Statistical Research increased from 33.8% in 1990 to and Training Center of the National 42.1% in 1997.1 Regional studies in Statistics Office in the Philippines. Australia suggested that Sample size was computed using approximately 50% of South PASS (Power Analysis and Sample Australians were CAM users with an Size Software) 2008 at a power of increase from 52.1% in 2000 and 80% and significance level of 0.05, 52.2% in 2004.2 Within the whole resulting in a sample size of at least African region, it was reported in 2001 146. Population allocation was used to that over 80% of the population used determine the number of samples African traditional medicine for needed for Mataas na Kahoy, primary healthcare needs.3 Most Caloocan and Paraňaque. From countries in the South East Asian Mataas na Kahoy and Paraňaque, 57 region, it is generally believed that samples were included for each and 70% to 80% of the population use from Caloocan, 32 households were CAM in the rural and semi urban areas selected. Simple random sampling where allopathic medicine is less was conducted to choose the available. Meanwhile, in the Western barangays in the rural community. Pacific region, it is acknowledged that Four out of the eleven barangays were CAM is practiced in many countries investigated. The barangays of Santol but is not regulated by most (population:1,684), Loob (population: governments. Similar data on the 988), Bubuyan (population:1,107) and widespread use and cultural Calingatan (population:2,386) were acceptance of CAM was found by the drawn. The starting point of every World Health Organization (WHO) on sampling was the barangay hall. the Eastern Mediterranean region Convenience sampling was conducted although the exact prevalence was not to select the respondents from the provided. households in the barangay. One adult representative from each National data on the prevalence of household drawn was requested for an CAM use particularly in the urban and interview. Respondents who were rural communities in the Philippines is included in the study are adults who lacking. As such, this study was are residents in the study areas for conducted to compare the prevalence more than a year, regardless of and perceptions on complementary whether they have used CAM or not and alternative medicine and identify and are physically and mentally able its predictors of use among adults in to participate in the survey. The the rural barangays in Batangas and survey instrument was administered in the urban communities in the cities to the respondents using a structured of Caloocan and Paraňaque and interview, composed of 3 parts, as Philippinses. follows: part 1 the respondent demographics; part 2 the evaluation 17 Pharmacy Practices of health status by using the RAND entered into a multivariate logistic Short Form (SF) 36-item Health regression model to assess their Survey Questionnaire and the 8-item relationship with CAM use in order to Brief Illness Perception Questionnaire obtain the predictors of use. The odds (BIPQ). The questions in the SF 36 are ratio (OR) and a 95% confidence scored in a scale of zero to 100 where interval (CI) for each variable were 100 represents highest level of determined. Variables not contributing functioning. Aggregate scores are substantially to the model were combined as total percentages of the systematically removed in a backward total points possible, and scores from stepwise regression process using the the items representing eight scales of likelihood ratio test as the criterion for health status were averaged to obtain removal. The Hosmer-Lemeshow χ2 the final scores in each dimension. In test was used to assess the goodness the BIPQ, 8 items were measured with of fit between the observed and a 0-10 scale where the highest score predicted number of outcomes for the of ten reflects a more threatening final model. view of the illness. These questionnaires were translated to Filipino and back-translated in English Results and Discussion to ensure content validity. Part 3 includes the study-specific questions Table 1 Socio-demographic characteristics of the respondents. particular to complementary and alternative medicine use. For quality Factors n % of data, the interviewers were trained Type of community and using the same prepared visual Urban 90 61.6 aids to further enhance Rural 56 38.4 comprehension of some questionnaire Age group concepts. The researches monitored 61 years and above 26 17.8 data collection and checked during 55 to 60 years 10 6.9 field interview. Six interviewers who 37 to 54 years 45 30.8 have had adequate background in 36 years and below 65 44.5 Sex public health were trained prior to the Male 88 39.7 conduct of the data collection. The Female 58 60.3 interview was conducted from Educational Attainment December 2011 to February 2012. At least college 104 71.2 The setting of the interview was of the High School 35 24.0 respondents’ own preference. Prior to At most elementary 7 4.8 the interview, informed consent was Employment Status reviewed and signed by the Employed 31 21.2 respondent. A copy was given to each Unemployed 115 78.8 Annual Income respondent. Data were verified and Less than USD 2,500 7 4.8 coded for analysis. Descriptive USD 2,500 to USD 10,500 78 53.4 statistics were used to describe the Greater than USD 10,500 61 41.8 prevalence and frequency of CAM use. Years in the barangay Association between health Greater than 10 years 91 62.3 perceptions and CAM use by type of 5 to 10 years 20 13.7 community was tested using Wald Less than 5 years 35 24.0 test. Comparison of existing prevalence and perceptions of CAM A total of 146 respondents were use between urban and rural included in the study. Table 1, More respondents were evaluated using than three-fifths of the respondents Fisher’s exact test. Candidate live in the urban areas. Three fourths variables were grouped and then of the respondents are aged 54 years 18 Roderick Salenga et al. /JAASP 1(2012) 16-26 or below. Majority of the respondents respondents claim that they are not are females (60.27%) and have at healthy. least college education (71.23%) Almost four-fifths of the respondents are unemployed. Most of the Table 3 Association of socio-demographic respondents (62.33%) have resided in characteristics with complemen- their respective barangays for more tary and alternative medicine than 10 years already. use Factors OR p 95%CI Type of community Table 2 Health perception and status of Urban 2.2 0.029 1.1, 4.4 the respondents (n=146) Rural 1.0 SF 36 Health Status Mean SD Age group Physical functioning 72.9 27.5 > 60 years 2.2 0.113 0.7, 3.5 Role limitations due to 55 to 60 years 1.5 0.586 0.4, 5.6 physical health 37.3 44.6 37 to 54 years 1.6 0.236 0.8, 5.7 Role limitations due to < 37