Predictors of complementary and alternative medicine use and its association with attitudes toward antiviral therapy among patients with hepatitis C in Pakistan: A cross-sectional study

Résumé fourni par la source

Complementary and alternative medicine (CAM) is increasingly utilized in low-income settings, yet its relationship with attitudes towards antiviral therapy among hepatitis C patients remains understudied. This study aims to assess the patterns and predictors of CAM use among hepatitis C patients and examine the association between CAM use and attitudes towards antiviral therapy. A cross-sectional study was conducted from May to December 2019 among 376 patients with hepatitis C attending two tertiary care hospitals in Islamabad, Pakistan. Participants were recruited using convenience sampling. Data on sociodemographic and clinical characteristics, CAM use, and attitudes towards antiviral therapy were collected through face-to-face interviews. Medication attitudes were measured using the Drug Attitude Inventory (DAI-10), which measures multidimensional attitudes towards therapy. The primary outcome measure was CAM use (yes/no), which was entered into a multivariable logistic regression model, using R version 4.2.2 to identify predictors of CAM use. CAM use was reported by 230 (61.2%) participants, and Hakeem (traditional Eastern medicine practitioner practicing Unani medicine) was the most commonly used modality. CAM use was primarily motivated by perceived benefits and the high cost of conventional treatment. Older age, secondary education, cardiovascular comorbidity, and kidney disease were significantly associated with higher CAM use. Notably, participants with a positive attitude towards antiviral therapy (DAI-10 score 6 − 10) had significantly higher odds of CAM use (OR = 2.39, 95% CI: 1.05–5.57, p = 0.039). CAM use is highly prevalent among hepatitis C patients, and is associated with more positive attitudes toward antiviral therapy, which is consistent with complementary patterns in this population, though concurrent antiviral use was not directly measured. However, low disclosure rates and widespread belief that CAM has no side effects may need attention regarding patient safety concerns. Routine assessment, open clinician-patient communication, and patient education on CAM safety and efficacy are essential to support optimal treatment outcomes.

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