Fear of side-effects, higher cost of medicine hampering treatment

KOCHI: Almost 30% of patients with diabetes make combined use of alternative medicines in state. Only 61% stick exclusively to modern medicine and 9% use only alternative medicine. The main reason for these are the high cost of modern medicine and fear about side-effects.

This is shown in a study – Complementary and alternative medicine use by diabetes patients in Kerala – conducted by Achutha Menon Centre for Health Science Studies. For the study, they assessed 400 patients to check the prevalence of exclusive use of combined use of alternative medicine, exclusive use of modern medicine and combined use.

“The higher use of alterative medicines might be due to limited availability of free and regular supply of modern medicine from public health system in Kerala. The combined use of alterative and modern medicines could be probably due to cultural practices, lack of perceived side-effects, easy availability and acceptability of alternative medicines,” said Dr K R Thankappan, Achutha Menon Centre for Health Science Studies.

Doctors dealing with patients admit that often compliance is low among patients as they don’t stick to prescribed medicines either due to fear of side-effects or higher costs. Depending on patient’s condition and other complications, the cost may vary from Rs 500 to Rs 3,000/month for modern medicine.

“Compliance is 65-70% and it depends on how well you counsel them and their financial status. At the onset of diabetes, patients take medicine for some time and then 30-40% stop it without physician’s advice. Later, when sugar level is high, they try to control it with diet, exercise and alterative medicines,” said Aster Medcity endocrinologist Dr Vipin VP.

Patient realizes the problem when the blood sugar level shoots up. “They return and the adherence rate holds good for one or two years. When blood sugar becomes stable, they try to manipulate medications,” he added.

So it is not much of a surprise for doctors that only 15% patients have diabetes under control. Reasonable control of blood sugar is important to prevent kidney disease, heart attacks, stroke and blindness.

“Poor treatment access, high cost, low awareness, health system challenges, inadequate number of trained physicians and the inertia of healthcare providers are barriers to achieve optimal blood sugar control. Beyond pharmacological therapy, individuals with diabetes also benefit from dietary and lifestyle management,” said Dr Jeemon Panniyammakal, assistant professor, epidemiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology.

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