Association Between Complementary and Alternative Medicine use and Quality of Life of hypertensive patients attending the General Outpatient Department of Asokoro District Hospital, Abuja, Nigeria.

Project Officer

1. Project PI:Dr Sumit Kumar Vishwakarma. Assistant Professor, General Medicine, Ramnath Prasad Institute of Higher Education Foundation

2. Co-PI:Dr. Falmata Lawan Gana, Scholar, Fellowship in Internal Medicine, Ramnath Prasad Institute of Higher Education Foundation

3. Co-PI: Dr Adamu Onu, Consultant Physician and Medical Director Garki Hospital, Abuja.

Project Cost: 70000 Indian /-

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This report details the successful completion of a BASE Corporate Social Responsibility (CSR) project undertaken by RPIHE Foundation in partnership with the Asokoro District Hospital, Abuja, Nigeria. The project's objective was to conduct a robust, evidence-based study to understand the impact of Complementary and Alternative Medicine (CAM) use on the quality of life (QOL) of hypertensive patients. This initiative aligns with our commitment to public health, community well-being, and supporting data-driven healthcare improvements in the regions where we operate.

1. Introduction

Hypertension is a chronic, non-communicable disease that poses a significant public health challenge in Nigeria and globally. While conventional medicine is the primary treatment, a large number of patients also use CAM therapies. This trend is driven by various factors, including the belief that CAM is more "natural," dissatisfaction with conventional treatments, and the influence of cultural beliefs. However, the use of CAM can potentially impact patient outcomes, particularly their QOL and adherence to prescribed medications.

This project was conceived to address the lack of localized data on this topic. By investigating the prevalence of CAM use and its association with QOL, we aimed to provide healthcare professionals at Asokoro District Hospital with critical information to enhance patient counseling, improve clinical outcomes, and foster a more holistic approach to patient care.

2. Methodology

The research was structured as a cross-sectional study. A total of 153 hypertensive patients attending the General Outpatient Department (GOPD) of Asokoro District Hospital were recruited for the study. Data collection was performed using a structured, interviewer-administered questionnaire. The questionnaire was designed to capture:

• Socio-demographic details: Such as age, gender, and education.

• Clinical information: Including the duration of hypertension.

• Patterns of CAM use: The types of CAM used, the reasons for use, and sources of information about these therapies.

• Quality of Life: Measured using the validated World Health Organization Quality of Life (WHOQOL-BREF) instrument, which assesses physical health, psychological health, social relationships, and environmental domains.

Statistical analysis was performed to identify factors associated with CAM use and to determine its relationship with QOL. Inferential tests, including logistic regression, were used to identify significant associations, with a p-value of less than 0.05 indicating statistical significance.

3. Key Findings and Results

The project yielded several important findings that shed light on the dynamics of CAM use among the patient population:

• High Prevalence of CAM Use: A significant majority of the study participants (53.6%, or 82 out of 153 patients) reported using some form of CAM. This high prevalence underscores the need for healthcare providers to actively inquire about CAM use during consultations.

• Predictors of CAM Use: The study identified specific patient profiles more likely to use CAM. Male patients were over four times more likely to use CAM (Odds Ratio [OR] = 4.12), and patients with a longer duration of hypertension were also significantly more prone to this practice. This suggests that physicians should be particularly vigilant in these patient groups.

• Negative Impact on Quality of Life: The most critical finding was the strong association between CAM use and a lower QOL. Patients using CAM had significantly lower mean QOL scores across all four domains of the WHOQOL-BREF (physical, psychological, social, and environmental) when compared to non-CAM users. Specifically, CAM users were found to be 90% less likely to have a high QOL (OR = 0.10).

• Patient Dissatisfaction: Interestingly, the results also showed that a slight majority of CAM users (51.2%) were unsatisfied with the outcomes of their CAM therapy. This indicates a potential for a negative cycle where patients with a poor QOL seek CAM, which in turn may not provide the desired results and could further impact their well-being.

• Information Sources: The primary sources of information for CAM were identified as CAM practitioners themselves, followed by mass media and personal friends. This highlights a need for better public health messaging to provide balanced, evidence-based information.

4. Conclusion and Recommendations

This CSR project successfully completed its objectives and provided crucial insights into the health-seeking behaviors and outcomes of hypertensive patients at Asokoro District Hospital. The findings highlight that CAM use is prevalent and, in this population, is negatively associated with the patient's quality of life.

Based on these results, we have provided the following recommendations to the hospital and its medical staff:

• Enhanced Patient-Physician Communication: Medical doctors and other healthcare professionals must be proactive in discussing CAM use with their patients. Open and non-judgmental dialogue is essential to understand the underlying reasons for its use and to provide appropriate advice.

• Physician Education: We recommend that the hospital facilitate training programs for its staff to increase their knowledge of common CAM therapies, their potential side effects, and possible interactions with conventional medications.

• Public Awareness Campaign: We propose a collaboration with the hospital to develop and distribute educational materials aimed at the general public. These materials should focus on the importance of adhering to conventional medical treatments and the potential risks of unsupervised CAM use.

• Continued Research: The findings of this project provide a strong foundation for future research. We recommend conducting prospective studies to investigate the causal relationship between CAM use and QOL, and to evaluate the efficacy and safety of specific herbal remedies common in the Nigerian context.

This project represents a significant step in promoting evidence-based patient care and improving the quality of life for individuals with chronic diseases in Nigeria. [Your Company Name] is proud to have supported this initiative and remains committed to fostering healthier communities.