Complementary and alternative medicine: practice and perspective of allopathic doctors at a tertiary care hospital

Dharani Sundarmurthy, Vijayalakshmi Devarashetty, Narayana Reddy S.


Background: Complementary and alternative medicine (CAM) has been defined as a group of diverse healthcare systems, not considered to be a part of conventional (allopathic) medicine. Approximately 80% of general population use traditional medicines (WHO). Thus, patients using CAM and its associated adverse effects may be encountered in practice of modern medicine. Hence it is necessary to assess the knowledge, attitude and practices of CAM among health care professionals (HCPs).

Methods: After obtaining IEC approval, the cross-sectional study was conducted in doctors at Bangalore Medical College and its attached hospitals. 200 doctors who gave informed consent were included in the study.

Results: 61.5% of the HCPs were aware that CAM includes AYUSH. 53% of the HCPs used CAM for self, especially for respiratory disorders (28.3%) and chronic painful conditions (21.6%). The common adverse effects attributed to use of CAM among patients which required consultation of the HCPs were hepatic (42.5%) and renal impairment (32.5%), allergy (10%), relapse (10%), and metal intoxication (5%). 71% didn’t prefer suggesting CAM for patients. 70% opined that CAM therapies be subjected to clinical trials.

Conclusions: HCPs had used CAM therapy for self at least once especially for respiratory disorders and chronic painful conditions. However majority of the HCPs didn’t prefer suggesting CAM to patients and as many as 70% of the HCPs  insisted that CAM therapies be subjected to scientific evaluation including clinical trials in view of patient safety before integrating them with conventional medicine.


CAM, Allopathic doctors, Ayurveda, Yoga, Attitude, Practice

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CAM basics: Updated 25 May 2012. Available at

Tabish SA. Complementary and alternative healthcare: is it evidence-based? International Journal of Health Sciences. 2008;2(1):V-IX.

Roy V. Time to sensitize medical graduates to the Indian Systems of Medicine and Homeopathy Editorial. Indian J Pharmacol. 2015;47:1.

Planning Commission, Government of India. Indian systems of medicine and homeopathy. Available at http://www.Planning

Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. Int J Clin Pract. 2012;66:924-39.

Kinsel JF, Straus SE. Complementary and alternative therapeutics: Rigorous research is needed to support claims. Annu Rev Pharmacol Toxicol. 2003;43:463-84.

Sharma R, Kapoor B, Verma U. Drug utilization pattern during pregnancy in Northern India. Indian J Med Sci. 2006;60:277-87.

Verma U, Sharma R, Gupta P, Gupta S, Kapoor B. Allopathic versus ayurvedic practices in tertiary care institutes of urban North India. Indian J Pharmacol. 2007;39:52-4.

Gupta M, Shafiq N, Kumari S, Pandhi P. Patterns and perceptions of complementary and alternative medicine (CAM) among leukaemia patients visiting haematology clinic of a north Indian tertiary care hospital. Pharmacoepidemiol Drug Saf. 2002;11(8):671-6.

Hasan SS, Ahmed SI, Bukhari NI, Loon WC. Use of complementary and alternative medicine among patients with chronic diseases at outpatient clinics. Complement Ther Clin Pract. 2009;15(3):152-7.

Sharma A, Agarwal A. Complementary and alternative medicine (CAM) use among patients presenting in out-patient department at tertiary care teaching hospital in southern Rajasthan, India - a questionnaire based study. Altern Integr Med. 2015;4:1.

Ernst E. The role of complementary and alternative medicine. Br Med J. 2000;321:1133-5.

WHO traditional medicine strategy: 2014-2023. Geneva: World Health Organization; 2013 Available at Accessed on 27 November 2013.

Singh V, Raidoo DM, Harries C. The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa. BMC Complementary and Alternative Medicine. 2004;4:3.

Bhalerao MS, Bolshete PM, Swar BD, Bangera TA, Kohle VR. Use of and satisfaction with complementary and alternative medicine in four chronic diseases: a cross sectional study from India. Natl Med J India. 2013;26:75-8.

Izzo A, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs. 2009;69:1777-98.

Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J. Lead, mercury, and arsenic in US and Indian manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008;300:915-23.

Ernst E. Herbal medicines: balancing benefits and risks. Novartis Found Symp. 2007;282:154-67.

Gawde SR, Shetty YC, Pawar DB. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: a cross-sectional study at a tertiary care hospital in India. Perspect Clin Res. 2013;4:175-80.

Kunnoor NS, Rathore R, Xavier D. Physicians perception on complementary and alternative medicine (CAM): a cross sectional survey at tertiary care hospital in India. Med chem. 2015;5:197-202.

Furlow ML, Patel DA, Sen A, Liu JR. Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology. BMC Complement Altern Med. 2008;8:35.

Roy V, Gupta M, Ghosh RK. Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India. Indian J Pharmacol. 2015;47(2):137-42.

Lewith, GT. Attitudes to and use of complementary medicine among physicians in the United Kingdom. Complementary Therapies in Medicine. 2001;9(3):167-72.

Zaman T, Agarwal S, Handa R. Complementary and alternative medicine use in rheumatoid arthritis: an audit of patients visiting a tertiary care centre. Natl Med J India. 2007;20:236-9.

Moses GM, McGuire TM. Drug interactions with complementary medicines. Aust Prescr. 2010;33:177-80. Available at

Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van RompayM. Trends in alternative medicine use in the United States, 1990-1997: Results of a Follow-up National Survey. JAMA. 1998;280:1569-75.

Shen J, Andersen R, Albert P, Wenger N, Glaspy J, Cole M. Use of complementary/alternative therapies by women with advanced-stage breast cancer. BMC Complementary and Alternative Medicine. 2002;2(8).

Thatte UM, Rege NN, Phatak SD, Dahanukar SA. The flip side of Ayurveda. (182ab). J Postgrad Med. 1993;39:179-82.

Garodia P, Ichikawa H, Malani N, Sethi G. Aggarwal. From ancient medicine to modern medicine: ayurvedic concepts of health and their role in inflammation and cancer. Journal of the Society for Integrative Oncology. 2007;5:1-16.