UTILIZATION OF SERVICES OF HOMEOPATHIC PRACTITIONERS AMONG PATIENTS IN KARACHI, PAKISTAN

Waris Qidwai

The Aga Khan University Hospital, Karachi, Pakistan

Background: The practice of homeopathy is becoming very popular. There is a need to study and understand as to why this is happening and to raise debate on the issue. Methods: The study was conducted on patients, visiting the Family Practice Centre, The Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the utilization of the services of homeopathic practitioners. The ethical requirements for conducting the study were met. Results: Three hundred and eighty-seven patients were surveyed. The study population included more women then men, with average age of 32.6 years. The majority was married, well educated, in private and government service, students or housewives. A substantial 36.4% of the respondents had used the services of Homeopathic practitioners for various ailments. The five main ailments for consulting them were skin diseases, influenza, headache, gastro-intestinal and musculo-skeletal problems. The main reason for consulting Homeopathic practitioners was the ‘recommendation of others’. The reasons for not consulting them were the ‘lack of belief in them’, ‘allopaths were considered more effective’, ‘Homeopathic practitioners were considered unscientific’, and ‘were not considered  a treatment option’. Among those who had consulted Homeopathic practitioners in the past, a substantial 67% of them were willing to consult them again in future. Conclusion: We have found a substantial utilization of services of Homeopathic practitioners among patients seeking allopathic treatment. Further studies are strongly recommended to study the need, utilization and organization of services offered by Homeopathic practitioners and the reasons for their popularity

Key-words: Homeopathy; Complementary therapies; Alternative medicine

INTRODUCTION

Homeopathy began with the discoveries of its founder Samuel Hahnemann (1755–1843), a German Physician. He first coined the word ‘homeopathy’, to refer to the law of similars that is its basis¹.

Homeopathy is a form of complementary medicine with three distinguishing characteristics. The remedies are prescribed on the totality of a person’s symptoms, the remedy likely to cure a person is a dilution of that substance which causes the same symptoms in a healthy person and the remedies are prepared using micro doses of substances, which are diluted and then vigorously shaken. Mainstream medicine criticizes homeopathy by saying that its gentleness has outlived its usefulness and treatment successes are probably no more than placebo action².

In the United States of America, the Food and Drug Administration regulate the manufacture and sale of homeopathic medicines. However, most of the homeopathic medicines are available in the United States without prescription³. 

In India, lure for homeopathy was quoted as one of the problems, faced during education program in bronchial asthma⁴. In rural Bangladesh, a study, which included homeopathic practitioners, found care of acute diarrhoea as largely irrational⁵.

In Pakistan, use of unconventional methods by cancer patients for treatment, which include homeopathy, were found to be widespread. This has been shown to result in delay in conventional treatment, which causes adverse influence on survival⁶.

By denying the existence of the use of homeopathic practitioner services does not help us serve our patients well. A need therefore exists to document the use of the services of homeopathic practitioners, not only to acknowledge this activity but also to understand its implications for medical practice.

MATERIAL AND METHOD

A questionnaire-based cross sectional survey was carried out. The venue for the study was the Family Practice Centre, the Aga Khan University hospital in Karachi, Pakistan.

It is a tertiary level teaching facility, in the private sector, where ten Family Physicians, on an average provide care to 24 patients each on a daily basis.

A questionnaire was developed in keeping with the study objectives. Data on the demographic profile of the patients was also collected. A process of convenience sampling was used, whereby 387 patients available in the waiting area were requested to participate in the study. All adults, both males and females were eligible to be included in the study. Those under 18 years of years of age were excluded. The consent form was signed by the participating patient after the objectives of the study were explained, and assurance of confidentiality was provided.

RESULTS

Three hundred and eighty-seven patients were surveyed. The study population included more women than men, with average age of 32.6 years. The majority of them were married, well educated, in private and government service, students or housewives (Table-1).

Table-1: Demographic Profile of the Study Population

*Standard deviation

We have found that 141 (36. %) of the respondents had used services of Homeopath practitioners for various ailments.

The five main ailments for consulting the Homeopath practitioners were skin diseases, influenza, headache, gastro-intestinal and musculo-skeletal problems (Table-2). The main reason for consulting them was the recommendation of others (Table-3). Lack of belief was the main reason for not consulting them (Table-4)

Among those who had consulted Homeopathic practitioners in the past, a substantial 67% of them were willing to consult them again in future.

Table-2: Types of ailments resulting in consultation with a homeopathic practitioners

Table-3: List of Reasons for consultation with Homeopathic practitioners

Table-4: List of reasons for non-consultation with homeopathic practitioners

DISCUSSION

The study population comprised mostly well-educated respondents, better placed socio-economically then the rest of the population in the country. Since patients from all walks of life and strata of the society are seen at the Family Practice Clinic, we believe to have a study sample more representative of the overall population. Nonetheless, a study conducted in the community settings would be useful.

A substantial proportion of the respondents (36%), had used services of Homeopathic practitioners for various ailments. It is significant, particularly because these patients had come for allopathic treatment, thus exhibiting preference for it.

The preference of respondents in seeking treatment from a homeopathic practitioner for particular ailments could mean they that they have better expertise in their management. This conclusion requires confirmation by further studies.

 The main reason for consultation with Homeopathic practitioners was the recommendation of others. This may be because of satisfactory experience of people in the community with the services of homeopathic practitioners or it could even be a result of a marketing influence. The effectiveness and reliability of homeopathic practitioners was another reason for consulting them. Further studies exploring these areas of patient perception need to be conducted.

Lack of belief in Homeopathic practitioners was the main reason for not consulting them. Further studies exploring the reasons cited for non-consultation with homeopathic practitioners are needed.

We have found a substantial use of the services of homeopath practitioners in our study population, even though they were interviewed while visiting to avail allopathic treatment.

Again the future intention to seek homeopathic treatment in our study sample was significant, even though they were interviewed while seeking allopathic treatment.

The findings of our study are in keeping with those in the developed world. In Belgium, the practice of homeopathy is found to be popular, especially in general practice⁷.

Critics of homeopathy term it as pseudo-medicine and challenge the very basic principles on which it is based⁸. It is said that drugs used by homeopaths are placebos and need not be integrated into medical training⁹.

In Norway, 50% of doctors were found to be positive towards homeopathic treatment¹⁰. In another study, it was found that Primary care physicians were ignorant of Homeopathy, identified it as a remedy of which they knew nothing, but for which they demanded scientific evidence¹¹.

There are reports that communication between homeopaths and the biomedical community can be enhanced by an interpretation of the homeopathic repertory in light of current medical diagnostic terminology¹².

It has been argued that, Homeopathy does not divert people from seeking mainstream care. Also it is said that, the use of alternative modes of care such as homeopathy can be understood as attractive and satisfying to educated individuals with chronic problems¹³.

There have been studies suggesting acceptance of the homeopathic system of care both at the level of the physicians as well as the patients^{10, 13.}

CONCLUSION

We have documented the utilization of services of Homeopathic practitioners, among patients seeking treatment from a tertiary level allopathic facility. Further debate and research on the issue is strongly recommended to study the need, utilization and the organization of homeopathic system of therapy in Pakistan.

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