Self-medication with modern and complementary alternative medicines in patients with chronic pain

The study aimed to assess the prevalence, pattern, and determinants of the self-medication practices with modern and/or complementary and alternative medicine (CAM) therapies in patients with chronic pain.

The descriptive cross-sectional study was conducted between August 2021 and January 2022 and assessed a representative sample of chronic pain patients visiting outpatient departments in India by administering a semi-structured questionnaire. The survey questionnaire consisted of forty multiple response items, including ten questions that assessed the subjects’ sociodemographic profile, for example, age, sex, education, marital status, employment status, residence, and distance of home from any health care facility. The next part of the questionnaire evaluated the practice and determinants of self-medication for chronic pain with modern or CAM therapies. It included thirty questions assessing the reasons, duration, sources of information, procurement methods, preference for a particular system of medicine, knowledge about risks or drug interactions, rationality, perception of the subject, and communication with the physician, among other aspects of self-medication for pain.

Out of the 325 respondents with chronic pain, those who practiced self‑medication (237) were significantly more in number than those who did not (P < 0.05). Among those who self-medicated, the practice was significantly higher in urban participants living closer to healthcare facilities, with better economic backgrounds and higher education (P < 0.05). Modern medicine was the predominant choice of self-treatment for chronic pain compared to various CAM therapies (P < 0.05). Among the alternatives, homeopathic and ayurvedic systems of medicines were preferred. The main reasons for self-medicating were urgency, ease, previous prescriptions, and presumed mildness of the underlying disease. More than one-third of the respondents opined in favor of continuing self-medication in the future.

The prevalent practice of self-medication for chronic pain may not be hazardous, but it can turn into a serious problem if not based on correct information. The inherent risks need to be minimized by increasing awareness, health education, and pharmacy regulations.