Treatment seeking behaviour of chest symptomatics

Setting: Departments of Community Medicine and Pulmonary Medicine, Post-Graduate Institute of Medical Education and Research, Chandigarh. Objective: To assess the treatment seeking behaviour of chronic chest symptomatics. Methods: Identification of chronic chest symptomatics by a physician in randomly sampled rural and urban population groups and interviewing them by means of a semi-structural questionnaire. Chronic chest symptomatics were those having one or more of the following symptoms for more than a month: cough, expectoration, breathlessness, blood in sputum, wheezing, pain in chest. Results: Among 1659 adults (15-65 years),12.0% were having chronic chest symptoms. Out of 192 chronic chest symptomatics,19.0% had not taken any treatment.Of those who took action initially, 52.5% had taken home remedies and 47.5% had relied on self-medication. Majority of them (82.0%) later switched over to a health care provider. Delay in seeking treatment varied from 7 to 365 days (mean 56.6, SD 23.5). Thirty four percent changed their health care provider more than two times. At the time of survey, 20.3% were taking treatment from unqualified medical practitioners, 18.2% from allopathic practitioners, 2.0% were in the care of government hospitals, and 8.3% were being treated by practitioners of Indian systems of medicine, and homeopathy. In rural area, major source of care was unqualified medical practitioners and in urban area, majority sought treatment from private allopathic doctors. Eighteen percent were still not satisfied with their current treatment. Conclusion: The study shows that most of the chronic chest symptomatics start with home treatment or selfmedication, and there is considerable delay in seeking treatment from a proper health care provider.