Leech therapy in Kazakhstan: Patients' characteristics and compliance with treatment
Leech therapy is one of the most commonly used methods of complementary medicine. In Kazakhstan, leech therapy is officially recognized method of rehabilitation, however, no studies describing patients of leech therapy clinics or factors associated with compliance with this treatment with original data from Kazakhstan have been published yet. The aim of this study is to present socio-demographic characteristics of patients receiving leech therapy and assess factors associated with compliance with leech therapy in Kazakhstan. This is a cross-sectional study which includes all patients who attended the clinic "Hirudo" (Almaty, Kazakhstan) from July 2012 through December 2014. Data were collected from medical records and by interviews performed by the first author. Independent associations between predictors and the compliance to treatment were assessed by multiple binary logistic regression. Adjusted odds ratios (aOR) with 95 % confidence intervals (CI) were calculated. Cardiovascular patients comprised 67,5 % of all patients during the study period. Pensioners were the most common social group (41,7 %). The main factors associated with compliance with leech therapy were lower costs compared to standard treatment (aOR = 25,3; 95 % CI: 17,2-37,3), satisfaction by the quality of care (aOR = 4,0; 95 % CI: 1,8-19,6) male gender (aOR = 1,5; 95 % CI: 1,0-2,2) and married status (aOR = 6,4; 95 % CI: 4,1-10,2). We also observed an inverse association between patients' age and compliance. Thus, compliance with leech therapy among Kazakhstani patients is mainly determined by lower costs compared to standard treatment and subjective satisfaction by the quality of care. Men and married patients are also more likely to comply with this treatment. However, we emphasize that the evidence needed for such an extensive use of leech therapy as in Kazakhstan is still missing warranting further research by means of well-designed clinical trials.