Herbal Product Use by African American Older Women

Self-Perceived Health and Chronic Conditions Among Users of Supplements With and Without Botanical Ingredients: Findings from the 2009-2014 National Health and Nutrition Examination Survey

The objective of this research was to investigate associations among self-reported health status, chronic conditions, and use of dietary supplements containing botanicals and describe reasons for use among U.S. adult supplement users. This was a cross-sectional analysis using data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES). Supplement information was collected with a 30-day recall interview. Self-reported general health status and doctor-informed diagnoses of chronic conditions were assessed using a health status questionnaire. We used weighted multivariate logistic regressions to assess associations between supplement use and perceived health and number of chronic conditions. Participants were 16,958 non-institutionalized U.S. adults aged 20 years and older. Adults with excellent or very good self-perceived health were more likely to use botanical supplements than adults with good perceived health (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.28-1.74). Adults with three or more chronic conditions were more likely to report using botanical supplements than adults with no chronic conditions (aOR, 1.49; 95% CI, 1.13-1.69). The most frequently reported reasons for both non-botanical and botanical supplements use were "personal choice or influenced by advertisements or word of mouth," "improve health," and "specific health conditions" (93.3%, 84.2%, and 64.7%, respectively). While perceptions of health are more positive among adults using botanical supplements, chronic conditions and reasons for botanical supplements use related to personal choice, improving health, or addressing specific conditions were more likely. Differentiating botanical supplements from other complementary and integrative therapies may be useful for facilitating a deeper understanding of the reasons.

Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey

Background

Polypharmacy is common among older adults, with increasing numbers also using prescription drugs with herbal medicinal products (HMPs) and dietary supplements. There is no reliable evidence from the UK on concurrent use of HMPs and dietary supplements with prescription drugs in older adults.

Aim

To establish prevalence of concurrent prescription drugs, HMPs, and dietary supplements among UK community-dwelling older adults and identify potential interactions.

Design and setting

Cross-sectional survey of older adults registered at two general practices in South East England.

Method

A questionnaire asking about prescription medications, HMPs, and sociodemographic information was posted to 400 older adults aged ≥65 years, identified as taking ≥1 prescription drug.

Results

In total 155 questionnaires were returned (response rate = 38.8%) and the prevalence of concurrent HMPs and dietary supplements with prescriptions was 33.6%. Females were more likely than males to be concurrent users (43.4% versus 22.5%; P = 0.009). The number of HMPs and dietary supplements ranged from 1 to 8, (mean = 3, median = 1; standard deviation = 1.65). The majority of concurrent users (78.0%) used dietary supplements with prescription drugs. The most commonly used dietary supplements were cod liver oil, glucosamine, multivitamins, and vitamin D. Others (20.0%) used only HMPs with prescription drugs. Common HMPs were evening primrose oil, valerian, and Nytol Herbal^® (a combination of hops, gentian, and passion flower). Sixteen participants (32.6%) were at risk of potential adverse drug interactions.

Conclusion

GPs should routinely ask questions regarding herbal and supplement use, to identify and manage older adults at potential risk of adverse drug interactions.

Preferences and attitudes of older adults of Bialystok, Poland toward the use of over-the-counter drugs

Purpose

The aim of the study was to assess preferences and attitudes toward the use of over-the-counter (OTC) drugs among residents of Bialystok aged 60 or older.

Patients and methods

The study included 170 people, inhabitants of Bialystok aged over 60: 85 students of the University of a Healthy Senior and the University of Psychogeriatric Prophylaxis, and 85 students of the University of the Third Age in Bialystok. The study made use of a diagnostic survey conducted via a questionnaire prepared by the authors.

Results

The vast majority of respondents bought OTC drugs for own use. About one-third of the respondents from each analyzed group bought OTC drugs less often than once every 3 months. Over half of the respondents bought OTC drugs due to a cold. A majority of the respondents were of the opinion that OTC drugs should be sold only in pharmacies. Over 40% of seniors took 1 OTC drug regularly. Most respondents also took vitamins and supplements. The main sources of information on OTC drugs for the studied seniors were their doctor and pharmacist. Respondents did not always consult the treatment method with a doctor or pharmacist. Over half of the respondents familiarized themselves with the contents of the OTC drug package leaflet. Over three-quarters of the respondents were familiar with drug disposal methods; however, despite declarations of being familiar with these principles, a significant percentage did not bring back medication to a pharmacy or clinic, or threw the drugs into the trash.

Conclusion

Our study found that in our sample there were many OTC drug consumers who did not always demonstrate responsible attitudes toward using this group of drugs. Thus, older people should be educated on the possible adverse effects of taking OTC drugs without consulting a doctor or pharmacist as well as basic drug disposal principles. Furthermore, legislation should be introduced that will limit the wide availability of OTC drugs, particularly to the elderly; and thus, lower the costs of hospitalization and outpatient treatment of this age group. Also, a wider-reaching study should be conducted. It should include a larger group of elderly people as well as information on intake of prescribed medications in order to be able to determine the frequency of drug consumption in this population, as well as seniors' preferences and attitudes in this regard.

Pregnancy and herbal medicines: An unnecessary risk for women's health-A narrative review

The indiscriminate use of herbal medicines to prevent or to heal diseases or even the use for questionable purposes such as weight loss has received both interest and scrutiny from the scientific community and general public alike. An increasing number of women put their own and the unborn child's health at risk due to a lack of knowledge about the phytochemical properties and adequate use of herbal medicine (phytomedicines or herbal supplements) and lack of communication with their healthcare provider. The purpose of this narrative review was to summarize the use of herbal medicines during pregnancy and their potential toxic effects to highlight the importance of caution when prescribing herbal medicines or supplements for women, because, in addition to suffering interactions and a great amount of information obtained in preclinical predictive studies, assessment of nephrotoxicity, neurotoxicity, hepatotoxicity, genotoxicity, and teratogenicity of traditional medicinal herbs still remains scarce in the clinical setting.

Hesperidin, a flavanoglycone attenuates experimental diabetic neuropathy via modulation of cellular and biochemical marker to improve nerve functions

AIM

Diabetic neuropathy (DN) is one of the most common long-term complications of diabetes mellitus and clinically can be characterized by an elevated nociceptive response with electrophysiological conduction abnormalities. The present investigation was designed to evaluate the neuroprotective effect of hesperidin against STZ induced diabetic neuropathic pain in laboratory rats.

MATERIALS AND METHODS

DN was induced in Sprague-Dawley rats (150-200 g) by intraperitoneal administration of streptozotocin (STZ) (55 mg/kg, p.o.). Rats were divided into various groups, namely, STZ control (vehicle), hesperidin (25, 50, and 100 mg/kg, p.o.), insulin (10 IU/kg, s.c.), and combination of hesperidin (100 mg/kg, p.o.) with insulin (10 IU/kg, s.c.) for 4 weeks. Various behavioral (allodynia and hyperalgesia), biochemical parameters [oxido-nitosative stress, Na-K-ATPase, aldose reductase (AR)], and molecular changes (TNF-α and IL-1β) along with hemodynamic changes were determined.

RESULTS

Rats treated with hesperidin (50 and 100 mg/kg, p.o., 4 weeks) significantly reduced (p < 0.05) hyperglycemia and its metabolic abnormalities induced by intraperitoneal administration of STZ. The decreased nociceptive threshold, motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV), serum insulin as well as Na-K-ATPase activity were significantly increase (p < 0.05) by hesperidin (50 and 100 mg/kg, p.o.) treatment. It significantly attenuated (p < 0.05) elevated glycated hemoglobin, AR activity, oxido-nitrosative stress, neural calcium, and pro-inflammatory cytokines (TNF-α and IL-1β) levels. Histological aberration induced after STZ administration was restored by administration of hesperidin (50 and 100 mg/kg, p.o.)

CONCLUSION

In combination with insulin, hesperidin not only attenuated the diabetic condition but also reversed neuropathic pain via control over hyperglycemia as well as hyperlipidemia to down-regulate generation of free radical, release of pro-inflammatory cytokines as well as elevation in membrane bound enzyme.

A systematic review of the prevalence of herb usage among racial/ethnic minorities in the United States

Clinical studies display a wide range of herb use prevalence among racial/ethnic minorities in the United States. We searched databases indexing the literature including CINAHL, EMBASE, Global Health, CAB Abstracts, and Medline. We included studies that reported herbal medicine prevalence among ethnic minorities, African American, Hispanic, or Asian adults living in the United States. Data from 108 included studies found the prevalence of herb use by African Americans was 17 % (range 1-46 %); for Hispanics, 30 % (4-100 %); and for Asians, 30 % (2-73 %). Smaller studies were associated with higher reported herb use (p = 0.03). There was a significant difference (p = 0.01) between regional and national studies with regional studies reporting higher use. While herb usage surveys in racial/ethnic minorities show great variability, indications suggest high prevalence. More research is needed to understand herb use among ethnic/racial minorities, reasons for use, and barriers to disclosure of use to clinicians.

The influence of Christian conversion in Mapuche traditional medicine in Temuco, Chile: toward a cultural syncretism or a form of ideological assimilation?

The Mapuche communities living in the urban areas of Chile have undergone radical cultural changes due to Christian conversion. This article analyzes the influence of these changes on the Mapuche ideas and practices of the traditional healers (machi) and patients in Temuco (IX Region), Chile, and the changes and adaptations in the perceptions of healing practices and rituals by the patients. The paper shows how, despite some evident challenges, the encounter with the religion of Christianity can create a process of cultural and spiritual syncretism and push traditional medicine toward an increased specialization in the therapeutic practices.

An ethnomedicinal survey on phytotherapy with professionals and patients from Basic Care Units in the Brazilian Unified Health System

ETHNOPHARMACOLOGICAL RELEVANCE

In this study, an ethnomedicinal survey was conducted in the city of Pelotas, Brazil, with professionals and patients in the Unified Health System (SUS). With the approval of the National Policy on Medicinal Plants and Herbal Medicines, and with the adoption of a National Policy on Integrative and Complementary Practices in the SUS in Brazil, there is growing concern regarding Brazilian medicinal plants and their proper use in medicine. The expansion of the therapeutic options offered to the users of the SUS includes access to medicinal plants and herbal drugs, as well as related services, such as phytotherapy. For improving health and for the social inclusion of phytotherapies, safety, efficacy, and quality are important strategies.

MATERIALS AND METHODS

Interviews of both professionals and patients were conducted at five Basic Care Units, and a sample size of 393 was obtained.

RESULTS

Of the patients attending the Basic Care Units, 91.6% had experienced the use of medicinal plants at least once to treat certain diseases. Of the professionals, 65% had used medicinal plants but only 10% prescribed phytotherapeutics to their patients. Generally, the users were homemakers (26%) of the female gender (71.5%) who were older than 60 years (26%) and had a family income between 1 and 2 Brazilian minimal salaries. The professionals were predominantly female (80%), and a high proportion (80%) believed in the positive effects of phytotherapy (80%), even though these professionals had not been taught phytotherapy as undergraduate students (75%) and had not discussed the topic with their teachers (85%). Patients (81.5%) and professionals (45%) reported that their knowledge of medicinal plants came from their parents or grandparents. From a total of 66 different herbs used by the subjects, mauve (24%) was the most commonly used, often to treat toothaches (24.2%).

CONCLUSION

It is concluded that a high proportion of users and professionals made use of medicinal plants, and of the large number of plants mentioned in the questionnaire, mauve was the most commonly used, mainly for the treatment of toothaches. The major source of the transmission of knowledge concerning herbal medicine was parents or grandparents.

Herbal product use by older adults

In the past two decades, there has been an exponential increase in the use of medicinal herbal products around the world. In various countries, these products are classified and promoted as foods, not pharmaceuticals, which facilitate their availability on the international market without requiring a medical prescription. Since older adults (OAs) are an important and growing sector of the population in many countries, it is important to know the prevalence of their herbal product use, since many OA take herbs along with diverse quantities of prescription and over the counter medications. For this reason, it is important to be aware of the possibilities of health complications due to the concomitant use of diverse medications and herbs. OA are an especially vulnerable population, since many of the human body's physiological activities, such as renal and hepatic detoxification and clearance usually decrease with age. Additionally, information on certain herbal products is either misleading, or simply unavailable. These products may indeed be a therapeutic option, but some can be used properly only under the guidance of a health professional. Those OA taking combinations of various medications and herbal supplements are also more at risk to experience some sort of herb-drug interactions. This publication reviews selected articles related to the use of herbal products by OAs and mentions the various patterns of use and health implications of the concomitant use of herbal products and prescription medications. This topic is currently not fully understood and further research is warranted.

Antihyperglycemic and antioxidative effects of new herbal formula in streptozotocin-induced diabetic rats

Herbal prescriptions have been recognized as potentially valid by the scientific medical establishment, and their use has been increasing. The present study investigated the antidiabetic effects of a new herbal formula (NHF) consisting of Polygonati Rhizoma, Rehmanniae Radix, Salviae Miltiorrhizae Radix, Puerariae Radix, Schizandrae Fructus, and Glycyrrhizae Radix. Streptozotocin-induced diabetic rats were orally administered NHF (300 mg/kg of body weight/day) for 4 weeks. The diabetic rats exhibited hyperglycemia, increased food and water intake, loss of body weight gain, elevated hepatic thiobarbituric acid-reactive substances (TBARS), and decreased activities of hepatic antioxidant enzymes (such as superoxide dismutase [SOD], catalase [CAT], and glutathione peroxidase [GSH-Px]), level of mRNA of glucose transporter (GLUT) 4 in soleus muscle, and numbers of insulin-positive cells and the size of beta-cells in pancreas. Administration of NHF significantly decreased the blood glucose level and the food and water intake and considerably increased the body weights of diabetic rats. Also, NHF treatment significantly increased plasma insulin levels and the number and size of insulin-immunoreactive cells in the pancreas of diabetic rats. Administration of NHF significantly lowered the levels of TBARS and increased the activities of SOD, CAT, and GSH-Px in the liver of diabetic rats. In addition, treatment with NHF increased the mRNA levels of GLUT4 in soleus muscle. Therefore NHF may be an effective preventive and therapeutic agent for diabetes mellitus.

Cross-cultural adaptation in urban ethnobotany: the Colombian folk pharmacopoeia in London

AIM OF THE STUDY

To investigate traditional health care practices and changes in medicinal plant use among the growing Colombian community in London.

MATERIALS AND METHODS

Ethnobotanical fieldwork consisted of qualitative, in-depth, semi-structured interviews with 23 Colombians living in London and botanical identification of 46 plant species actively used as herbal remedies. Subsequently, research data were compared with literature on ethnobotany and traditional herbal medicine in the home country, using a framework on cross-cultural adaptation, adjusted for the purpose of this study.

RESULTS

Similarities and discrepancies between data and literature are interpreted as potential indicators of continuity and loss (or deculturation) of traditional remedies, respectively. Remedies used in London that are not corroborated by the literature suggest possible newly acquired uses.

CONCLUSIONS

Cross-cultural adaptation related to health care practices is a multifaceted process. Persistence, loss and incorporation of remedies into the Colombian folk pharmacopoeia after migration are influenced by practical adaptation strategies as well as by symbolic-cultural motives of ethnic identity.

Acceptance of a potential HIV/AIDS vaccine among minority women

PURPOSE

To explore the attitudes, opinions and concerns of minority women regarding acceptance of a potential HIV/ AIDS vaccine.

METHODS

In-depth interviews were conducted with high-risk minority women (> or =18 years of age) attending an urban Atlanta health clinic specializing in sexually transmitted diseases, including HIV/AIDS prevention and treatment. Interviews were transcribed and content analyzed to identify common factors related to acceptance of an HIV/AIDS vaccine.

RESULTS

Nine major themes were identified. These were general acceptance of an HIV/AIDS vaccine, concerns about the vaccine, vaccine knowledge, testing and research, provider recommendation, mistrust, alternative medicine, misperceptions and vaccine accessibility/availability. A strong theme emerged about the need for information from HIV/AIDS vaccine clinical trials, including the demographics of the studies' volunteer base, to inform decision-making about taking an HIV/AIDS vaccine in the future.

CONCLUSIONS

Although fewer than half of the women indicated they would receive or recommend the vaccine, most agreed that development of a vaccine was an important endeavor. The findings of this study may assist in future efforts to determine how best to promote acceptance of an HIV/AIDS vaccine to minority women should one become available.

Herb and supplement use among the retail population of an independent, urban herb store

The prevalence of herbal medicine use among American adults is well documented. Because of the possible herb-drug interactions, health care providers need to be aware of herb and supplement use by their patients. This descriptive pilot study (N = 35) was designed to explore the demographics, beliefs, concurrent pharmaceutical use with herbs and supplements and their primary sources of information, and reporting of use to health care providers by customers at a retail specialty "herb" store. Results revealed that 62.5% of study participants who used herbs regularly also used pharmaceuticals. Among those who used herbs and supplements with pharmaceuticals, only 33% reported that they "always" tell their care provider about them. Forty-one percent reported that they receive most of their information about herbs and supplements from retail staff, but only 3% of participants reported that their primary source of information was a doctor, nurse, or pharmacist. Findings provide direction for future study.

Associations between home remedy use and a validated self-reported adherence measure in an urban African-American population with poorly controlled hypertension

OBJECTIVE

To determine associations between home remedy use and self-reported adherence among urban African Americans with poorly controlled hypertension.

METHODS

A cross-sectional structured interview of African Americans admitted to medical units for uncontrolled hypertension at an urban academic hospital from 1999-2004. Logistic regression was used to test associations between home remedy use and self-reported adherence.

RESULTS

One-hundred-eighty-three of 272 participants completed the study (67%); 39 (21%) reported using home remedies for hypertension. In a multivariate model, home remedy use was independently associated with greater medication adherence (OR for nonadherence=0.32, 95% CI: 0.14-0.75; p<0.01) and dietary adherence (OR for changing diet=3.28, 95% CI: 1.10-9.81; p=0.03), but not lifestyle or appointment adherence. These associations remained strong while controlling for age; sex; employment status; and key covariates, including greater medication side effects (OR=4.31; 95% CI: 1.64-11.3; p<0.01), greater difficulty paying for medications (OR=2.94, 95% CI: 1.25-6.92; p=0.01) and longer duration of diagnosis (OR for log years=1.53; 95% CI: 1.02-2.33; p=0.045).

CONCLUSION

Home remedy use may be a marker of positive self-care for some hypertensive African Americans and not a promoter of nonadherence.

Protection of testicular dysfunctions by MTEC, a formulated herbal drug, in streptozotocin induced diabetic rat

Single injection of streptozotocin (STZ) resulted diabetes mellitus which was reflected here by the levels of fasting blood glucose and serum insulin. Moreover, this experimental diabetes also resulted testicular dysfunctions evaluated by count, viability and motility of sperm as well as by the activities of key enzymes for androgen synthesis. Diabetes induced testicular oxidative stress has been indicated here by the monitoring of testicular peroxidase and catalase activities as well as by quantification of TBARS and CD of testis. Testicular glucose was increased and leydig cell nuclear area was decreased in STZ induced diabetes. Treatment of herbal formulated drug named as MTEC consist of aqueous-methanol extract of Musa paradisiaca, Tamarindus indica, Eugenia jambolana and Coccinia indica to streptozotocin induced diabetic rat at the ratio of 2:2:1:1 at the dose of 60 mg/d for two times a day for 14 d resulted a significant protection in fasting blood glucose and serum insulin levels (p<0.05) along with correction of testicular above parameters towards the control level (p<0.05). This herbal formulated drug has no general toxic effects on the body weight, as well as on the activities of serum glutamate and pyruvate transaminases in serum. The results support the validity of this herbal drug for the management of testicular disorders noted in diabetic state.

Comprehensive, Integrative Management of Pain for Patients with Sickle-Cell Disease

PURPOSES

The study was conducted to: (1) investigate both pharmacologic and complementary therapies used for pain management by caregivers of children with sickle cell disease (SCD), (2) investigate the prevalence and types of complementary therapies used for pain management by caregivers of children with SCD, and (3) explore caregivers' interests in using complementary therapies in the future.

METHODS

A cross-sectional, descriptive design was used. Sixty-three caregivers of children with SCD were asked to complete a questionnaire while they visited a SCD clinic. Chi-square tests were performed to compare demographic variables, examine use of pharmacologic therapies for pain management between age groups, and compare use of pharmacologic and complementary therapies.

RESULTS

The most frequently used pain medications for children with SCD (mean age 9 years) were ibuprofen (37.5%), acetaminophen with codeine (32.1%), and acetaminophen with oxycodone (14.5%). More than 70% of 63 caregivers (mean age 33 years) were using some form of complementary therapies (3.67 +/- 2.95, range: 0-9) for their child. The most commonly used therapies were prayer, spiritual healing by others, massage, and relaxation. Complementary therapy use was significantly higher among caregivers of children who were taking two or more analgesics compared to children taking no analgesics or one analgesic (chi (2) = 3.954, p = 0.047). Although no difference was found in nonopioid analgesic use, there was significant difference in opioid analgesic use (chi (2) = 14.736, p = 0.002) and total medication use (chi (2) = 11.025, p = 0.012) between children < or = 12 years and > or =13 years.

CONCLUSIONS

Caregivers of children using greater numbers of conventional pain medications were more likely to be using complementary therapies as well. If offered in the future, many caregivers were willing to try various types of complementary therapies for pain management.

Herbal, Prescribed, and Over-the-Counter Drug Use in Older Women: Prevalence of Drug Interactions

Older adults are at particular risk for drug and herbal interactions because they have multiple health problems that require treatment and are generally more susceptible to adverse drug effects. This study used a database containing self-reported herbal, prescription, and over-the-counter (OTC) drugs concurrently taken by a sample of 58 women who were aged 65 years or older. Drug-drug interactions (DDIs) were identified using a Web-based pharmaceutical program. At least 1 moderate or high-risk DDI was identified in 74% of participants, with 136 total DDIs identified. Fifty-two percent (71) of total DDIs were between prescribed and OTC or herbals, with 63% (45) of these involving nonsteroidal antiinflammatory drugs (NSAIDs). It is imperative that health care providers identify all prescribed, OTC, and herbal drugs taken by their patients and assess all interactions in order to avoid the possibility of adverse drug effects.

The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products

The purpose of this paper is to explore the possibility that adverse reactions and drug interactions arising from the use of homeopathic and herbal medicines could lead to confusion when adverse reactions to conventional medicines are reported. An extensive literature review was conducted on the occurrence of adverse reactions and drug interactions following the use of homeopathic or herbal remedies, and the potential for these to confound adverse event reporting to conventional medicines considered. The survey demonstrates the potential for herbal remedies and homeopathic products, to produce adverse drug reactions or drug interactions, and shows the scope for potential for confusion with those arising from conventional medicines. There is a need for greater awareness that adverse reactions apparently due to a conventional medicine, might in reality be due to a herbal medicine or a drug interaction between a herbal medicine and a conventional drug, particularly when a health professional is unaware of the extent of a patient's self-medication with alternative therapies.