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Syed Shamsuddin SM, Ahmad N, Idris IB, Aizuddin AN, Ibrahim R, Mustafa Din W, Kaharudin IH, Abdul Rahman MR, Wahab S, Mohd Ghazali Q. Natural health product knowledge as a significant factor associated with health-promoting lifestyle in a low-income urban community in Kuala Lumpur. BMC Public Health 2024; 24:2146. [PMID: 39112939 PMCID: PMC11308702 DOI: 10.1186/s12889-024-19601-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 07/26/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Low income communities are vulnerable to non-communicable diseases (NCDs), which affect their economy and disability status. An effective approach to address the NCD burden is through the multidimensional concept of health-promoting lifestyle. Another preferred approach by the population worldwide for NCD treatment is natural health product (NHP). Studies on NHP and health-promoting lifestyle among this vulnerable population, specifically the low-income urban community, are limited. Therefore, this study, aimed at investigating the NHP knowledge and health-promoting lifestyle, and to determine the factors associated with health-promoting lifestyle in a low income urban community in Cheras, Kuala Lumpur. This study has focused on sociodemographic characteristics, annual health monitoring activities, and health status, which are modifiable and non-modifiable factors. METHODS Phase 1 of the study involves developing the Malay-version NHP knowledge questionnaire, whereas Phase 2 involves a cross-sectional study of 446 randomly selected low-income respondents to determine their level of health-promoting lifestyle and the associated factors. The respondents' sociodemographic, socioeconomic, health monitoring activity, health status, and NHP knowledge data were obtained using the newly developed Malay-version NHP questionnaire and the Health-Promoting Lifestyle Profile II (HPLP II) questionnaire. The independent variables include sociodemographic status, annual health monitoring activities, health status and NHP knowledge were analysed using simple and multiple linear regression. RESULTS In this study, the 10-item NHP knowledge questionnaire developed in the Malay version contains two domains [safe use (eight items) and point of reference (two items)] (total variance explained: 77.4%). The mean of NHP knowledge score was 32.34 (standard deviation [SD] 7.37). Meanwhile, the mean score of health-promoting lifestyle was 109.67 (SD 25.01). The highest and lowest scores of health-promoting lifestyles are attributed to spiritual growth and physical activity, respectively. Ethnicity is associated with a higher health-promoting lifestyle level, same goes to the occupational status - NHP knowledge interaction. "Unclassified" education status and annual blood glucose level monitoring are associated with a lower level of health-promoting lifestyle. CONCLUSION A new questionnaire in Malay version was developed to measure NHP knowledge. Compared to other subpopulations, the respondents' health-promoting lifestyle levels in this study were low, associated with ethnicity, education status, and health monitoring activities. The findings provided insight into the interaction between NHP knowledge and occupational status, which is associated with a higher health-promoting lifestyle level. Accordingly, the future health-promoting lifestyle intervention programmes in healthcare delivery should target these factors.
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Affiliation(s)
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Idayu Badilla Idris
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wardah Mustafa Din
- Pusat Pengajian Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Iszan Hana Kaharudin
- Pusat Pengajian Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Mohd Rizam Abdul Rahman
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sazman Wahab
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Qistina Mohd Ghazali
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Roziman NSM, Mustafa Din W, Mahadi Z, Islahudin F, Said MM. Safe use elements of finished herbal products: insights from consumers and practitioners in Malaysia. BMC Complement Med Ther 2024; 24:252. [PMID: 38961355 PMCID: PMC11223321 DOI: 10.1186/s12906-024-04546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 06/11/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The use of finished herbal products (FHPs) among Malaysians today is expanding rapidly leading to a huge market of FHPs in the country. However, the mass production of FHPs in today's market is alarming due to safety-use issues that could lead to serious adverse effects. Nevertheless, demands are still high for FHPs as most consumers perceived it as safe to consume as it is made from natural substances as the active ingredients. This study aims to explore the safe use elements of FHPs identified by two stakeholders: consumers and practitioners in Malaysia and further compare these elements with the current regulations. METHODS As an exploratory study, its approach is to investigate at an in-depth level of understanding of safe use elements from the involved stakeholders: consumers and practitioners. We had a total of 4 focus group discussion sessions (1 FGD session with consumer and 3 FGD sessions with practitioners) as a method of collecting data from the participants. The FGDs were conducted in local native Malaysian and then being translated by researchers without changing their meanings. Thematic analysis was done which involves methodically reading through the verbatim transcripts and consequently segmenting and coding the text into categories that highlight what the participants have discussed. RESULTS From the result, we found that both practitioners and consumers agreed a safe FHP must be in compliance with the guidelines from the Ministry of Health Malaysia (MOH). There are other safe use elements highlighted including halal certification, trusted over-the-counter outlets, and published reports on the safety, efficacy, and quality. CONCLUSIONS In conclusion, both practitioners and consumers agreed that the most important safe-use element is compliance with MOH guidelines, but the depth of discussion regarding the safety elements among these stakeholders holds a very huge gap. Thus, initiatives must be planned to increase the knowledge and understanding about the MOH guidelines towards achieving a sustainable ecosystem in the safe use of FHPs.
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Affiliation(s)
| | - Wardah Mustafa Din
- Pusat Pengajian Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, 43650 UKM, Selangor, Malaysia.
| | - Zurina Mahadi
- Pusat Pengajian Citra Universiti, Universiti Kebangsaan Malaysia, Bangi, 43650 UKM, Selangor, Malaysia
| | - Farida Islahudin
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Mazlina Md Said
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
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Mustafa Din W, Arham AF, Md. Yusoff Y. Set of data on consumers' perceived safety and efficacy towards natural health products to control or cure Covid-19 viruses in Malaysia. Data Brief 2024; 54:110548. [PMID: 38912420 PMCID: PMC11190492 DOI: 10.1016/j.dib.2024.110548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 06/25/2024] Open
Abstract
This study evaluated the level of knowledge of effects, knowledge of safe use, information complexity of natural health products and consumers' perceived safety and efficacy toward natural health products used to control or cure Covid-19 viruses in Malaysia. The validated questionnaires were used to survey randomly selected stakeholders in Malaysia, who were asked to participate voluntarily in an online survey from 1st September 2020 to 31st December 2020. 723 respondents of adults above 18 years old returned completed questionnaires. The survey used for data collection consisted of 5 questions on knowledge of effects, 4 questions on knowledge for safe-use, 9 questions on perception towards safety and efficacy and 4 questions on the information complexity of natural health products. Besides that, 8 questions are being asked on the demography of respondents at the very end of the survey. The Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. The mean score, correlation and regression values were the focus of this study. The findings provide various opportunities to investigate Malaysian consumers' perceptions which facilitates the development of regulation and strategic plans related to health, and encourage additional research by other researchers interested in the measures and data given.
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Affiliation(s)
- Wardah Mustafa Din
- School of Liberal Studies, Universiti Kebangsaan Malaysia, 43650 Bangi, Malaysia
| | - Ahmad Firdhaus Arham
- School of Liberal Studies, Universiti Kebangsaan Malaysia, 43650 Bangi, Malaysia
| | - Yusnaini Md. Yusoff
- School of Liberal Studies, Universiti Kebangsaan Malaysia, 43650 Bangi, Malaysia
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Widjiati W, Luqman EM, Kuntjorodjakti S, Aulanni’am A, Shabira Z, Taqwa SF, Mega RL, Chou D, Mubarak AS, Hendrawan VF. The impact of Apis dorsata forest honey administration on follicle-stimulating hormone and luteinizing hormone levels in rats ( Rattus norvegicus) forced swim test as a chronic physical animal model. Open Vet J 2024; 14:738-742. [PMID: 38549577 PMCID: PMC10970116 DOI: 10.5455/ovj.2024.v14.i2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/27/2024] [Indexed: 04/02/2024] Open
Abstract
Background Chronic physical stress has many effects on the nervous system and can cause structural changes in different parts of the brain and hemomodulatory, including hormonal. Current pharmacotherapeutic treatments have limited efficacy and are associated with many deleterious side effects. Aim The aim of this research is to determine how Apis dorsata forest honey administration affects follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels in rats who are subjected to forced swim tests as a model of chronic physical stress placed in a container filled with water from which it cannot escape. Methods This was an experimental laboratory study with 32 rats divided into four treatment groups: control (C), Treatment 1 (T1) with a forced swim test + honey (2 g/rat/day), Treatment 2 (T2) with a forced swim test + honey (4 g/rat/day), and Treatment 3 (T3) with a forced swim test + honey (6 g/rat/day). All treatments were administered for 14 days. Then, blood was taken for FSH and LH serum tests, and a one-way ANOVA and Duncan test were used to statistically test the data analysis. Results The results of this study indicate that the administration of forest honey had no significant effect (p > 0.05) on the FSH parameter, but there was a significant decrease in LH levels in the T2 and T3 groups (p < 0.05). Conclusion It can be concluded that giving forest honey to rats who were subjected to a 14-day forced swim test had no effect on FSH and LH levels. In rats given a forced swim test as a model of chronic stress, administration at doses of 4 and 6 g/rat/day reduced LH serum levels. Thus, giving forest honey could maintain reproductive health in rat that experience chronic stress.
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Affiliation(s)
- Widjiati Widjiati
- Department of Veterinary Science, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Epy Muhammad Luqman
- Department of Veterinary Science, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Suryo Kuntjorodjakti
- Department of Veterinary Science, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Aulanni’am Aulanni’am
- Department of Chemistry, Faculty of Medicine, Brawijaya University, Malang, East Java, Indonesia
| | - Zahra Shabira
- Magister Student of Veterinary Reproduction, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Sultan Fadhilla Taqwa
- Magister Student of Veterinary Reproduction, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Riski Lesta Mega
- Magister Student of Veterinary Reproduction, Veterinary Medicine Faculty, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Dean Chou
- Department of Biomedical Engineering National Cheng Kung University, Tainan City, Taiwan
| | - Ahmad Shofy Mubarak
- Department of Marine, Faculty of Fisheries and Marine Sciences, Airlangga University, Mulyorejo, Surabaya, East Java, Indonesia
| | - Viski Fitri Hendrawan
- Departement of Veterinary Reproduction, Veterinary Medicine Faculty, Brawijaya University, Puncak Dieng, Dau, Malang, East Java, Indonesia
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Ab Dullah SS, Sabran MR, Hasiah AH, Abdullah R. Risk assessment of aflatoxin B 1 in herbal medicines and plant food supplements marketed in Malaysia using margin of exposure and RISK21 approaches. Genes Environ 2023; 45:31. [PMID: 37993956 PMCID: PMC10666461 DOI: 10.1186/s41021-023-00286-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023] Open
Abstract
Aflatoxin B1 (AFB1) is a mycotoxin produced by several species of Aspergillus fungi which can cause liver cancer in animals and humans. This study aims to perform the risk assessment of AFB1 in herbal medicines and plant food supplements (PFS) in Malaysian market. A total of 31 herbal medicines and PFS were purchased through online platforms and over the counter using a targeted sampling strategy. Of 31 samples analysed using the ELISA method, 25 (80.6%) were contaminated with AFB1 at levels ranged from 0.275 to 13.941 μg/kg. The Benchmark Dose Lower Confidence level of 10 (BMDL10) of 63.46 ng/kg bw/day and the estimated dietary intake of the adult population ranged from 0.006 to 10.456 ng/kg bw/day were used to calculate the Margin of Exposure (MOE). The MOEs for 24 (96%) out of the 25 positive samples were lower than 10,000. The RISK21 matrix revealed that AFB1 exposure levels from herbal medicines and PFS differed greatly over the world. The calculated population risk of acquiring liver cancer from AFB1 exposure ranged from 0 to 0.261 cancers/100,000 populations/year and accounted for an estimated percentage of liver cancer incidence ranged from 0.002 to 4.149%. This study revealed a moderate risk of liver cancer attributable to AFB1 from herbal medicine and PFS among Malaysian populations and emphasised an urgency for risk management actions.
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Affiliation(s)
- Siti Soleha Ab Dullah
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia
- Biomedical Research Policy and Strategic Planning Unit, Institute for Medical Research, National Institute of Health, Persiaran Setia Murni, Setia Alam, 40170, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Mohd Redzwan Sabran
- Department of Nutrition, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia
| | - Ab Hamid Hasiah
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia
| | - Rozaini Abdullah
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, 43400 UPM, Serdang, Selangor Darul Ehsan, Malaysia.
- Natural Medicines and Products Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
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Widjiati W, Kuntjorodjakti S, Ananda AT, Sajida MVP, Ilmi AF, Adisti MZ, Chou D, Luqman EM. The Effect of Administering Forest Honey to Rats Exposed to Physical Stress on Corticosteroid Levels, Folliculogenesis and the Number of Corpus Luteum. BIOMEDICAL AND PHARMACOLOGY JOURNAL 2023; 16:1431-1440. [DOI: 10.13005/bpj/2721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Livestock that has stress releases glucocorticoids in response to it, and it causes inhibition of the hypothalamus-pituitary-gonadal axis (HPG) signaling pathway so that it reduces reproductive efficiency. Forest honey can reduce corticosteroid levels as a stress response from physical stress induction which is expected to increase reproductive efficiency including folliculogenesis and the formation of the corpus luteum. This study aims to determine the effect of forest honey on rats (Rattus novergicus) exposed to physical stress on corticosteroid levels, folliculogenesis, and the number of corpus luteum. This study is an experimental laboratory one using 32 rats which were divided into 4 treatment groups; control positive (C) treated with physical stress, treatment 1 (T1) treated with physical stress + honey 2 g/rat/day PO, treatment 2 (T2) treated with physical stress + honey 4 g/rat/day PO and treatment 3 (T3) treated with physical stress + honey 6 g/rat/day PO. All treatments were carried out for 14 days. The results showed that T1 had the lowest corticosteroid level compared to all treatment groups and the corticosteroid level of this group was significantly different (p <0.05) compared to that of C and T3. The folliculogenesis profile showed that the number of primary secondary, tertiary, and Graafian follicles of group T1 was significantly different (p<0.05) compared to that of C, T2, and T3. In terms of the number of corpus luteum, it showed that T1 had the highest number of corpus luteum, and the number of corpus luteum in this group was significantly different (p<0.05) from that of C, T2, and T3. It can be concluded that the administration of forest honey at a dose of 2g/rat/day could reduce corticosteroid levels, improve the folliculogenesis profile, and increase the number of corpus luteum in rats exposed to physical stress. The use of forest honey could reduce corticosteroid levels as a stress response from physical stress induction which was expected to increase reproductive efficiency.
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Affiliation(s)
- Widjiati Widjiati
- 1Department of Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia,
| | - Suryo Kuntjorodjakti
- 1Department of Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia,
| | - Aditya Tri Ananda
- 2Postgraduate Reproductive Biology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia
| | - Mey Vanda Pusparina Sajida
- 2Postgraduate Reproductive Biology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia
| | - Alivia Fairuz Ilmi
- 2Postgraduate Reproductive Biology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia
| | - Meisa Zalfa Adisti
- 3Graduate Student Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia,
| | - Dean Chou
- 4Department of Biomedical Engineering National Cheng Kung University, No. 1, Dasyue Rd, East District, Tainan City, Taiwan
| | - Epy Muhammad Luqman
- 1Department of Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Jawa Timur, Indonesia,
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Saadi H, Jafari S, Karimi S. Factors affecting the intention of Iranian rural women to use medicinal herbs. BMC Complement Med Ther 2023; 23:170. [PMID: 37245033 DOI: 10.1186/s12906-023-03964-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/18/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND This study aimed to identify factors affecting the behavioral intention of Iranian rural women to use medicinal herbs. The research model was developed by integrating "dissatisfaction with modern medicine" into the "theory of planned behavior". METHODS Data were collected through questionnaire from a sample of 260 Iranian rural women, which were randomly selected. The validity and reliability of the scale were confirmed using expert opinions and Cronbach's alpha method, respectively. RESULTS Based on the results of structural equation modeling, attitude (β = 0.44; p < 0.01), subjective norms (β = 0.27; p < 0.01) and dissatisfaction with modern medicine (β = 0.11; p < 0.05) had significant positive effects on rural women's intention to use medicinal herbs. In addition, subjective norms indirectly affected rural women's intention to use medicinal herbs through attitude (β = 0.23; p < 0.01). CONCLUSIONS Subjective norms was a key factor in determining the intention of Iranian rural women to use medicinal herbs, followed by attitude and dissatisfaction with modern medicine. Therefore, this study could contribute to our understanding on how the intention of Iranian rural women to use medicinal herbs was influenced by different factors.
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Affiliation(s)
- Heshmatollah Saadi
- Department of Agricultural Extension and Education, Bu-Ali Sina University, Hamedan, Iran.
| | - Somayeh Jafari
- Department of Agricultural Extension and Education, Bu-Ali Sina University, Hamedan, Iran
| | - Saeid Karimi
- Department of Agricultural Extension and Education, Bu-Ali Sina University, Hamedan, Iran
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Iddrisu M, Doat AR, Abdulai AM, Wuni A. They patronize herbal medicine, coincidence or planned behaviour: A case of hypertensive patients in Tamale? Nurs Open 2023. [PMID: 37060167 DOI: 10.1002/nop2.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/08/2023] [Accepted: 03/24/2023] [Indexed: 04/16/2023] Open
Abstract
AIM This study assessed, if use of herbal medicine (HM) among hypertensive patients is coincidence or planned. DESIGN Cross-sectional survey. METHODS The study used a cross-sectional survey for collection of data from four (4) herbal medicine clinics in the Tamale metropolis in northern Ghana. RESULTS The final or overall regression model was significant at R2 = 0.350, F(7, 214) = 16.464, p < 0.001. No sociodemographic characteristic predicted herbal medicine use. Only religion and educational level were associated with herbal medicine use. Attitude (p = 0.002), subjective norms (p = 0.001) and behavioural intention (p = 0.000) significantly predicted HM use. PUBLIC CONTRIBUTION Data were collected from respondents only after they had verbally given free and informed consent to take part in the study. The results of this study therefore showed that herbal medicine use among these patients is not coincidence but planned. Health professionals by this study should appreciate the effect of religion and educational background in their health education on Herbal Medicines.
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Affiliation(s)
| | - Abdul Razak Doat
- Department of Nursing, School of Nursing and Midwifery, CK Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | | | - Abubakari Wuni
- Nursing and Midwifery Training College, Tamale, Ghana
- Department of medicine for the elderly, Cambridge University Hospital's NHS Foundation, Adddenrookes Hospital, Cambridge United Kingdom, Cambridge, United Kingdom
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Xiong Y, Liu C, Li M, Qin X, Guo J, Wei W, Yao G, Qian Y, Ye L, Liu H, Xu Q, Zou K, Sun X, Tan J. The use of Chinese herbal medicines throughout the pregnancy life course and their safety profiles: a population-based cohort study. Am J Obstet Gynecol MFM 2023; 5:100907. [PMID: 36813231 DOI: 10.1016/j.ajogmf.2023.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Chinese herbal medicines have been long used among pregnant populations in China. However, despite the high susceptibility of this population to drug exposure, it continued to remain unclear about how often they were used, to what extent they were used at different pregnancy stages, and whether their use was based on sound safety profiles, particularly when used in combination with pharmaceutical drugs. OBJECTIVE This descriptive cohort study aimed to systematically investigate the use of Chinese herbal medicines throughout pregnancy and their safety profiles. STUDY DESIGN A large medication use cohort was developed by linking a population-based pregnancy registry and a population-based pharmacy database, which documented all prescriptions at both outpatients and inpatients from conception to 7 days after delivery, including pharmaceutical drugs and processed Chinese herbal medicine formulas that were approved by the regulatory authority and prepared under the guidance of national quality standards. The prevalence of the use of Chinese herbal medicine formulas, prescription pattern, and combination use of pharmaceutical drugs throughout pregnancy were investigated. Multivariable log-binomial regression was performed to assess temporal trends and further explore the potential characteristics associated with the use of Chinese herbal medicines. Of note, 2 authors independently conducted a qualitative systematic review of patient package inserts of the top 100 Chinese herbal medicine formulas used to identify their safety profiles. RESULTS This study included 199,710 pregnancies; of those pregnancies, 131,235 (65.71%) used Chinese herbal medicine formulas, including 26.13% during pregnancy (corresponding to 14.00%, 8.91%, and 8.26% in the first, second, and third trimesters of pregnancy) and 55.63% after delivery. The peak uses of Chinese herbal medicines occurred between 5 and 10 weeks of gestation. The use of Chinese herbal medicines significantly increased over the years (from 63.28% in 2014 to 69.59% in 2018; adjusted relative risk, 1.11; 95% confidence interval, 1.10-1.13), which was particularly great during pregnancy (from 18.47% in 2014 to 32.46% in 2018; adjusted relative risk, 1.84; 95% confidence interval, 1.77-1.90). Our study observed 291,836 prescriptions involving 469 Chinese herbal medicine formulas, and the top 100 most used Chinese herbal medicines accounted for 98.28% of the total prescriptions. Of those, a third (33.39%) were dispensed at outpatient visits; 6.79% were external use, and 0.29% were administered intravenously. However, Chinese herbal medicines were very often prescribed in combination with pharmaceutical drugs (94.96% overall), involving 1175 pharmaceutical drugs with 1,667,459 prescriptions. The median of pharmaceutical drugs prescribed in combination with Chinese herbal medicines per pregnancy was 10 (interquartile range, 5-18). The systematic review of drug patient package inserts found that the 100 most frequently prescribed Chinese herbal medicines contained a total of 240 herb constituents (median, 4.5); 7.00% were explicitly indicated for pregnancy or postpartum conditions; 43.00% were reported with efficacy or safety data from randomized controlled trials. Information was lacking about whether the medications had any reproductive toxicity, were excreted in human milk, or crossed the placenta. CONCLUSION The use of Chinese herbal medicines was prevalent throughout pregnancy and increased over the years. The use of Chinese herbal medicines peaked in the first trimester of pregnancy and was very often used in combination with pharmaceutical drugs. However, their safety profiles were mostly unclear or incomplete, suggesting a strong need for postapproval surveillance for the use of Chinese herbal medicines during pregnancy.
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Affiliation(s)
- Yiquan Xiong
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Chunrong Liu
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Mingxi Li
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Xuan Qin
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Jin Guo
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Wanqiang Wei
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Guanhua Yao
- Xiamen Health Commission, Xiamen, China (Dr Yao and Dr Qian)
| | - Yongyao Qian
- Xiamen Health Commission, Xiamen, China (Dr Yao and Dr Qian)
| | - Lishan Ye
- Xiamen Health and Medical Big Data Center, Xiamen, China (Ms Ye, Mr Liu, and Mr Xu)
| | - Hui Liu
- Xiamen Health and Medical Big Data Center, Xiamen, China (Ms Ye, Mr Liu, and Mr Xu)
| | - Qiushi Xu
- Xiamen Health and Medical Big Data Center, Xiamen, China (Ms Ye, Mr Liu, and Mr Xu)
| | - Kang Zou
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Xin Sun
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan).
| | - Jing Tan
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan).
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Yussof I, Ab Muin NF, Mohd M, Hatah E, Mohd Tahir NA, Mohamed Shah N. Breast cancer prevention and treatment misinformation on Twitter: An analysis of two languages. Digit Health 2023; 9:20552076231205742. [PMID: 37808244 PMCID: PMC10559708 DOI: 10.1177/20552076231205742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
Objective To determine the prevalence and types of misinformation on Twitter related to breast cancer prevention and treatment; and compare the differences between the misinformation in English and Malay tweets. Methods A total of 6221 tweets related to breast cancer posted between 2018 and 2022 were collected. An oncologist and two pharmacists coded the tweets to differentiate between true information and misinformation, and to analyse the misinformation content. Binary logistic regression was conducted to identify determinants of misinformation. Results There were 780 tweets related to breast cancer prevention and treatment, and 456 (58.5%) contain misinformation, with significantly more misinformation in Malay compared to English tweets (OR = 6.18, 95% CI: 3.45-11.07, p < 0.001). Other determinants of misinformation were tweets posted by product sellers and posted before the COVID-19 pandemic. Less misinformation was associated with tweets utilising official/peer-reviewed sources of information compared to tweets without external sources and those that utilised less reliable information sources. The top three most common content of misinformation were food and lifestyle, alternative medicine and supplements, comprising exaggerated claims of anti-cancer properties of traditional and natural-based products. Conclusion Misinformation on breast cancer prevention and treatment is prevalent on social media, with significantly more misinformation in Malay compared to English tweets. Our results highlighted that patients need to be educated on digital health literacy, with emphasis on utilising reliable sources of information and being cautious of any promotional materials that may contain misleading information. More studies need to be conducted in other languages to address the disparity in misinformation.
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Affiliation(s)
- Izzati Yussof
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Fa’izah Ab Muin
- Oncology and Radiotherapy Department, Hospital Canselor Tuanku Muhriz, Cheras, Malaysia
| | - Masnizah Mohd
- Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ernieda Hatah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Asyikin Mohd Tahir
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noraida Mohamed Shah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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11
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Liew CH, Shabaruddin FH, Dahlui M. The Burden of Out-of-Pocket Expenditure Related to Gynaecological Cancer in Malaysia. Healthcare (Basel) 2022; 10:healthcare10102099. [PMID: 36292545 PMCID: PMC9601824 DOI: 10.3390/healthcare10102099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 01/09/2023] Open
Abstract
This study aimed to estimate the economic burden on gynaecological cancer patients and their households, in terms of out-of-pocket expenditure, catastrophic health expenditure (CHE) and poverty impact. A cross-sectional study was conducted at an academic tertiary-care health centre in an upper-middle-income country. Data were obtained via structured interviews of 120 gynaecological cancer patients alongside review of medical charts. Mean (SD) and median (IQR) annual household out-of-pocket expenditures were USD 2780 (SD = USD 3926) and USD 1396 (IQR = 3013), respectively. Two thirds (n = 77/120, 64%) of households experienced CHE and 17% (n = 20/120) were impoverished due to out-of-pocket expenditure related to gynaecological cancer. Factors associated with CHE, explored using multivariate logistic regression analysis, estimated that the highest income quintile households, Q5, were 90% less likely to incur CHE compared to the lowest income quintile households, Q1 (adjusted odds ratio = 0.100; p-value < 0.05) and that patients who were not receiving chemotherapy were 88% less likely to incur CHE compared to those receiving chemotherapy (adjusted odds ratio = 0.120; p-value < 0.05). These results indicate the necessity to broaden the coverage of existing financial assistance for patients from low- and middle-income households, such as extending coverage to adult patients of all ages and to those treated in all public hospitals, including academic health centres.
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Affiliation(s)
- Chee Hui Liew
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Department of Pharmacy, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur 50586, Malaysia
| | - Fatiha Hana Shabaruddin
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence:
| | - Maznah Dahlui
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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12
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Palileo-Villanueva LM, Palafox B, Amit AML, Pepito VCF, Ab-Majid F, Ariffin F, Balabanova D, Isa MR, Mat-Nasir N, My M, Renedo A, Seguin ML, Yusoff K, Dans AL, Mckee M. Prevalence, determinants and outcomes of traditional, complementary and alternative medicine use for hypertension among low-income households in Malaysia and the Philippines. BMC Complement Med Ther 2022; 22:252. [PMID: 36180884 PMCID: PMC9526286 DOI: 10.1186/s12906-022-03730-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Traditional, complementary and alternative medicine (TCAM) is used to treat a broad range of conditions. In low- and middle-income countries (LMICs), TCAM use is particularly common among those with low socio-economic status. To better understand the patterns and impact of TCAM use on the management of non-communicable diseases in these populations, this study examines the prevalence and characteristics of TCAM use for hypertension, its determinants, and its association with hypertension management outcomes and wellbeing among low-income adults in two Southeast Asian countries at different levels of economic and health system development, Malaysia and the Philippines. METHODS We analysed cross-sectional data from 946 randomly selected adults diagnosed with hypertension from low-income rural and urban communities in Malaysia (n = 495) and the Philippines (n = 451). We compared the prevalence, characteristics and household expenditure on TCAM use between countries and used multi-level, mixed-effects regression to estimate associations between TCAM use and its determinants, and five hypertension management outcomes and wellbeing. RESULTS The prevalence of TCAM use to manage hypertension was higher in the Philippines than in Malaysia (18.8% vs 8.8%, p < 0.001). Biologically-based modalities, e.g. herbal remedies, were the most common type of TCAM used in both countries, mainly as a complement, rather than an alternative to conventional treatment. Households allocated around 10% of health spending to TCAM in both countries. Belief that TCAM is effective for hypertension was a positive predictor of TCAM use, while belief in conventional medicine was a negative predictor. TCAM use was not strongly associated with current use of medications for hypertension, self-reported medication adherence, blood pressure level and control, or wellbeing in either country. CONCLUSIONS A small, but significant, proportion of individuals living in low-income communities in Malaysia and the Philippines use TCAM to manage their hypertension, despite a general lack of evidence on efficacy and safety of commonly used TCAM modalities. Recognising that their patients may be using TCAM to manage hypertension will enable health care providers to deliver safer, more patient-centred care.
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Affiliation(s)
| | - Benjamin Palafox
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Centre for Global Chronic Conditions, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Arianna Maever L Amit
- College of Medicine, University of the Philippines Manila, Manila, Philippines.,School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Veincent Christian F Pepito
- College of Medicine, University of the Philippines Manila, Manila, Philippines.,School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Fadhlina Ab-Majid
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Farnaza Ariffin
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Dina Balabanova
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Centre for Global Chronic Conditions, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Mohamad-Rodi Isa
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Nafiza Mat-Nasir
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Mazapuspavina My
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Alicia Renedo
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Centre for Global Chronic Conditions, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Maureen L Seguin
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Centre for Global Chronic Conditions, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Khalid Yusoff
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.,Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Antonio L Dans
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Martin Mckee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Centre for Global Chronic Conditions, 15-17 Tavistock Place, London, WC1H 9SH, UK
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13
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van Hunsel FPAM, van der Kooi D, van de Koppel S, Kroes BH, Woerdenbag HJ. Analysis of Reports on Adverse Drug Reactions Related to Herbal Medicinal Products and Herbal Supplements in the Netherlands Received by the National Pharmacovigilance Centre Lareb. Drug Saf 2022; 45:651-661. [PMID: 35608783 DOI: 10.1007/s40264-022-01180-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The inclusion of herbal medicinal products and herbal supplements in pharmacovigilance systems is important because a systematic approach of collecting and analyzing adverse drug reactions related to these products will help practitioners, patients, and regulators to gain more knowledge and prevent harm. OBJECTIVE We aimed to categorize the adverse drug reaction reports on herbal medicinal products and herbal supplements submitted to the Pharmacovigilance Centre Lareb between 1991 and February 2021 on the basis of their regulatory status, herbs included, and adverse drug reactions involved. METHODS We categorized products on the basis of their registration status and herbal ingredients. The products were then categorized according to the Herbal Anatomical Therapeutic Chemical Classification System. We used descriptive statistics in Microsoft Excel 2019. Pivot tables were used for the analysis and presentation of the data. RESULTS Until February 2021, a total of 789 reports of herbal medicinal products and herbal supplements were received by Lareb. In these reports, a total of 823 herbal products were labeled as suspect. These products caused a total of 1727 adverse drug reactions. Of the 823 products, 229 were registered as a medicine, and 594 were on the market as a herbal supplement. Of the 823 herbal products, 522 reports concerned single-herb products, 256 reports concerned combination products, 27 reports concerned vitamin products containing herbal ingredients, and 18 reports concerned product issues. Approximately 15% of reports concerned serious adverse drug reactions, and adulterated products harbored a high risk of causing serious adverse drug reactions. CONCLUSIONS Analysis of the herbal medicinal products and herbal supplements in the Dutch pharmacovigilance database revealed a variety of suspected herbal ingredients. The reports provide insight into the variety of herbal products used in the Netherlands and the adverse reactions associated with their use. Pharmacovigilance of herbal products is essential to ensure their safe use.
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Affiliation(s)
| | - Djurre van der Kooi
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.,Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - Sonja van de Koppel
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Burt H Kroes
- Dutch Medicines Evaluation Board, Utrecht, The Netherlands
| | - Herman J Woerdenbag
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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14
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Park JE, Yi J, Kwon O. Twenty years of traditional and complementary medicine regulation and its impact in Malaysia: achievements and policy lessons. BMC Health Serv Res 2022; 22:102. [PMID: 35078459 PMCID: PMC8788105 DOI: 10.1186/s12913-022-07497-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many countries are trying to integrate traditional and complementary medicine (T&CM) into their health care systems. However, it is not easy to integrate T&CM within a given health care system. This study aims to draw policy outcomes and lessons from the case of Malaysia, which has been making efforts for over 20 years to integrate various types of T&CM into the national health care system (NHS).
Methods Documents were searched in major databases and websites using words such as Malaysia and T&CM, and additional documents were secured using snowballing techniques. Data were classified and organized according to the World Health Organization health systems framework.
Results Malaysia has focused on managing the safety and quality of T&CM, and to that end it has been institutionalized by enacting specialized laws rather than by applying existing medical law directly. Malaysia was able to institutionalize T&CM by adopting a step-by-step approach that considered the appropriateness of administrative policies and measures. Conclusions Malaysia's experiences in implementing its T&CM policies will raise practical implications for countries struggling to integrate their existing T&CM into the NHS and utilize it for universal health coverage.
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15
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Alotiby A, Alshareef M. Comparison Between Healthcare Professionals and the General Population on Parameters Related to Natural Remedies Used During the COVID-19 Pandemic. J Multidiscip Healthc 2022; 14:3523-3532. [PMID: 34992379 PMCID: PMC8714005 DOI: 10.2147/jmdh.s343140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/15/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Herbal medicine is commonly used for symptom relief and treatment because of its availability and lack of prescription regulation. However, the use of herbs is associated with adverse effects, drug interaction, and sometimes life-threatening complications. During the coronavirus disease (COVID-19) pandemic, herbs were used when modern medicine failed to treat or immunize people against the virus in its early course. Although trials are still ongoing, herbal medicine was recommended for COVID-19 in Eastern countries based on expert consensus. Methods A descriptive web-based anonymous survey was created and distributed online all-over Saudi Arabia to gather information on commonly used herbs, knowledge, and attitude towards them among general population (GP) and health care workers (HCWs). Results Although the use of natural products was high among the GP, both groups used similar herbs, reflecting cultural traditions and beliefs. However, the GP had better knowledge about and attitudes toward the use of herbal medicine than HCWs did. Conclusion Mental exhaustion during the COVID-19 pandemic and a lack of research-based evidence might influence HCWs’ trust in and knowledge about herbal medicine. Therefore, research and educational courses on herbal medicine for all medical practitioners are needed for proper patient counseling to reduce risk and ensure patient safety.
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Affiliation(s)
- Amna Alotiby
- Department of Hematology and Immunology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Maram Alshareef
- Department of Community Medicine and Pilgrims Health, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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16
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Mohamad TAST, Islahudin F, Jasamai M, Jamal JA. Traditional Practitioner’s Knowledge of Malay Post-Partum Herbal Remedies in Malaysia. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/ani1usvkcv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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17
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Denu ZA, Yassin MO, Yesuf M, Azale T, Biks GA, Gelaye KA. Disability scores rate changes and predictors among road traffic injury victims admitted at Gondar specialized comprehensive hospital northwest Ethiopia: A prospective follow-up study. TRAFFIC INJURY PREVENTION 2021; 23:40-45. [PMID: 34739307 DOI: 10.1080/15389588.2021.1990895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Measuring the level of disability following trauma is a key step for secondary and tertiary level trauma prevention. It can give important evidence for decision-makers and program implementers on the need for establishing rehabilitation centers. METHODS This is a longitudinal follow-up study on 235 road traffic injury survivors. Patients were followed for 12 months, and the outcome was ascertained using the brief WHODAS-II 12-item instrument at 1, 3, 6, and 12-months post-injury. The level of disability was divided into five groups from no disability to very severe based on their disability scores. Work status was assessed at each survey using a single question "are you back to work?" We employed a linear mixed model to identify disability scores changes over time and risk factors associated with disability. Statistically, a significant association was declared at p < 0.05. RESULTS The overall mean disability score was 24.9 ± 11.3 at one month and 8.3 ± 6.4 after 12 months of injury. Disability score has decreased by 1.3 units over time during 12 months post-injury. Functional limitation persisted on 25-88% of participants at specific dimensions of disability at the end of the study. After a year of injury, 44% of participants didn't return to work. Injury severity score (β = 0.47, p < 0.001, length of hospital stays (β = 0.88, p < 0.005) and discharge against medical advice (β = 2.18, p < 0.001) were found to be predictors of disability following road traffic injuries. CONCLUSION The current study demonstrated that, though there was a decrease in disability score over time, a significant number of participants were with some degree of limitation after one year of injury, and nearly half of them didn't return to work. Shortening of long waiting times and counseling services need to be considered by the hospital. Community-based Rehabilitation centers (CBR) should be expanded. Further study should be conducted to uncover the reasons for preferring traditional bone fixers over medical management.
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Affiliation(s)
- Zewditu Abdissa Denu
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mensur Osman Yassin
- Department of Surgery, School of Medicine College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhammed Yesuf
- Department of Orthopedics and trauma, School of Medicine College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Communication and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Policy and Management, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Aprilio K, Wilar G. Emergence of Ethnomedical COVID-19 Treatment: A Literature Review. Infect Drug Resist 2021; 14:4277-4289. [PMID: 34703254 PMCID: PMC8541748 DOI: 10.2147/idr.s327986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/06/2021] [Indexed: 12/24/2022] Open
Abstract
The emergence of COVID-19 as a new pandemic in the modern era has led the public to a new perspective of health. In the earlier days of the COVID-19 pandemic, many factors made people go on their own ways in finding its supposed "cure". With conventional medicines' limited availability and access, traditional medicines become more appealing due to its widespread availability and increased perception of safety. Several herbal medicines are then believed to be able to alleviate or cure COVID-19 and its symptoms. Similarities and patterns in herbal medicines being used show local wisdom of the respective communities regarding their knowledge of diseases and its treatment, known as ethnomedicine. Despite not being approved yet by regulatory bodies as a definitive guideline in COVID-19 management, the application of ethnomedicine results in several herbal medicine candidates that show a promising result regarding its efficacy in managing COVID-19. This literature review aims to study how a society and its knowledge of medicine responds to a new and currently developing disease, and whether if that knowledge merits further study in search of a cure for the pandemic. Furthermore, the narrative aspect in this review also explores socio-politics and public health aspects and considerations of non-conventional COVID-19 treatment.
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Affiliation(s)
- Kevin Aprilio
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Gofarana Wilar
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
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Khairullah AR, Solikhah TI, Ansori ANM, Hanisia RH, Puspitarani GA, Fadholly A, Ramandinianto SC. Medicinal importance of Kaempferia galanga L. (Zingiberaceae): A comprehensive review. JOURNAL OF HERBMED PHARMACOLOGY 2021. [DOI: 10.34172/jhp.2021.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Kaempferia galanga included in the Zingiberaceae family is one of the potential medicinal plants with aromatic rhizome. In traditional medicine in Asian countries, this plant is widely used by local practitioners. This plant is widely cultivated in most Southeast Asian countries such as Cambodia, Vietnam, Malaysia, Thailand, and Indonesia. Ethyl-para-methoxycinnamate and ethyl-cinnamate are found as the main compounds in hexane, dichloromethane, and methanol extracts of K. galanga. This plant is traditionally used as an expectorant, stimulant, diuretic, carminative, and antipyretic remedy. In addition, K. galanga is used for treatment of diabetes, hypertension, cough, asthma, joint fractures, rheumatism, urticaria, vertigo, and intestinal injuries. Therefore, this study aimed to give a sneak peek view on galangal’s ethnobotany, toxicology, pharmacology, and phytochemistry.
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Affiliation(s)
- Aswin Rafif Khairullah
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Tridiganita Intan Solikhah
- Division of Veterinary Clinic, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Arif Nur Muhammad Ansori
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ristag Hamida Hanisia
- Master Program in Biotechnology, School of Life Sciences and Technology, Bandung Institute of Technology, Indonesia
| | - Gavrila Amadea Puspitarani
- Infectious Diseases and One Health, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, Scotland
| | - Amaq Fadholly
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sancaka Cashyer Ramandinianto
- Master Program in Veterinary Disease and Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
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20
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Nguyen PH, Tran VD, Pham DT, Dao TNP, Dewey RS. Use of and attitudes towards herbal medicine during the COVID-19 pandemic: A cross-sectional study in Vietnam. Eur J Integr Med 2021; 44:101328. [PMID: 36570027 PMCID: PMC9760728 DOI: 10.1016/j.eujim.2021.101328] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022]
Abstract
Introduction Herbal medicine has a long and rich history of practice in Vietnam. The use and attitudes towards herbal medicine, during the COVID-19 pandemic was explored in this study. The aims were to examine (1) the prevalence and indications for herbal medicine use, (2) the factors associated with herbal medicine use, and (3) Vietnamese peoples' attitudes towards herbal medicine. Methods A cross-sectional online survey was conducted in Vietnamese adults aged 18 years and older, distributed equally across the Northern, Central, and Southern regions of Vietnam, between September and October 2020. Descriptive statistics, chi-square tests, and univariate and multivariate logistic regression analyses were performed to achieve the study objectives. Results Nearly half of the respondents reported using herbal medicine for common illnesses during the COVID-19 pandemic. The prevalence was strongly associated with marital status, urbanicity, monthly income, and health status perception. Ginger (Zingiber officinale Rosc.), honey (Mel), garlic (Allium sativum L.), and perilla (Perilla frutescens (L.) Britt.) were the most commonly used herbal medicines, mainly for the treatment of sore throat, cough, nasal congestion, and fever. Nearly 70% of the participants believed herbal medicines to be safe, to have less side effects than conventional medicines, and to be effective for minor health conditions. Conclusion The use of herbal medicine during the COVID-19 pandemic was a common practice among Vietnamese people. These findings may have implications for future medical research in Vietnam, and for policy-makers and those in the pharmaceutical industry with regard to future regulations and product development.
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Affiliation(s)
- Phuc Hung Nguyen
- Department of Drug Administration, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, 179 Nguyen Van Cu, Can Tho 900000, Viet Nam
| | - Van De Tran
- Department of Drug Administration, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, 179 Nguyen Van Cu, Can Tho 900000, Viet Nam
- Department of Traditional Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, 179 Nguyen Van Cu, Can Tho 900000, Viet Nam
| | - Duy Toan Pham
- Department of Chemistry, College of Natural Sciences, Can Tho University, Campus II, 3/2 Street, Can Tho 900000, Viet Nam
| | - Tran Nhat Phong Dao
- Department of Traditional Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, 179 Nguyen Van Cu, Can Tho 900000, Viet Nam
| | - Rebecca Susan Dewey
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, United Kingdom
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21
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Tengia-Kessy A, Msalale GC. Understanding forgotten exposures towards achieving Sustainable Development Goal 3: a cross-sectional study on herbal medicine use during pregnancy or delivery in Tanzania. BMC Pregnancy Childbirth 2021; 21:270. [PMID: 33794794 PMCID: PMC8017693 DOI: 10.1186/s12884-021-03741-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
Background In most of the sub-Sahara African countries, use of herbal medications is widely practiced during pregnancy or delivery for various reasons despite uncertainties on their pharmacological profiles. Use of unregistered herbal medicines has the potential of causing adverse health effects to the mother and the newborn, thus deterring achievement of Sustainable Development Goal 3, which aims to “ensure healthy lives and promote well-being for all at all ages”. One of the targets is on reduction of morbidity and mortality among mothers and newborns. This study investigated use of herbal medicines and predictors of usage during pregnancy or delivery as a forgotten exposure towards understanding some of the challenges in achieving Sustainable Development Goal 3. Methods This cross-sectional quantitative study gathered information from women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, women attending reproductive, maternal and child health clinics in Tabora were selected and interviewed. Proportions were compared using chi-square test and Poisson regression analysis was performed to determine independent correlates of herbal medicine use. Results Of 340 recruited women, 208 [61.2 %; 95 % confidence interval: 55.4, 66.3 %] used herbal medicines during pregnancy or delivery. Major reasons for use included accelerating labour, 81 (38.9 %) and reducing labour pains, 58 (27.9 %). Women who made less than four antenatal visits had a 24 % higher adjusted prevalence ratio of using herbal medicines as compared to those who had at least four visits [adjusted prevalence ratio:1.24; 95 % confidence interval: 1.02, 1.50, p = 0.03]. Furthermore, the adjusted prevalence ratio of using herbal medicines was 35 % higher among women who were not discouraged by health care providers against their use as compared to those who were discouraged (adjusted prevalence ratio: 1.35; 95 % confidence interval: 1.13, 1.60, p = 0.01). Conclusions Use of herbal medicines during pregnancy or delivery among women in Tanzania is common. Independent predictors of herbal medicine use were number of antenatal visits and stance of maternity health care providers on their use. Comprehensive investigations on the magnitude, patterns and predictors of use of herbal medicines during pregnancy or delivery are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03741-5.
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Affiliation(s)
- Anna Tengia-Kessy
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P. O. Box 65015, Dar es Salaam, Tanzania.
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22
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Kretchy IA, Koduah A, Opuni KFM, Agyabeng K, Ohene‐Agyei T, Boafo EA, Ntow PO. Prevalence, patterns and beliefs about the use of herbal medicinal products in Ghana: a multi‐centre community‐based cross‐sectional study. Trop Med Int Health 2021; 26:410-420. [DOI: 10.1111/tmi.13541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
| | - Kwabena F. M. Opuni
- Department of Pharmaceutical Chemistry School of Pharmacy University of Ghana Legon Ghana
| | | | - Thelma Ohene‐Agyei
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
| | - Eugene A. Boafo
- Department of Pharmaceutical Chemistry School of Pharmacy University of Ghana Legon Ghana
| | - Prisca O. Ntow
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
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23
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Abubakar U, Zulkarnain AI, Samri F, Hisham SR, Alias A, Ishak M, Sugiman H, Ghozali T. Use of complementary and alternative therapies for the treatment of dysmenorrhea among undergraduate pharmacy students in Malaysia: a cross sectional study. BMC Complement Med Ther 2020; 20:285. [PMID: 32948163 PMCID: PMC7501717 DOI: 10.1186/s12906-020-03082-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 01/21/2023] Open
Abstract
Background Dysmenorrhea is a common problem that affects female students’ quality of life and academic activities. Complementary and alternative therapies (CATs) are used for the treatment of dysmenorrhea. This study investigated the practices and perceptions of female undergraduate students with dysmenorrhea towards CATs. Methods This was a cross-sectional study conducted among undergraduate pharmacy students in a public university in Malaysia using a validated and pre-tested self-administered questionnaire. The study was conducted in November and December 2019. The data was analysed using descriptive and inferential statistical tests. Results Of the 318 female undergraduate students invited, 219 completed the questionnaire (response rate: 68.9%) with 52% aged between 21 and 23 years. The prevalence of dysmenorrhea was 72.1%, and the prevalence of ever-use and current use of CATs was 70.3 and 54.4%, respectively. Bed rest (71.5%), hot compress/heating pad (47.5%) and massage (43.0%) were the most common CATs used by the respondents. The most common reasons for using CAT were to reduce the need for analgesics (61.4%), efficacy (37.3%) and recommendation by others (32.9%). About 23 and 9% of the respondents believed that CATs were equally “effective” and “more effective” than analgesics, respectively. Reducing the need for analgesics (AOR: 4.066, 95% CI: 2.136–7.739) and those who agreed that CATs are effective (AOR: 2.701, 95% CI: 1.337–5.457) were independently associated with the current use CATs for the treatment of menstrual pain. Conclusion The prevalence of ever-use and current use of CATs is high among female undergraduate pharmacy students. Bed rest and heat applications are the most common CATs used. Reducing the need for analgesics and efficacy are the factors associated with the current use of CATs. Students should be educated about the safe and effective use of CATs to reduce adverse effects and improve their quality of life.
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Affiliation(s)
- Usman Abubakar
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia.
| | - Amni Izzati Zulkarnain
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Fatihah Samri
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Sabrina Ros Hisham
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Anis Alias
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Muhammad Ishak
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Hajarah Sugiman
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Taufik Ghozali
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
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