DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20164509

A study to determine the knowledge and level of awareness of medical undergraduates about herbal medicines and herb-drug interactions

Jaspreet K. Boparai, Amandeep Singh, Ashwani K. Gupta, Prithpal S. Matreja, P. M. L. Khanna, Vipan Gupta, Rakesh K. Gautam

Abstract


Background: The increasing usage of herbal medicines worldwide has increased the probability of co-administration of herbal and allopathic medicines. This may lead to serious safety concerns, including herb-drug interactions (HDIs). Many HDIs may be overlooked due to poor doctor-patient communication about herbal drug usage probably because of lack of knowledge of herbal medicines and HDIs among physicians. The study was thus planned to identify the knowledge and awareness of medical students regarding the use of herbal medicines and about HDIs, to help improve the teaching skills and curriculum development for medical students.

Methods: 286 medical students of 2nd, 3rd and 4th year MBBS course completed the study. All the participants were asked to fill a self-administered questionnaire consisting of 15 questions which included both open-ended and close-ended questions related to age, sex, knowledge, awareness and usage of herbal medicines and about herb-drug interactions. Data was analyzed and expressed as counts and percentages.

Results: Majority (95.45%) of the students were aware of the fact that herbs can be used as medicines. They were most familiar with the herbs tulsi, neem, turmeric, aloe, ashwagandha and ginger. 46.85% consider herbal medicines to be risk free, and majority (55.6%) were not aware of the fact that herbs can cause herb-drug interactions. Media and elderly family members were their most common sources of information regarding herbal medicines. Majority (75.17%) would prefer allopathic medicines over herbal medicines. Only 23.07% always informed the physician about their usage of herbal medicines, although most (84.96%) felt that history regarding use of herbal medicines should be taken. Majority were not aware of the regulatory status of herbal medicines.

Conclusions: Lack of knowledge and awareness of medical students about herbal medicines and herb-drug interactions was seen in the study. There is a need to inform the students of allopathic system of medicine about the adverse outcomes of herbal medicines and the knowledge about herb-drug interactions should be a part of the medical curriculum.


Keywords


Allopathic medicine, Herbal medicines, Herb-drug interactions, Medical curriculum, Pharmacology practical

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References


General guidelines for methodologies on research and evaluation of traditional medicine. WHO/EDM/TRM/2000.1 Available at: http://www.who.int/medicines/areas/traditional/definitions/en/

Robinson MM, Zhang X. The World Medicines Situation 2011- Traditional Medicines: Global Situation, Issues and Challenges. WHO: Geneva, Switzerland. 2011:1-14.

Vaidya AD, Devasagayam TP. Current status of Herbal. Drugs in India: An Overview. J. Clin. Biochem. Nutr. 2007;41(1):1-11.

Hussain MS. Patient counseling about herbal-drug interactions. Hussain Afr J Tradit Complement Altern Med. 2011;8(S):152-63.

Heinrich M, Booker A. Herbal medicines in the United Kingdom. In: Medicinal and Aromatic Plants of the World. Paris: EOLSS; 2012.

Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs. 2009;69:1777-98.

Déciga-Campos M, Rivero-Cruz I, Arriaga-Alba M, Castañeda-Corral G, Angeles-López GE, Navarrete A et al. Acute toxicity and mutagenic activity of Mexican plants used in traditional medicine. J. Ethno Pharmacol. 2007;110:334-42.

Patel M, Bessong P, Liu H. Traditional medicines, HIV, and related infections: workshop 2C. Adv. Dent. Res. 2011;23:159-64.

Fugh-Berman A. Herb-drug interactions. Lancet 2000;355:134-8.

Gohil KJ, Patel JA. Herb-drug interactions: A review and study based on assessment of clinical case reports in literature. Ind J Pharmacol. 2007;39:129-39.

Posadzki P, Watson L, Ernst E. Herb-drug interactions: an overview of systematic reviews. British Journal of Clinical Pharmacology. 2013;75(3):603-18.

Chao MT, Wade C, Kronenberg F. Disclosure of complementary and alternative medicine to conventional medical providers: variation by race/ethnicity and type of CAM. J Natl Med Assoc. 2008;100:1341-9.

Howell L, Kochhar K, Saywell R, Zollinger T, Koehler J, Mandzuk C, et al. Use of herbal remedies by Hispanic patients: do they inform their physician? J Am Board Fam Med. 2006;19:566-78.

Gardiner P, Graham RE, Legedza AT, Eisenberg DM, Phillips RS. Factors associated with dietary supplement use among prescription medication users. Arch Intern Med. 2006;166:1968-74.

Kennedy J, Wang CC, Wu CH. Patient Disclosure about Herb and Supplement Use among Adults in the US. Evid Based Complement Alternat Med. 2008;5:451-6.

Klepser TB, Doucette WR, Horton MR. Assessment of patients’ perceptions and beliefs regarding herbal therapies. Pharmacotherapy. 2000;20:83-7.

Clement YN, Williams AF, Khan K, Bernard T, Bhola S, Fortuné M, et al. A gap between acceptance and knowledge of herbal remedies by physicians: the need for educational intervention. BMC Complement Altern Med. 2005;5:20.

Fakeye TO, Onyemadu O. Evaluation of knowledge base of hospital pharmacists and physicians on herbal medicines in Southwestern Nigeria. Pharm. Pract. 2008;6:88-92.

Xu S, Levine M. Medical residents’ and students’ attitudes towards herbal medicines: a pilot study. Can J Clin Pharmacol. 2008;5:14.

Gardiner P, Graham R, Legedza AT, Ahn AC, Eisenberg DM, Phillips RS. Factors associated with herbal therapy use by adults in the United States. Altern Ther Health Med. 2007;13:22-9.

Zimmerman C, Kandiah J. A pilot study to assess students' perceptions, familiarity, and knowledge in the use of complementary and alternative herbal supplements in health promotion. Altern Ther Health Med. 2012;18:28-33.

Sekhri K, Bhanwra S, Nandha R. Herbal products: a survey of students’ perception and knowledge about their medicinal use. Int J Basic Clin Pharmacol. 2013;2:71-6.

Ameade EP, Amalba A, Helegbe GK, Mohammed BS. Herbal medicine: a survey on the knowledge and attitude of medical students in Tamale, Ghana. Peak Journal of Medicinal Plant Research. 2015;3(1):1-8.

Vanherweghem JL, Degaute JP. The policy of admission to the education in medicine and dentistry in the French-speaking community of Belgium. Acta Clin. Belg. 1998;53:2-3.

Ernst E. Toxic heavy metals and undeclared drugs in Asian herbal medicines. Trends Pharmacol Sci. 2002;23:136-9.

Liang Y, Xie P, Chan K. Quality control of herbal medicines. J Chromatogr. 2004;812:53-70.

Perkin JE, Wilson WJ, Schuster K, Rodriguez J, Allen-Chabot A. Prevalence of nonvitamin, nonmineral supplement usage among university students. J Am Diet Assoc. 2002;102:412-4.

Sahoo N, Manchikanti P. Herbal Drug Regulation and Commercialization: An Indian Industry Perspective. J Altern Complement Med. 2013;19(12):957-63.

Bent S. Herbal Medicine in the United States: Review of Efficacy, Safety, and Regulation. J Gen Intern Med 2008;23(6):854-9.

Rivera JO, Loya AM, Ceballos R. Use of Herbal Medicines and Implications for Conventional Drug Therapy Medical Sciences. Altern Integ Med 2013;2:130.