Patient reporting of herbal remedy use

There has been a large increase over the last 10 years in the use of herbal remedies by the general population of the United States (Greenwald, 1998). The FDA does not regulate herbal remedies as drugs but as nutritional supplements (Glisson, Crawford, & Street, 1999). Up to 75% of patients are self-medicating with herbal remedies without consulting primary care physicians and practitioners (Glisson et al., 1999). There is a potential for drug-drug interactions, side effects from inappropriate dosing, and delay in the treatment of serious medical conditions with self-medication with herbal remedies (Barnes, Mills, Abbott, Willoughby, & Ernst, 1998) Understanding the reason for the nondisclosure of herbal remedy use is critical to the improvement of physician-patient communication and patient care and safety (Glisson et al.)).

A self-administered survey was conducted in a large rural primary care facility to further define demographics of herbal remedy users, to assess why they choose to utilize herbal remedies, and to assess the patient-provider communication barriers concerning herbal remedy use. The survey had an 86.5% return rate and showed that in this population sample of 865 subjects, 49% had used herbal remedies at some time. The herbal remedy users were more likely to be 36 to 45 years of age (%2=7.2, p=0.01), have about the same household income as nonusers, 2 be married, have some college or vocational education (% =13.4, p=0.001) or bachelor degree (X2=9.8, p=0.01), and, like nonusers, rate their overall health as "good" on the day of the survey.

In summary, the percent of herbal remedy users in primary care practices is much higher than the previous studies have shown. Fifty-seven percent of all subjects had not offered or asked information about herbal remedies from their providers and staff. Ninety-five percent of respondents had not been asked about them by the staff. Communication barriers may be causing a situation where herbal remedy users might have drug/herbal remedy interactions that would affect their medical care. Suggestions are offered for better provider/patient communication as well as future research.