Use of both conventional medicines and herbs/natural products are increasing in the United States. Consequently, individuals are more likely to be exposed to potentially harmful interactions between these products.
To examine the use of both herbs/natural products and conventional medications in a rural community, examine the prevalence of potential interactions between herbs/natural products and conventional medications, and identify factors associated with exposure to such interactions.
Population-based epidemiological study.
Data for this paper were collected between 1999 and 2004 as part of the Johnston County Osteoarthritis Project.
Limited to civilian, noninstitutionalized, white or African American residents, aged 45 years or older, of Johnston County, North Carolina. Data used in this paper are from 2523 individuals who completed face-to-face interviews.
Prevalence of herb/natural product use and exposure to potential interactions between these products and conventional medications.
Nineteen percent (n=488) of participants used at least 1 herb/natural product. Among those who used both conventional medications and herbs/natural products, more than 1 in 5 (97 [21.9%]) were using a combination of products associated with a potential interaction. Odds of exposure to a potential interaction were lower among people who had health insurance and increased with the number of products used.
Many people are exposed to potential interactions between herbs/natural products and conventional medications. Research is needed to better understand the effect such interactions may have on patient care.
"We considered the simple associations between DS documentation and several demographic and clinical factors using chi square tests and t-tests. Covariates were selected based on previous studies that demonstrated to predict DS use  . Using variables with crude p-values of 0.2 or less and additionally the number of prescription medications, we created a multivariate logistic regression model. "
[Show abstract][Hide abstract] ABSTRACT: Objective: To explore inpatient reconciliation of dietary supplement (DS) use and determine characteristics associated with DS documentation. Methods: We analyzed DS use among 558 inpatients recruited from the Re-Engineered Discharge clinical trial to identify: (1) if patients self-reported DS and (2) if DS use was documented at admission. We examined socio-demographics for association with documentation using chi squares and t-tests. Logistic regression was performed to assess adjusted associations with DS documentation. Results: Sixty percent reported DS use (. n=. 333). Among users, 36% had admission DS documentation, 20% were asked about use at admission, 18% reported disclosing use to a provider, and 48% reported they would continue to use DS. Overall, 6% of participants were asked, disclosed, and had documentation of DS. Logistic regression revealed increased age associated with lower odds of DS documentation. Identifying as Hispanic or African American reduces DS documentation odds compared to those identifying as white. Conclusions: There is lack of consistent DS medical reconciliation in the inpatient setting. While more than half of patients used DS prior to hospitalization, most were not asked about use on admission. Practice implications: This study adds to literature on medical reconciliation which requires that providers inquire and document patient DS use.
"A study published in 2004 indicated that 17 % of collegiate female athletes in the US took non-traditional supplements . This was similar to the use in adults older than 45 years in the general population (19 %) . "
[Show abstract][Hide abstract] ABSTRACT: Supplement use among athletes is widespread, including non-traditional and biological compounds. Despite increasing research, a comprehensive and critical review on polyphenol supplementation and exercise is still lacking. This review is relevant for researchers directly involved in the topic, as well as those with a broad interest in athletic performance enhancement and sports nutrition. The purpose of this review is to present background information on groups of polyphenols and their derivatives because their differing chemical structures influence mechanisms of action; to discuss the potential of plant, fruit and vegetable-based biological supplements, high in polyphenol content, to affect exercise performance and biomarkers of oxidative stress and exercise-induced muscle damage; and to critically discuss the exercise studies and biomarkers used. Subjects in the studies reviewed were either sedentary, healthy individuals, or active, recreationally trained or well-trained athletes. Polyphenol supplementation in exercise studies included mainly extracts (multicomponent or purified), juices, infusions or an increased intake of polyphenol-rich foods. This review includes details of supplement doses and exercise test protocols. Many studies considered only the performance or one or two selected biomarkers of antioxidant capacity instead of a comprehensive choice of biomarkers to assess damage to lipids or proteins. Evidence is insufficient to make recommendations for or against the use of polyphenol supplementation (neither specific polyphenols nor specific doses) for either recreational, competitive or elite athletes. Polyphenols have multiple biological effects, and future exercise studies must be designed appropriately and specifically to determine physiological interactions between exercise and the selected supplement, rather than considering performance alone.
"A total of 154 articles were selected from the initial 550 retrieved literature reports based on their relevance to the purpose of review. After thorough evaluation and analysis, 98 articles with full text (75 review articles , , –, and 23 primary studies, i.e., 4 animal studies –, 4 clinical trials –, and 15 observational studies , –) were included for further evaluation (Figure 1). The summaries of retrieved primary literature are listed in Table 2, while the summaries of retrieved review articles are listed in Appendix S1. "
[Show abstract][Hide abstract] ABSTRACT: Background
The risks attributed to drug-herb interactions, even when known, are often ignored or underestimated, especially for those involving anti-clotting drugs and Chinese medicines. The aim of this study was to structurally search and evaluate the existing evidence-based data associated with potential drug interactions between anticoagulant/antiplatelet drugs and Chinese herbal medicines (CHMs) and evaluate the documented mechanisms, consequences, and/or severity of interactions.
Methodology and Findings
Information related to anticoagulant/antiplatelet drug-CHM interactions was retrieved from eight interaction-based textbooks, four web resources and available primary biomedical literature. The primary literature searches were conducted in English and/or Chinese from January 2000 through December 2011 using the secondary databases (e.g., PubMed, Airiti Library, China Journal full-text database). The search terms included the corresponding medical subject headings and key words. Herbs or natural products not used as a single entity CHM or in Chinese Medicinal Prescriptions were excluded from further review. The corresponding mechanisms and severity ratings of interactions were retrieved using MicroMedex®, Lexicomp® and Natural Medicines Comprehensive Database®. Finally, we found 90 single entity CHMs contributed to 306 documented drug-CHM interactions. A total of 194 (63.4%) interactions were verified for its evidence describing possible mechanisms and severity. Of them, 155 interactions (79.9%) were attributable to pharmacodynamic interactions, and almost all were rated as moderate to severe interactions. The major consequences of these interactions were increased bleeding risks due to the additive anticoagulant or antiplatelet effects of the CHMs, specifically danshen, dong quai, ginger, ginkgo, licorice, and turmeric.
Conventional anticoagulants and antiplatelet drugs were documented to have harmful interactions with some commonly used single entity CHMs. For those patients who are taking conventional anti-clotting medications with CHMs for cardiovascular or cerebrovascular diseases, the potential risks of increased bleeding due to drug-CHM interactions should not be ignored.
PLoS ONE 05/2013; 8(5):e64255. DOI:10.1371/journal.pone.0064255 · 3.23 Impact Factor
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