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Release: Feb. 9, 2000

UI survey shows patients believe doctors should know about herbal therapy use

IOWA CITY, Iowa — Although you don't need a doctor's prescription for herbs, you should tell your health care providers about any herbs you are taking, suggest Iowans who responded to a University of Iowa Health Care survey.

According to the results, both respondents who did and didn't use herbs indicated that they believed that physicians should be aware of herb use.

"We are pleased that people are beginning to understand that they must let their health care providers know about herb use because even though you can buy herbs without a doctor's prescription, they are drugs and do affect the body," said Teresa Klepser, Pharm.D., UI assistant professor of pharmacy.

Herbal therapies are becoming increasingly popular. Americans spent an estimated $5.1 billion on herbal therapies alone in 1997. Some people use herbs as alternatives to traditional medications. Others use natural drugs to complement or supplement prescribed drugs and treatments.

Herbal products are officially classified as dietary supplements. Therefore, the U.S. Food and Drug Administration does not regulate them nor do herbs require post-marketing safety surveillance. This means that the burden of identifying and reporting herb-related adverse affects falls to health care providers. Another big concern is drug interaction. Although many drugs and herbs may be safe when taken alone, the risk of significant interactions increases when several agents are ingested in combination.

If patients do not disclose their herb use, health care providers have no way of knowing about associated problems. Past surveys have indicated that many people do not tell their health care providers about their herbal usage. One alarming finding from a previous study showed that 60 percent of the approximately 15 million adults who had consumed dietary supplements, including herbs, while taking prescription drugs, did not tell their physicians about their herb use.

A group of UI pharmacists decided to conduct a statewide survey because they wanted to find out about the situation in Iowa.

In addition to learning that Iowans believe physicians should know about herbal therapy use, the survey also showed that:

    • Of the respondents, 41.6 percent indicated that they had used an herbal product.
    • The five most commonly used were aloe (136 respondents or 41.2 percent), garlic (95 respondents or 28.8 percent), ginseng (81 respondents or 24.5 percent) echinacea (72 respondents or 21.8 percent), and St. John's Wort (69 respondents or 20.9 percent)
    • Of the herbal users, 76 percent were women.
    • As for education, 75 percent of the herbal users had some degree of higher education. Herb use was lowest among those indicating a high school degree or less as their highest level of education.
    • Compared with nonusers, individuals who had used herbs had a less positive perception of the safety of prescription drugs and a more positive perception concerning the safety of herbal products.
    • Nonusers generally perceived the risks associated with herbal products and prescription drugs to be comparable.

The results from the UI survey were based on the responses of 794 completed surveys -- 623 from individuals who filled out the questionnaire while visiting UI-affiliated clinics around the state and 171 from people who responded to a mailing. The survey results are included in an article in the recent issue of Pharmacotherapy.

UI pharmacists are continuing to look at herb use and plan to conduct further surveys of population subgroups, such as older individuals.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.