Concurrent Use of Conventional Drugs with Chinese Herbal Products in Taiwan: A Population-based Study

10.4103/2225-4110.119734

Ming-Chen Chen；Jung-Nien Lai；Pau-Chung Chen；Jung-Der Wang

Chinese herbal product ； Co-prescription ； Conventional drug ； Herb-drug interaction

Journal of Traditional and Complementary Medicine

3卷4期（2013 / 10 / 01）

256 - 262

英文

The increased use of Chinese herbal products (CHPs) worldwide has raised the concern of herb-drug interactions. The aim of this study was to determine the prevalence and utilization patterns of concurrent use of conventional drugs and CHPs in Taiwan. The usage and frequency of services in the co-prescription of a CHP and a conventional drug were evaluated. Subjects were recruited from a simple random sample of 1,000,000 subjects from over 22 million beneficiaries of the National Health Insurance in 2007. The logistic regression method was employed to estimate the odds ratios (ORs) for the co-prescription of a CHP and a conventional drug (CH + D) and a conventional drug alone (D-alone). The prevalence of the CH + D was 14.1%. Females, regular salary earners, and elderly (65 years and above) were more likely to consume a CHP and a conventional drug concurrently. Painkillers, especially acetaminophen, and anti-cough medicines were the top two conventional drugs that were most frequently co-prescribed with a CHP. Anti-cough medication is the most common conventional drug co-prescribed with CHP, after painkillers. We recommend that safety issues be investigated in future research and integrating both healthcare technologies may be beneficial for the overall health and quality of life of patients.

1. Department of Chinese Medicine and Pharmacy (previous name: Committee on Chinese Medicine and Pharmacy), Ministry of Health and Welfare, Taiwan. [http://http://www.mohw.gov.tw/CHT/DOCMAP/query_liense.aspx?mode=1] [Last accessed on 2013 Oct 02].
2. National Health Research Institutes. National Health Insurance Research database. Available from:[http://nhird.nhri.org.tw/date_01.html] [Last accessed on 2013 Oct 02].。http://nhird.nhri.org.tw/date_01.html
3. Bush, TM,Rayburn, KS,Holloway, SW,Sanchez-Yamamoto, DS,Allen, BL,Lam, T(2007).Adverse interactions between herbal and dietary substances and prescription medications: A clinical survey.Altern Ther Health Med,13,30-35.
4. Casey, M,Adams, J,Sibbritt, D(2008).An examination of the clinical practices and perceptions of professional herbalists providing patient care concurrently with conventional medical practice in Australia.Complement Ther Med,16,228-232.
5. Cassidy, CM(1998).Chinese medicine users in the United States part I: Utilization, satisfaction, medical plurality.J Altern Complement Med,4,17-27.
6. Centers for Disease Control and Prevention. International Classification of Diseases, Ninth Revision (ICD‑9). 1979. Available from: http://www.cdc.gov/nchs/icd/icd9.htm [Last cited in 2009 Oct 21].
7. Chang, LC,Huang, N,Chou, YJ,Lee, CH,Kao, FY,Huang, YT(2008).Utilization patterns of Chinese medicine and Western medicine under the National Health Insurance Program in Taiwan, a population-based study from 1997 to 2003.BMC Health Serv Res,8,170.
8. Chen, FP,Chen, TJ,Kung, YY,Chen, YC,Chou, LF,Chen, FJ(2007).Use frequency of traditional Chinese medicine in Taiwan.BMC Health Serv Res,7,26.
9. Chen, LC,Wang, BR,Chou, YC,Tien, JH(2005).Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan.Pharmacoepidemiol Drug Saf,14,651-657.
10. Chen, YC,Hwang, SJ,Lai, HY,Chen, TJ,Lin, MH,Chen, LK(2009).Potentially inappropriate medication for emergency department visits by elderly patients in Taiwan.Pharmacoepidemiol Drug Saf,18,53-61.
11. Chi, C,Lee, J,Lai, J,Chen, S(1997).Utilization of Chinese medicine in Taiwan.Altern Ther Health Med,3,40-53.
12. Chou, P(2001).Factors related to utilization of traditional Chinese medicine in Taiwan.Zhonghua Yi Xue Za Zhi,64,191-202.
13. Cleary-Guida, MB,Okvat, HA,Oz, MC,Ting, W(2001).Aregional survey of health insurance coverage for complementary and alternative medicine: Current status and future ramifications.JAltern Complement Med,7,269-273.
14. Delgoda, R,Younger, N,Barrett, C,Braithwaite, J,Davis, D(2010).The prevalence of herbs use in conjunction with conventional medicines in Jamaica.Complement Ther Med,18,13-20.
15. Dergal, JM,Gold, JL,Laxer, DA,Lee, MS,Binns, MA,Lanctôt, KL(2002).Potential interactions between herbal medicines and conventional drug therapies used by older adults attending a memory clinic.Drugs Aging,19,879-886.
16. Druss, B(1999).Association between use of unconventional therapies and conventional medical services.JAMA,287,651-656.
17. Eisenberg, DM,Davis, RB,Ettner, SL,Appel, S,Wilkey, S,Van, Rompay, M(1998).Trends in alternative medicine use in the United States, 1990‑1997: Results of a follow‑up national survey.JAMA,280,1569-1575.
18. Eisenberg, DM,Kessler, RC,Van Rompay, MI,Kaptchuk, TJ,Wilkey, SA,Appel, S(2001).Perceptions about complementary therapies relative to conventional therapies among adults who use both: Results from a national survey.Ann Intern Med,135,344-351.
19. Forrest, J,Clements, JA,Prescott, LF(1982).Clinical Pharmacokinetics of Paracetamol‑Springer.Clinical Pharmacokinet,7,93-107.
20. Fugh‑Berman, A(2000).Herb‑drug interactions.Lancet,355,134-138.
21. Hsieh, SC,Lai, JN,Lee, CF,Hu, FC,Tseng, WL,Wang, JD(2008).The prescribing of Chinese herbal products in Taiwan: A cross-sectional analysis of The national health insurance reimbursement database.Pharmacoepidemiol Drug Saf,17,609-619.
22. Hu, Z,Yang, X,Ho, PC,Chan, SY,Heng, PW,Chan, E(2005).Herb-drug interactions: A literature review.Drugs,65,1239-1282.
23. Izzo, AA,Ernst, E(2009).Interactions between herbal medicines and prescribed drugs: An updated systematic review.Drugs,69,1777-1798.
24. Kang, J,Lee, C,Chen, C(1994).Factors related to the choice of clinic between Chinese traditional medicine and Western medicine.J Formos Med Assoc,93,S49-S55.
25. Lee, YC,Huang, YT,Tsai, YW,Huang, SM,Kuo, KN,McKee, M(2010).The impact of universal National Health Insurance on population health: The experience of Taiwan.BMC Health Serv Res,10,225.
26. Li, CG,Yang, L,Zhou, S-F(2007).Interaction between Chinese herbal medicines and drugs.Aust J Acupunct Chin Med,2,17-24.
27. Lim, M,Sadarangani, P,Chan, H,Heng, J(2005).Complementary and alternative medicine use in multiracial Singapore.Compl Therap Med,13,16-24.
28. Lin, HY,Liao, CC,Cheng, SH,Wang, PC,Hsueh, YS(2008).Association of potentially inappropriate medication use with adverse outcomes in ambulatory elderly patients with chronic diseases.Drugs Aging,25,49-59.
29. Loh, CH(2009).Use of traditional Chinese medicine in Singapore children: Perceptions of parents and paediatricians.Singapore Med J,50,1162-1168.
30. Ma, GX(1999).Between two worlds: The use of traditional and Western health services by Chinese immigrants.J Commun Health,24,421-437.
31. Ma, H,Lum, C,Dai, L(2008).Potentially inappropriate medication in elderly patients in outpatient clinics.Asian J Gerontol Geriatr,3,27-33.
32. Miller, LG(1998).Herbal medicinals: Selected clinical considerations focusing on known or potential drug-herb interactions.Arch Intern Med,158,2200-2211.
33. Ng, TP,Tan, CH,Kua, EH,Singapore Chinese Longitudinal Aging Study(2004).The use of Chinese herbal medicines and their correlates in Chinese older adults: The Singapore Chinese Longitudinal Aging Study.Age Ageing,33,135-142.
34. Roy, MJ,Koslowe, PA,Kroenke, K,Magruder, C(1998).Signs, symptoms, and ill‑defined conditions in Persian Gulf War veterans: Findings from the Comprehensive Clinical Evaluation Program.Psychosom Med,60,663-668.
35. Verbeeck, RK,Blackburn, JL,Loewen, GR(1983).Clinical pharmacokinetics of non-steroidal anti-inflammatory drugs.Clin Pharmacokinet,8,297-331.
36. Williams, CM(2002).Using medications appropriately in older adults.Am Fam Physician,25,1917-1925.
37. Wolsko, PM,Eisenberg, DM,Davis, RB,Ettner, SL,Phillips, RS(2002).Insurance coverage, medical conditions, and visits to alternative medicine providers: Results of a National survey.JAMA,162,281-287.
38. World Health Organization.The regional strategy for traditional medicine in the Western Pacific. (2011‑2020).
39. Yeh, LL,Liu, JY,Lin, KS,Liu, YS,Chiou, JM,Liang, KY(2007).Arandomised placebo-controlled trial of a traditional Chinese herbal formula in The treatment of primary dysmenorrhoea.PLoS One,2,e719.
40. Yeh, LL,Liu, JY,Liu, YS,Lin, KS,Tsai, TF,Wang, LH(2009).Anemia-related hemogram, uterine artery pulsatility index, and blood pressure for The effects of Four-Agents-Decoction (Si Wu Tang) in the treatment of primary dysmenorrhea.J Altern Complement Med,15,531-538.
41. Zhou, L,Zuo, Z,Chow, MS(2005).An overview of its chemistry, pharmacology, pharmacokinetics, and clinical use.J Clin Pharmacol,45,1345-1359.
42. Zhou, S,Huang, M,Xu, A,Yang, H,Duan, W,Paxton, JW(2005).Prediction of herb–drug metabolic interactions: A simulation study.Phytother Res,19,464-471.

1. Shun-Ku Lin,Pei-Chia Lo,Jung-Nien Lai(2020).Long-term use of Chinese herbal medicine therapy reduced the risk of asthma hospitalization in school-age children: A nationwide population-based cohort study in Taiwan.Journal of Traditional and Complementary Medicine,10(2),141-149.