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Acute adverse events from over-the-counter Chinese herbal medicines: a population-based survey of Hong Kong Chinese.

Kim JH, Kwong EM, Chung VC, Lee JC, Wong T, Goggins WB - BMC Complement Altern Med (2013)

Bottom Line: Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2).Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7).A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals.Despite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. JHKim@cuhk.edu.hk.

ABSTRACT

Background: Although over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events.

Methods: A cross-sectional telephone survey was conducted among Hong Kong Chinese adults in 2011 (n = 1100) with informed verbal consent. Stepwise logistic regression of demographic, attitudinal and behavioral variables was used to determine factors associated with past-year adverse events.

Results: Of study respondents, 71.7% (789/1100) reported past-year COTC use and 2.3% (25/1100) reported at least one COTC-related adverse event in the past year. Of the 27 adverse events cases reported among COTC users, the most common were allergic reactions (n = 11) dizziness (n = 5), and gastro-intestinal problems (n = 4). Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2).Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7). Package labels were also felt to be unclear by 42.9% of COTC users. A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals.

Conclusions: Despite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.

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Related in: MedlinePlus

Study recruitment.
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Figure 1: Study recruitment.

Mentions: The target population was comprised of all Cantonese-speaking Hong Kong residents over the age of 18. After the preliminary survey instrument was anonymously pilot-tested on 50 respondents and revised for clarity and accuracy, an anonymous, random telephone survey was conducted in September 2011 using the ‘last birthday’ method of selecting respondents. For unanswered calls, at least 4 other independent calls were made. Trained interviewers interviewed 1100 respondents using colloquial Cantonese. The sample size was derived from power calculations to allow for adequate sample size to conduct multivariable logistic regression with ten covariates. After briefing the individual about the purpose of the survey, interviewers obtained verbal consent to participate in the study before conducting the interview. Research ethics approval was obtained from the ethics board of the sponsoring university. A flow chart of the study recruitment process is shown below (Figure 1). Of households with an eligible member, the overall response rate was 70.1%.


Acute adverse events from over-the-counter Chinese herbal medicines: a population-based survey of Hong Kong Chinese.

Kim JH, Kwong EM, Chung VC, Lee JC, Wong T, Goggins WB - BMC Complement Altern Med (2013)

Study recruitment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222756&req=5

Figure 1: Study recruitment.
Mentions: The target population was comprised of all Cantonese-speaking Hong Kong residents over the age of 18. After the preliminary survey instrument was anonymously pilot-tested on 50 respondents and revised for clarity and accuracy, an anonymous, random telephone survey was conducted in September 2011 using the ‘last birthday’ method of selecting respondents. For unanswered calls, at least 4 other independent calls were made. Trained interviewers interviewed 1100 respondents using colloquial Cantonese. The sample size was derived from power calculations to allow for adequate sample size to conduct multivariable logistic regression with ten covariates. After briefing the individual about the purpose of the survey, interviewers obtained verbal consent to participate in the study before conducting the interview. Research ethics approval was obtained from the ethics board of the sponsoring university. A flow chart of the study recruitment process is shown below (Figure 1). Of households with an eligible member, the overall response rate was 70.1%.

Bottom Line: Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2).Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7).A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals.Despite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. JHKim@cuhk.edu.hk.

ABSTRACT

Background: Although over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events.

Methods: A cross-sectional telephone survey was conducted among Hong Kong Chinese adults in 2011 (n = 1100) with informed verbal consent. Stepwise logistic regression of demographic, attitudinal and behavioral variables was used to determine factors associated with past-year adverse events.

Results: Of study respondents, 71.7% (789/1100) reported past-year COTC use and 2.3% (25/1100) reported at least one COTC-related adverse event in the past year. Of the 27 adverse events cases reported among COTC users, the most common were allergic reactions (n = 11) dizziness (n = 5), and gastro-intestinal problems (n = 4). Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2).Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7). Package labels were also felt to be unclear by 42.9% of COTC users. A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals.

Conclusions: Despite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.

Show MeSH
Related in: MedlinePlus