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Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study.

Hung YC, Tseng YJ, Hu WL, Chen HJ, Li TC, Tsai PY, Chen HP, Huang MH, Su FY - PLoS ONE (2015)

Bottom Line: The mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users.Zhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan.Our results should be taken into account by physicians when devising individualized therapy for IHD.

View Article: PubMed Central - PubMed

Affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung 833, Taiwan; School of Chinese Medicine for Post Baccalaureate, I-Shou University, No.1, Sec. 1, Syuecheng Rd., Dashu District, Kaohsiung City 84001, Taiwan.

ABSTRACT

Objective: Combinations of Chinese herbal products (CHPs) are widely used for ischemic heart disease (IHD) in Taiwan. We analyzed the usage and frequency of CHPs prescribed for patients with IHD.

Methods: A nationwide population-based cross-sectional study was conducted, 53531 patients from a random sample of one million in the National Health Insurance Research Database (NHIRD) from 2000 to 2010 were enrolled. Descriptive statistics, the multiple logistic regression method and Poisson regression analysis were employed to estimate the adjusted odds ratios (aORs) and adjusted risk ratios (aRRs) for utilization of CHPs.

Results: The mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users. Zhi-Gan-Cao-Tang (24.85%) was the most commonly prescribed formula CHPs, followed by Xue-Fu-Zhu-Yu-Tang (16.53%) and Sheng-Mai-San (16.00%). The most commonly prescribed single CHPs were Dan Shen (29.30%), Yu Jin (7.44%), and Ge Gen (6.03%). After multivariate adjustment, patients with IHD younger than 29 years had 2.62 times higher odds to use TCM than those 60 years or older. Residents living in Central Taiwan, having hyperlipidemia or cardiac dysrhythmias also have higher odds to use TCM. On the contrary, those who were males, who had diabetes mellitus (DM), hypertension, stroke, myocardial infarction (MI) were less likely to use TCM.

Conclusions: Zhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan. Our results should be taken into account by physicians when devising individualized therapy for IHD. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines.

No MeSH data available.


Related in: MedlinePlus

Flowchart of recruitment of subject recruitment from the 1-million random sample of the National Health Insurance Research Database (NHIRD) from 2000 to 2010 in Taiwan.Abbreviation: IHD, ischemic heart disease; TCM, traditional Chinese medicine.
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pone.0137058.g001: Flowchart of recruitment of subject recruitment from the 1-million random sample of the National Health Insurance Research Database (NHIRD) from 2000 to 2010 in Taiwan.Abbreviation: IHD, ischemic heart disease; TCM, traditional Chinese medicine.

Mentions: We selected patients with IHD and a diagnosis code of 414, one of three major diagnosis codes according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The patients were selected from the random sample of one million individuals in the NHI dataset; Fig 1 depicts a flowchart of the recruitment process. We identified 75,761 patients diagnosed with IHD (ICD-9-CM code: 414) from the registries of outpatient care by visits and inpatient care by admission. We excluded patients with prevalent IHD (n = 22,207) that had been diagnosed prior to the end of 1999 and those with missing information on age or sex (n = 23). Thus, the final cohort included 53531 patients. These were divided into two groups: 9854 TCM nonusers and 43677 TCM users, and the values of their mean age were 66.75 (SD = 13.5) and 61.82 (13.14) years, respectively. Given the fixed sample size of 53531, the level of absolute precision d, that specifies the width of the 95% confidence interval (CI) would be 0.26% under the assumption that the TCM use in IHD patients was 75%. Because common values for d are usually around ±5% for estimated proportions in the range of 20%-80%, the width of the 95% CI in the present study is small, indicating the size of sample provides high precision for estimating the prevalence of TCM use in patients with IHD.


Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study.

Hung YC, Tseng YJ, Hu WL, Chen HJ, Li TC, Tsai PY, Chen HP, Huang MH, Su FY - PLoS ONE (2015)

Flowchart of recruitment of subject recruitment from the 1-million random sample of the National Health Insurance Research Database (NHIRD) from 2000 to 2010 in Taiwan.Abbreviation: IHD, ischemic heart disease; TCM, traditional Chinese medicine.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556444&req=5

pone.0137058.g001: Flowchart of recruitment of subject recruitment from the 1-million random sample of the National Health Insurance Research Database (NHIRD) from 2000 to 2010 in Taiwan.Abbreviation: IHD, ischemic heart disease; TCM, traditional Chinese medicine.
Mentions: We selected patients with IHD and a diagnosis code of 414, one of three major diagnosis codes according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The patients were selected from the random sample of one million individuals in the NHI dataset; Fig 1 depicts a flowchart of the recruitment process. We identified 75,761 patients diagnosed with IHD (ICD-9-CM code: 414) from the registries of outpatient care by visits and inpatient care by admission. We excluded patients with prevalent IHD (n = 22,207) that had been diagnosed prior to the end of 1999 and those with missing information on age or sex (n = 23). Thus, the final cohort included 53531 patients. These were divided into two groups: 9854 TCM nonusers and 43677 TCM users, and the values of their mean age were 66.75 (SD = 13.5) and 61.82 (13.14) years, respectively. Given the fixed sample size of 53531, the level of absolute precision d, that specifies the width of the 95% confidence interval (CI) would be 0.26% under the assumption that the TCM use in IHD patients was 75%. Because common values for d are usually around ±5% for estimated proportions in the range of 20%-80%, the width of the 95% CI in the present study is small, indicating the size of sample provides high precision for estimating the prevalence of TCM use in patients with IHD.

Bottom Line: The mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users.Zhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan.Our results should be taken into account by physicians when devising individualized therapy for IHD.

View Article: PubMed Central - PubMed

Affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung 833, Taiwan; School of Chinese Medicine for Post Baccalaureate, I-Shou University, No.1, Sec. 1, Syuecheng Rd., Dashu District, Kaohsiung City 84001, Taiwan.

ABSTRACT

Objective: Combinations of Chinese herbal products (CHPs) are widely used for ischemic heart disease (IHD) in Taiwan. We analyzed the usage and frequency of CHPs prescribed for patients with IHD.

Methods: A nationwide population-based cross-sectional study was conducted, 53531 patients from a random sample of one million in the National Health Insurance Research Database (NHIRD) from 2000 to 2010 were enrolled. Descriptive statistics, the multiple logistic regression method and Poisson regression analysis were employed to estimate the adjusted odds ratios (aORs) and adjusted risk ratios (aRRs) for utilization of CHPs.

Results: The mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users. Zhi-Gan-Cao-Tang (24.85%) was the most commonly prescribed formula CHPs, followed by Xue-Fu-Zhu-Yu-Tang (16.53%) and Sheng-Mai-San (16.00%). The most commonly prescribed single CHPs were Dan Shen (29.30%), Yu Jin (7.44%), and Ge Gen (6.03%). After multivariate adjustment, patients with IHD younger than 29 years had 2.62 times higher odds to use TCM than those 60 years or older. Residents living in Central Taiwan, having hyperlipidemia or cardiac dysrhythmias also have higher odds to use TCM. On the contrary, those who were males, who had diabetes mellitus (DM), hypertension, stroke, myocardial infarction (MI) were less likely to use TCM.

Conclusions: Zhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan. Our results should be taken into account by physicians when devising individualized therapy for IHD. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines.

No MeSH data available.


Related in: MedlinePlus