Taking herbs with other drugs may harm health and fizzle finances
Older black women who use herbal medications view themselves as healthier than their counterparts who don’t use the preparations, yet many aren’t clearly informed of the products’ true benefits—or their potential dangers, University of Florida nursing researchers report in a recent issue of Clinical Nursing Research.
Building on a similar study they conducted of nearly 90 white women, UF researchers evaluated patterns of herbal product use among 57 black women ages 65 and older who took them for perceived health benefits or to manage an existing medical condition, such as arthritis, heart problems or back pain. The researchers also compared them with older black women who did not use herbal medicines and with the older white women previously studied.
“What we are finding is that a significant portion of older African-American women were mixing prescribed, non-prescribed medications, and herbal products such as garlic or glucosamine, and not discussing this with their health-care providers, which may possibly cause adverse health effects,” said Saunjoo Yoon, Ph.D., R.N., an assistant professor at UF’s College of Nursing and the study’s principal investigator. “Even if the herbals are not dangerous, they may not be necessary, wasting their money.”
Many were combining as many as seven herbs, prescription drugs and over-the-counter medicines, a practice that may threaten to cause physical and financial harm, the researchers say. Scientific studies increasingly show some herbs alter the way the body metabolizes other drugs, triggering symptoms as severe as bleeding in the brain or high blood pressure.
Ultimately, Yoon said, she would like to use the study findings to educate health-care providers about the importance of obtaining a more complete medication history for all patients, especially older ones. As part of that effort, researchers aim to conduct a larger study with a larger, randomly obtained sample of older black women to confirm the findings and to ensure they can be generalized to the population at large.
In the current study, UF researchers surveyed the women about their health status and use of conventional drugs and herbal products. The women were recruited by verbal announcements at meetings, personal contacts and posters displayed at meal sites, housing developments, community senior organizations, health fairs and churches in North Central Florida.
A third of the women reported using at least one herbal preparation within the past year; altogether, 33 different herbal products were taken, researchers found.
The most common herbal preparations were glucosamine, garlic or aloe products and gingko biloba. Of the herbal products used, nearly three-quarters were taken to maintain health or prevent possible health problems. Most study subjects described them as somewhat or very effective.
Nearly half the herbals used were not discussed with health-care providers, and most users were mixing the products with prescription and over-the-counter medicines.
UF researchers say because the U.S. population is aging and increasingly diverse, it’s crucial to examine habits that contribute to health disparities among groups of women. Although women who took herbs reported feeling healthier than study participants who did not, the practice might hurt more than help, and not just physically. Most women in the study had a limited income and may have found it difficult to pay for prescription medicines, much less for herbal preparations, Yoon said. The findings highlight the need for older women to talk to their health-care providers to ensure they are not purchasing unnecessary medications out-of-pocket, she said.
The researchers also noted distinct cultural differences between how black women and white women receive and interpret their health information, which has implications for how the risks and benefits of using herbal products are best conveyed.
“We found that both African-American and Caucasian women use herbal products to manage their health, but African-American women were much more likely to obtain recommendations from friends, family and community members, whereas Caucasian women were more likely to read health magazines and watch health programs to find out about herbal medications,” Yoon said. “This is important because we find that family and friends are more trustworthy sources of information for African-American women, and can be used as a conduit of information in their communities.”
Study findings “suggest that health-care providers specifically ask older women what they use to manage their health, clearly inform them regarding self- and health-care provider-prescribed treatments, and realize that all of their health information does not come from professional health care sources,” the authors stated in their paper.
“Dr. Yoon’s research illustrates that it is imperative for health-care providers to find a better screening system for medications, whether prescribed or over-the-counter, and improve communication between the patient and provider,” said Grace M. Kuo, Pharm.D., an assistant professor of family and community medicine at Baylor College of Medicine and program director of the Southern Primary-care Urban Research Network. “In addition, increased cultural competency on the part of health-care providers can help to prevent health disparities. By learning about the cultural health practices of different minority groups, we can better communicate with all of our patients.”