HERBAL MEDICINE USE: KNOWLEDGE AND ATTITUDE IN PATIENTS AT TERTIARY CARE LEVEL IN NORTHERN BORDER REGION OF KINGDOM OF SAUDI ARABIA 1 1 2 3

of 4

Please download to get full document.

View again

All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
PDF
4 pages
0 downs
2 views
Share
Description
Background: Herbal medicines are being widely used and likely to cause side effects and interactions with allopathic drugs. Objective: To assess knowledge, attitude and use of herbal medicines among patients in the Northern Border Area of Saudi
Tags
Transcript
  HERBAL MEDICINE USE: KNOWLEDGE AND ATTITUDE IN PATIENTS AT TERTIARY CARE LEVEL IN NORTHERN BORDER REGION OF KINGDOM OF SAUDI ARABIA 1123 Ashfaque Rahim Memon, Mohammad Akram Randhawa, Ashique Ali Arain, Yosef Soltan H Alrawaili, Yara Shargi K 33333 Alrawaili, Nahed Falah Alharthi, Nadia Saleh Alhassan, Sami Owaid M Alshammari, Muneef Suwailem A Alanazi ABSTRACT Background: Herbal medicines are being widely used and likely to cause side effects and interactions with allopathic drugs. Objective: To assess knowledge, attitude and use of herbal medicines among patients in the Northern Border Area of Saudi Arabia. Methodology: A cross sectional study was carried out among 445 patients attending outpatient departments of tertiary stst care health units in Arar city of Saudi Arabia from 1 November 2015 to 31March 2016. Besides demographic data, information regarding knowledge, attitude and use of herbal medicines was obtained using predesigned questionnaire. Response to various questions was analyzed with SPSS program version 16. Data was further analyzed by using chi-square test. Results: A significant  percentage of patients were familiar with herbal medicine use (93.7 %). Male patients has more knowledge of herbal medicines than females (P = 0.024). High proportion of patients were personally using herbs (93.6 %), mostly in relatively lower income families. Almost 90% Physicians don't ask history of herbal medicines consumption. Only 5% of patients were taking herbal medicine prescribed by Hakeem (Authorized Physician). Persons (parents and grandparents) were prescribing herbal medicines. Conclusion: The residents of Saudi Arabia (Northern Region, Arar) have shown high usage of herbal medicine, additionally its awareness was high. Keywords: Herbal medicines, Knowledge, Attitude, Practice INTRODUCTION Herbal medicine use is increasing day by day, many of the Asians are found to be depending on 1 it. Herbal supplementations have become famous in west as well accounting about 50 of 2 population use. Chronically sick patients like CVDs (cardiovascular diseases), DM, and cancer 3,4 are the most users of alternative medicine. Infertility and female gender increases the chances 5-7 of using complimentary medicine. Probably the popularity of herbs is due to the concept of being 8 natural drugs and having no side effects. Satisfaction, cultural and religious belief are among the other factors influencing the use of 9 herbal drugs   Alternative medicine is now being used by well-educated adults of well-disciplined communities without bringing into the knowledge 10,11 of physicians   There are greater chances of drug-drug interaction between the allopathic and herbal components if taken up by the same patient. This fact invites to collect evidence based data about usage, awareness and attitude about the herbal medicines. A good proportion of the Middle east population is reported to experience harmful 12 effects from such herbal remedies. Limited studies were carried out on health professionals in 13,14 KSA pertaining use of herbal drugs. Patient specific searches were conducted on infertile couples in Riyadh and Makkah (KSA) for the similar 15,16 purpose. Current survey study was based on use, attitude and knowledge about herbal products among patients in four hospitals of the Arar region attending their OPDs (Out Patient Departments). METHODOLOGY This was a cross sectional study conducted by using a questionnaire on randomly selected study subjects. Questionnaire was developed prior to start of study. The intention was to gather the patient awareness in respect of use, attitude and knowledge about the herbal medicines. Out Patient Departments were selected from the hospitals of tertiary care level from Arar city of kingdom of Saudi Arabia. Hospitals were (1) King Abdul Aziz bin Mossad Hospital (2) Cardiac Center and (3) Central Hospital. The survey was st st conducted from 1November, 2015 to 31 March, 2016. Monkey and Fluid Surveys were used to assess 17,18 the sample size through internet online service   Interviews were managed from 445 participating patients after getting consent for study. Purpose and possible benefits of the current survey were also infromed to participants verbally. Ethical approval was sought from hospital ethical committee. Statistical Analysis:  Percentage, mean, S.D and Original ArticleJSZMC Vol.8 No.31241  1. Department of Pharmacology, College of Medicine, Northern Border University, Arar, Saudi Arabia. Pharmacology, Isra University Hyderabad. 2. Department of 3. Final year medical students, College of Medicine, Northern Border University, Arar, Saudi Arabia.  Correspondence: Dr. Ashfaque Rahim Memon,  Lecturer, Department of Pharmacology, College of Medicine, Northern Boarder University, Saudi Arabia. E-mail:Mobile: Received: 13-06-2017  Accepted:  27-08-2017 ashfaquememon1974@gmail.com +966535239724    Question N (%) Did you ever use any herbal medicine? (n=445) o   Yes   o    No   421 (94.6%)24 (5.4%)How is your personal experience of using herbal medicine? (n=421)   o   Very good   o   Good   o   Fair    o   Bad   301 (71.5%)104 (24.7%)16(3.6%)0Did you ever experience any side effect with the use of herbal medicine? (n=421)   o   Yes   o    No   26 (5.8%)395 (88.8%) Have you started allopathic drugs first for your current disease before starting herbal drug? (n=421) o Yes, herbal drug then added when getting less improvement with allopathic drugs o    No, herbal drug was started earlier  o    No, both therapies were started together 175 (41.6%)218 (51.8%)28 (6.6%)How do your friends and Family react to your use of herbal medicine? o   They are encouraging o   They are discouraging o   They are not reacting o   They are getting afraid 351 (83.4%)11 (2.6%)50 (11.9%)9 (2.1%)Do you inform your doctor about your use of herbal medicine? (n=421)   o   Yes   o    No   249 (59%)173 (41%)When you inform your doctor about your use of herbal drug, what was his response? (n=249) o To continue o To stop223 (89.5%)26 (10.4%)   Original ArticleJSZMC Vol.8 No.31242 range were measured from available data. SPSS 16 was the version used for analysis of obtained data. RESULTS The mean age study subjects was 35±6 years. Male and female patients was 49 and 51 respectively being 63 married and 27 unmarried. Response rate was (83.6 ) most of the participants were from Medical OPD (27.2 ) while Cardiac, Diabetes, Surgery, ENT and others were 24.5 , 15.5 , 13.3 ,10.6 and 8.9 respectively. Urban participants were 83 while 17 were from the rural region. Regarding knowledge and use 93.7 of the patients were having awareness while 96 of the study population agreed their medicinal values with comments agree and strongly agree 69.7 and 26.7 respectively. (Table I) 61 of the subjects were of opinion that herbs are free from adverse effects. 74 of the population was agreeing to combine allopathic and herbal drugs together. (Table II) Table I: Patient s knowledge and attitude towards herbal medicines. (n=445) Male subjects were more familiar with herbs as compared to females. (P=0.024) Married subjects were considering herbal remedies safer in comparison to unmarried. (P=0.001) Males were found using more herbal products in comparison to female. (P=0.043) 94.6 of the surveyed subjects admitted that they used herbal medicines and had a good experience with that but 5.8 of them complained their bad experience of adverse effects with Table II. A large number of subjects (>52 ) admitted the use of herbal drugs prior the initiation of allopathic drugs. Parents (41 ) were recommending the herbal drug use along with the allopathic medicine upon less effective response. 59 did inform their physician about herbal medicine usage but majority 89 of doctors didn't stop them taking such herbal products. Only 5 of patients were taking such medicine under consultation from the certified persons (Hakeems) while others are advised by parents, grandparents, relatives and internet source 43 , 23 , 10 ,19 respectively. Table II: Patient s personal experience of herbal medicines usage DISCUSSION Herbal drugs are frequently used and popular in Alternative and Complementary medicine and have Question   N (%)Do you know about some herbs with medicinal usage?   o   Yes   o    No   417 (93.7%)28 (6.3%) Do you think herbal drugs have some value in treating diseases?   o   Strongly Agree   o   Agree   o   Disagree   o   Strongly disagree   o   Don’t know   310 (69.7%)119 (26.7%)9 (2%)2 (0.4%)5 (1.1%) Do you think herbal drugs are free of side effects?   o Strongly Agree o Agree o Disagree o Strongly disagree o Don’t know155 (34.8%)117 (26.3%)146 (32.8%)15 (3.4%)12(2.7%) Do you think combining herbal drugs with allopathic drugs will be useful in treating diseases? o Strongly Agree o Agree o Disagree o Strongly disagree o Don’t know180 (40.4)150 (33.7)64 (14.4)22 (4.9)29 (6.5)  Original ArticleJSZMC Vol.8 No.31243 more preference for use as compared to other strategies of CAM worldwide as shown by the 19 published evidence in past. The results of our current survey also depict the high level of knowledge (93.7 ), usage (94.6 ), of herbs in this region that is in accordance to previous work. Roselle, Pimpinella Anisum, Peppermint, alvia fruticosa , Fenugreek, Asafetida,   Nigella sativa and Myrrh are among the commonly used herbs. Hypertension, renal colic, constipation, diabetes, cough, diarrhea and menstrual disturbances were the conditions to be treated by herbal remedies in this Arab region of the globe as suggested by many 20,21 authors.Other parts of the world are also focusing on discovering new agents from the herbal medicine like clove has been explored for its numerous uses 22 including the hepato-protective effects. Clear contrast exists between our results and past literature revealing herbal remedies were more 19,23 commonly used by the female gender. Recent publications show herbs as well as other of alternative medicine are becoming more popular 23 in youngsters now a days. Our results (59 ) show some similarity to previous work carried out in Riyadh, KSA which tells that 50 of patients do not inform the health care practitioners about the 18 herbal use. This may result in severe drug interaction and 23 prove harmful and lethal for patients. Often physicians miss to ask for herbal use in their history taking session from patients. Our findings also support this observation showing that 90 of doctors did not recommend stopping herbal medicine despite knowing. This is probably due to the fact that physicians' knowledge regarding herbal and other forms of alternative medicine is not sufficient so they do not comment on herbal 20 medicine usage by their patients. Wassie SM et al in an Ethopian survey reported the incidence of adverse effects in 22.7 herbal users ranging from worsening of comorbidities to 24 fistula formation , bleeding and psychosis. A 5 of patients complained side effects. (Feeling of more Acidity, vomiting, itching and cough) in our results that lies in contrast to mentioned research. The increasing use of herbs needs proper rules and regulations under medical act after finalizing the drug developmental steps in animal and human models. Health departments are supposed to certify professionals for such practice. Well organized awareness campaigns in public, communities and media are required to be promoted by health services departments. Physicians, health care persons and medical students need to be trained and educated about common types of CAM or alternative 20,23 medicine including herbs. CONCLUSION Peoples of the Arar (Northern Region, Kingdom of Saudi Arabia) are well aware about herbs and their use as medicines is very high. This may result into a situation of drug reactions between allopathic drugs and the herbs resulting into decreased effectiveness of both or increasing the toxicity of either agent or even both. Conflict of Interest:  It is declared that the study was an Academic promotion for student research training and no funding and conflict assist among us. REFERENCES 1.   Tangkiatkumjai M, Boardman H, Praditpornsilpa K, Walker DM. Prevalence of herbal and dietary supplement usage in Thai outpatients with chronic kidney disease: a cross-sectional survey. BMC Complement Altern Med. 2013; 13:153.2.   Elolemy AT, Albedah AM. Public knowledge, attitude and practice of complementary and alternative medicine in Riyadh region, Saudi Arabia. Oman Med J. 2012 Jan; 27(1):20-6. 3.   Omeish AF, Abbadi W, Ghanma IM, Drabaa Z, Botoosh FA, Seif A, Massadeh M. Hospital-based study on the use of herbal medicine in patients with coronary artery disease in Jordan. J Pak Med Assoc. 2011 Jul; 61(7):683-7.4.   Khalaf AJ, Whitford DL. The use of complementary and alternative medicine by patients with diabetes mellitus in Bahrain: a cross-sectional study. BMC Complement Altern Med. 2010 Jul 14; 10:35-9.5.   Alkharfy KM. Community pharmacists' knowledge, attitudes and practices towards herbal remedies in Riyadh, Saudi Arabia. East Mediterr Health J. 2010 Sep; 16(9):988-93.6.   Fakeye TO, Adisa R, Musa IE. Attitude and use of herbal medicines among pregnant women in Nigeria. BMC Complement Altern Med. 2009 Dec 31; 9:53. 7.   Kashani L, Hassanzadeh E, Mirzabeighi A, Akhondzadeh S. Knowledge, attitude and practice of herbal remedies in a group of infertile couples. Acta Med Iran. 2013 Apr 6; 51(3):189-94.8.   Gawde SR, Shetty YC, Pawar DB. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: A cross-sectional study at a tertiary care hospital in India. Perspect Clin Res. 2013 Jul; 4(3):175-80. 9.   Onyeka TC, Ezike HA, Nwoke OM, Onyia EA, Onuorah EC, Anya SU, Nnacheta TE. Herbal medicine: a survey of use in Nigerian pre surgical patients booked for ambulatory anesthesia. BMC  Original ArticleJSZMC Vol.8 No.3  Complement Altern Med. 2012 Aug 20; 12:130.10.   Kuo GM, Hawley ST, Weiss LT, Balkrishnan R, Volk RJ. Factors associated with herbal use among urban multi ethnic primary care patients: a cross-sectional survey. BMC Complement Altern Med. 2004 Dec 2; 4:18-22.11.   Junaid R, Abaas M, Fatima B, Anis I, Hussain M. Attitude and practice of patients and doctors towards complementary and alternative medicine. J Pak Med Assoc. 2012 Aug; 62(8):865-8.12.   Al-Braik FA, Rutter PM, Hasan MY, Brown DT. Potential adverse reactions to herbal medicines in patients attending a nephrology clinic in Abu Dhabi, United Arab Emirates. Saudi Med J. 2011 Feb; 32(2):171-6.13.   Abdullah Al-Rowais N, Al Bedah AM, Khalil MK, El Olemy AT, Khalil AA, Alrasheid MH, Al Khashan H, Al Yousef M, Abdel Razak Ba Fart A. Knowledge and attitudes of primary health care physicians towards complementary and alternative medicine in the Riyadh region, Saudi Arabia. Forsch Komplement med. 2012; 19(1):7-1214.   Alkharfy KM. Community pharmacists' knowledge, attitudes and practices towards herbal remedies in Riyadh Saudi Arabia. East Mediterr Health J. 2010 Sep;16(9):988-993.15.   Al-Jaroudi DH. Beliefs of subfertile Saudi women. Saudi Med J. 2010 Apr; 31(4):425-427.16.   Al-Saeedi M, Elzubier AG, Bahnassi AA, Al-Dawood KM. Patterns of belief and use of traditional remedies by diabetic patients in Mecca, Saudi Arabia. East Mediterr Health J. 2003;9(12):99-107.17.   Kashani L1, Hassanzadeh E, Mirzabeighi A, AkhondzadehS. Knowledge, attitude and practice of herbal remedies in a group of infertile couples.Acta Med Iran. 2013 Apr 6; 51(3):189-194. 18.   Ahmed TawfikElolemy and Abdullah M.N. AlBedah. Public Knowledge, Attitude and Practice of Complementary and Alternative Medicine in Riyadh Region, Saudi Arabia. Oman Med J. 2012 Jan; 27(1): 20–26. 19.   AnasYounis Duraz and Shah Alam Khan. Knowledge, Attitudes and Awareness of Community Pharmacists towards the Use of Herbal Medicines in Muscat Region. Oman Med J. 2011 Nov; 26(6): 451–453.20.   Awad AI1, Al-Ajmi S, Waheedi MA. Knowledge, perceptions and attitudes toward complementary and alternative therapies among Kuwaiti medical and pharmacy students. Med PrincPract. 2012;21(4):50-421.   Wassie SM1, Aragie LL1, Taye BW2, Mekonnen LB. Knowledge, Attitude, and Utilization of Traditional Medicine among the Communities of Merawi Town, Northwest Ethiopia: A Cross-Sectional Study. Evid Based Complement Alternat Med. 2015:138073. doi: 10.1155/2015/138073. 22.   Sadia Kazi,Palwasha Abbasi, Ashique Ali. Syzygium aromaticum: A potential hepato-protective agent. JSZMC.2016;7(2):956-959.23.   Mohammed Abdullah Al Mansour, Abdullah MN Al- Bedah, Mohammed Othman AlRukban. Medical students' knowledge, attitude, and practice of complementary and alternative medicine: a pre-and post- exposure survey in Majmaah University, Saudi Arabia. Adv Med Educ Pract. 2015; 6: 407–420.24.   Wassie SM1, Aragie LL1, Taye BW2, Mekonnen LB. Knowledge, Attitude, and Utilization of Traditional Medicine among the Communities of Merawi Town, Northwest Ethiopia: A Cross-Sectional Study. Evid Based Complement Alternat Med. 2015:138073. doi: 10.1155/2015/138073. 1244 Article Citation:   Memon AR, Randhawa MA, Arain AA. Herbal medicine use: knowledge and attitude in  patients at tertiary care level in northern border region of Kingdom Saudi Arabia. JSZMC 2017;8(3): 1241-1244  
Related Search
Advertisements
Similar documents
View more...
Advertisements
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks