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Choi D, Im HB, Choi SJ, Han D. Safety classification of herbal medicine use among hypertensive patients: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1321523. [PMID: 38881876 PMCID: PMC11176523 DOI: 10.3389/fphar.2024.1321523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/27/2024] [Indexed: 06/18/2024] Open
Abstract
Background The use of herbal medicines (HMs) for the treatment of hypertension (HTN) is increasing globally, but research on the potential adverse effects and safety of HMs in HTN patients is limited. Therefore, this systematic review and meta-analysis aim to determine the global prevalence of HM usage among HTN patients and assess the safety of identified herbs based on current scientific evidence. Methods The PubMed/MEDLINE, EMBASE (Ovid), and Cumulated Index to Nursing and Allied Health Literature (CINAHL) databases were searched for cross-sectional studies on the use of HM among HTN patients. Our review includes studies published in English up to the year 2023. After extracting and appraising the data from the studies, a meta-analysis was conducted using the Stata version 16.0 to estimate the pooled prevalence of HM use in patients with HTN (PROSPERO: CRD42023405537). The safety classification of the identified HM was done based on the existing scientific literature. Results This study analyzed 37 cross-sectional studies from 21 countries and found that 37.8% of HTN patients used HM to manage their health. The prevalence of HM use varied significantly based on publication year and geographical region. Among the 71 identified herbs, Allium sativum L., Hibiscus sabdariffa L., and Olea europaea L. were the most commonly used. However, four herbs were identified as contraindicated, 50 herbs required caution, and only 11 herbs were considered safe for use. Conclusion The study highlights the potential risks of toxicities and adverse effects associated with HM use in the treatment of HTN. Ensuring patient safety involves using safe HMs in appropriate doses and avoiding contraindicated HMs. Future research should focus on identifying commonly used herbs, especially in resource-limited countries with poor HTN management, and additional clinical research is required to assess the toxicity and safety of commonly used HMs.
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Affiliation(s)
- Dain Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
| | - Hyea Bin Im
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
| | - Soo Jeung Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
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Maduka NR, Okubor OP. Prevalence and Predictors for use of Herbal medicine in the treatment of Infertility in a secondary Health facility in South-South Nigeria. Niger Med J 2024; 65:255-265. [PMID: 39022570 PMCID: PMC11249478 DOI: 10.60787/nmj-v65i3-402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Infertility is one of the major medical problems seen in the Gynaecology clinic. Herbal medicine (HM) has become one of the treatment options used to circumvent infertility problems. This study aims to explore the prevalence and predictors for HM use in the management of infertility in our region. Methodology The method used was a cross-sectional study of 117 women attending the infertility clinic at Central Hospital Agbor, Delta State, Nigeria. The interviewer administered a questionnaire comprised of socio-demographic characteristics, infertility-related aspects, and information on herbal medicine usage. The main outcome measure was the Prevalence of HM use for infertility treatment and the possible predictors. Analysis was done using SPSS version 22. Results The mean age of participants was 34.1 with a standard deviation of 6.66 years. The minimum age of participants was 23 years while the maximum age was 48 years. The prevalence of HM use was 79.9%. The factors that were significantly associated with the use of HM were marital status (p 0.033), history of primary infertility (0.026) and having used HM for the management of other ailments (0.000). Women who were married and having fertility issues were more likely to seek alternative methods like the use of HM. Conclusion The prevalence of use of HM among participants attending the fertility clinic was high at 79.9%. We recommend that health professionals should enquire about the use of HM as this may help in educating the patients about the health risks of using HM. There is a need to explore the potential benefits and risks of HM use.
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Affiliation(s)
- Ngozi Roy Maduka
- Department of Obstetrics and Gynaecology,Central Hospital Agbor, Delta State, Nigeria
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Suciu M, Vlaia L, Boujneh E, Suciu L, Buda VO, Jianu N, Vlaia V, Cristescu C. Prevalence and Determinants of Self-Medication Practices among Cardiovascular Patients from Béja, North West Tunisia: A Community-Pharmacy-Based Survey. PHARMACY 2024; 12:68. [PMID: 38668094 PMCID: PMC11054241 DOI: 10.3390/pharmacy12020068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/30/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
In Tunisia, self-medication is a common practice, and there is a continual rise in the prevalence of cardiovascular disease. Given the lack of data on the self-medication practices (SMPs) among cardiovascular patients in this area, the present study aimed to identify the prevalence and determinants of SMPs among cardiovascular patients in the city of Béja. A community-pharmacy-based survey was conducted among selected cardiovascular patients in Béja, Tunisia, from May 2021 to June 2021. Data were collected using a self-administered questionnaire provided by pharmacists during in-person surveys with patients. Descriptive statistics were used to summarize the data, while Fisher's exact test was used for categorical variables, with the significance level set at p < 0.05. The frequency of self-medication among the 150 respondents was 96%; 70.14% of participants reported that the primary reason why people engage in self-medication is the existence of an old prescription. The most prevalent conditions leading patients to self-medicate were headaches (100%), fever (83.33%), toothache (65.97%), and dry cough (47.92%). The most frequently self-administered drugs were paracetamol (100%), antibiotics (56.94%), and antitussives (47.92%). The results of our study indicate that SMPs among Tunisian cardiovascular patients have a high prevalence. With this in mind, healthcare practitioners should ask their patients about their self-medication practices and advise cardiovascular patients about the risks and benefits associated with this practice.
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Affiliation(s)
- Maria Suciu
- Department II—Pharmacology-Pharmacotherapy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (M.S.); (L.S.); (C.C.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Lavinia Vlaia
- Department II—Pharmaceutical Technology, Formulation and Technology of Drugs Research Center, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Eya Boujneh
- Tunisian Pharmacist, Abdellatif Boujnah Pharmacy, Avenue Mongi Slim, Béja 9000, Tunisia;
| | - Liana Suciu
- Department II—Pharmacology-Pharmacotherapy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (M.S.); (L.S.); (C.C.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Valentina Oana Buda
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
- Department I—Clinical Pharmacy, Communication in Pharmacy, Pharmaceutical Care, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
| | - Narcisa Jianu
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
- Department I—Clinical Pharmacy, Communication in Pharmacy, Pharmaceutical Care, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
| | - Vicențiu Vlaia
- Organic Chemistry, Formulation and Technology of Drugs Research Center, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania;
| | - Carmen Cristescu
- Department II—Pharmacology-Pharmacotherapy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania; (M.S.); (L.S.); (C.C.)
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Iddrisu M, Doat AR, Abdulai AM, Wuni A. They patronize herbal medicine, coincidence or planned behaviour: A case of hypertensive patients in Tamale? Nurs Open 2023. [PMID: 37060167 DOI: 10.1002/nop2.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/08/2023] [Accepted: 03/24/2023] [Indexed: 04/16/2023] Open
Abstract
AIM This study assessed, if use of herbal medicine (HM) among hypertensive patients is coincidence or planned. DESIGN Cross-sectional survey. METHODS The study used a cross-sectional survey for collection of data from four (4) herbal medicine clinics in the Tamale metropolis in northern Ghana. RESULTS The final or overall regression model was significant at R2 = 0.350, F(7, 214) = 16.464, p < 0.001. No sociodemographic characteristic predicted herbal medicine use. Only religion and educational level were associated with herbal medicine use. Attitude (p = 0.002), subjective norms (p = 0.001) and behavioural intention (p = 0.000) significantly predicted HM use. PUBLIC CONTRIBUTION Data were collected from respondents only after they had verbally given free and informed consent to take part in the study. The results of this study therefore showed that herbal medicine use among these patients is not coincidence but planned. Health professionals by this study should appreciate the effect of religion and educational background in their health education on Herbal Medicines.
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Affiliation(s)
| | - Abdul Razak Doat
- Department of Nursing, School of Nursing and Midwifery, CK Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | | | - Abubakari Wuni
- Nursing and Midwifery Training College, Tamale, Ghana
- Department of medicine for the elderly, Cambridge University Hospital's NHS Foundation, Adddenrookes Hospital, Cambridge United Kingdom, Cambridge, United Kingdom
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Amissah-Arthur MB, Gyaban-Mensah A, Boima V, Yorke E, Dey D, Ganu V, Mate-Kole C. Health-seeking behaviour, referral patterns and associated factors among patients with autoimmune rheumatic diseases in Ghana: A cross-sectional mixed method study. PLoS One 2022; 17:e0271892. [PMID: 36094929 PMCID: PMC9467363 DOI: 10.1371/journal.pone.0271892] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background Challenges exist in the diagnosis and management of autoimmune rheumatic diseases in low and middle income countries due to factors, such as poverty and under-resourced healthcare infrastructure. Furthermore, other contributory factors such as societal, cultural and religious practices influence health seeking behaviour which has a bearing on access and delivery of healthcare. Objectives To examine the health seeking behaviour and referral patterns of Ghanaian patients with autoimmune rheumatic diseases and assess the associated factors that influence these. Method A cross-sectional study using an explanatory sequential mixed method design was carried out in a Rheumatology clinic at a national referral centre. 110 participants were purposively recruited for the quantitative phase. The qualitative phase comprised 10 participants for in-depth interviews and 10 participants for a focus group discussion. Analysis using descriptive statistics, t-tests and logistic regression models were performed. Transcripts generated from the interviews and focused group discussion were analysed using thematic analysis. Results Median duration from onset of symptoms until seeking help was 1 week (IQR = 12); from seeking help until obtaining a final diagnosis was 12 months (IQR = 33). Multiple factors determined the choice of first facility visited, X2 (12, N = 107) = 32.29, p = .001. Only twenty-one participants (19.6%) had knowledge of their disease prior to diagnosis. Education predicted prior knowledge [OR = 2.6 (95% CI = .66–10.12), p < .021]. Unemployed participants had increased odds of seeking help after a month compared to those who were employed [Odds ratio = 2.60 (95% CI = 1.14–5.90), p = .02]. Knowledge of autoimmune rheumatic diseases was low with multiple causative factors such as biomedical, environmental and spiritual causes determining where patients accessed care. Forty (36.4%) participants utilised complementary and alternative treatment options. Conclusion We observed that knowledge about autoimmune rheumatic diseases among Ghanaian patients was low. Patients sought help from numerous medical facilities, traditional healers and prayer camps often contributing to a delay in diagnosis for most patients. This was influenced by individual perceptions, cultural beliefs and socioeconomic status. Active awareness and educational programmes for the public and healthcare workers are required, as well as strategic planning to integrate the biomedical and traditional care services to enable earlier presentation, accurate diagnosis and better clinical outcomes for the patients.
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Affiliation(s)
- Maame-Boatemaa Amissah-Arthur
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
- * E-mail:
| | | | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Ernest Yorke
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Dzifa Dey
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Vincent Ganu
- Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Charles Mate-Kole
- Department of Psychiatry, Korle Bu Teaching Hospital, Accra, Ghana
- Center for Ageing Studies, College of Humanities, University of Ghana, Legon, Ghana
- Department of Psychology, College of Humanities, University of Ghana, Legon, Ghana
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Lee EKP, Poon P, Yip BHK, Bo Y, Zhu MT, Yu CP, Ngai ACH, Wong MCS, Wong SYS. Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta-Analysis Involving 27 Million Patients. J Am Heart Assoc 2022; 11:e026582. [PMID: 36056737 PMCID: PMC9496433 DOI: 10.1161/jaha.122.026582] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Nonadherence to antihypertensive medications is the leading cause of poor blood pressure control and thereby cardiovascular diseases and mortality worldwide. Methods and Results We investigated the global epidemiology, regional differences, and trend of antihypertensive medication nonadherence via a systematic review and meta‐analyses of data from 2010 to 2020. Multiple medical databases and clinicaltrials.gov were searched for articles. Observational studies reporting the proportion of patients with anti‐hypertensive medication nonadherence were included. The proportion of nonadherence, publication year, year of first recruitment, country, and health outcomes attributable to antihypertensive medication nonadherence were extracted. Two reviewers screened abstracts and full texts, classified countries according to levels of income and locations, and extracted data. The Joanna Briggs Institute prevalence critical appraisal tool was used to rate the included studies. Prevalence meta‐analyses were conducted using a fixed‐effects model, and trends in prevalence were analyzed using meta‐regression. The certainty of evidence concerning the effect of health consequences of nonadherence was rated according to Grading of Recommendations, Assessment, Development and Evaluations. A total of 161 studies were included. Subject to different detection methods, the global prevalence of anti‐hypertensive medication nonadherence was 27% to 40%. Nonadherence was more prevalent in low‐ to middle‐income countries than in high‐income countries, and in non‐Western countries than in Western countries. No significant trend in prevalence was detected between 2010 and 2020. Patients with antihypertensive medication nonadherence had suboptimal blood pressure control, complications from hypertension, all‐cause hospitalization, and all‐cause mortality. Conclusions While high prevalence of anti‐hypertensive medication nonadherence was detected worldwide, higher prevalence was detected in low‐ to middle‐income and non‐Western countries. Interventions are urgently required, especially in these regions. Current evidence is limited by high heterogeneity. Registration URL: www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021259860.
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Affiliation(s)
- Eric K P Lee
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Paul Poon
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Benjamin H K Yip
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Meng-Ting Zhu
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Chun-Pong Yu
- Li Ping Medical Library The Chinese University of Hong Kong Shatin Hong Kong
| | - Alfonse C H Ngai
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care The Chinese University of Hong Kong Shatin Hong Kong
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Lassale C, Gaye B, Diop IB, Mipinda JB, Kramoh KE, Kouam Kouam C, Ikama MS, Takombe JL, Damorou JM, Toure IA, Balde DM, Dzudie A, Houenassi M, Kane A, Kimbally-Kaki SG, Kingue S, Limbole E, Mfeukeu Kuate L, Ferreira B, Nhavoto C, Sidy Ali A, Azizi M, N'Guetta R, Antignac M, Jouven X. Use of traditional medicine and control of hypertension in 12 African countries. BMJ Glob Health 2022; 7:bmjgh-2021-008138. [PMID: 35654446 PMCID: PMC9163537 DOI: 10.1136/bmjgh-2021-008138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Use of traditional medicine (TM) is widespread in sub-Saharan Africa as a treatment option for a wide range of disease. We aimed to describe main characteristics of TM users and estimate the association of TM use with control of hypertension. Methods We used data on 2128 hypertensive patients of a cross-sectional study (convenience sampling), who attended cardiology departments of 12 sub-Saharan African countries (Benin, Cameroon, Congo, Democratic Republic of the Congo, Gabon, Guinea, Côte d’Ivoire, Mauritania, Mozambique, Niger, Senegal, Togo). To model association of TM use with odds of uncontrolled, severe and complicated hypertension, we used multivariable mixed logistic regressions, and to model the association with blood pressure (systolic (SBP) and diastolic (DBP)) we used mixed linear models. All models were adjusted for age, sex, wealth, adherence to hypertension conventional treatment and country (random effect). Results A total of 512 (24%) participants reported using TM, varying across countries from 10% in the Congo to 48% in Guinea. TM users were more likely to be men, living in rural area, poorly adhere to prescribed medication (frequently due to its cost). Use of TM was associated with a 3.87 (95% CI 1.52 to 6.22)/1.75 (0.34 to 3.16) mm Hg higher SBP/DBP compared with no use; and with greater odds of severe hypertension (OR=1.34; 95% CI 1.04 to 1.74) and of any hypertension complication (OR=1.27; 95% CI 1.01 to 1.60), mainly driven by renal complication (OR=1.57; 95% CI 1.07 to 2.29) after adjustment for measured confounders. Conclusions The use of TM was associated with higher blood pressure, more severe hypertension and more complications in Sub-Saharan African countries. The widespread use of TM needs to be acknowledged and worked out to integrate TM safely within the conventional healthcare.
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Affiliation(s)
- Camille Lassale
- Cardiovascular Epidemiology and Genetics, Hospital del Mar Medical Research Institute IMIM, Barcelona, Spain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Bamba Gaye
- Paris Cardiovascular Research Centre, INSERM U970, Université de Paris, Paris, France
- Cardiology department, University Hospital of Fann, Dakar, Senegal
- African Research Network, Dakar, Senegal
- Laboratoire de Physiologie et Explorations Fonctionnelles, Université Cheikh Anta Diop, Dakar, Senegal
| | | | - Jean Bruno Mipinda
- Cardiology department, Libreville University Hospital Center, Libreville, Komo-Mondah, Gabon
| | | | | | - Méo Stéphane Ikama
- Cardiology Department, National University Hospital of Brazzaville, Marien NGouabi University, Brazzaville, Congo
| | - Jean Laurent Takombe
- Department of Internal Medicine of la Gombe, Ngaliema Hospital, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Ibrahim Ali Toure
- Internal Medicine and Cardiology Department, University Hospital of Lamorde Niamey University, Niamey, Niger
| | - Dadhi M Balde
- Department of Cardiology, University Hospital of Conakry, Conakry, Guinea
| | - Anastase Dzudie
- Cardiac Intensive Car & Cardiac Pacing Unit, Douala General Hospital, Douala, Cameroon
| | | | - Abdoul Kane
- Cardiology Department, University Hospital of Aristide Le Dantec, Dakar, Senegal
| | - Suzy Gisèle Kimbally-Kaki
- Cardiology Department, National University Hospital of Brazzaville, Marien NGouabi University, Brazzaville, Congo
| | - Samuel Kingue
- University of Yaoundé, Ministry of Public Health, Yaoundé, Cameroon
| | - Emmanuel Limbole
- Department of Internal Medicine of la Gombe, Ngaliema Hospital, Kinshasa, Congo (the Democratic Republic of the)
- Cardiology Department, University of Kinshasa Faculty of Medicine, Kinshasa, Congo (the Democratic Republic of the)
| | - Liliane Mfeukeu Kuate
- Internal Medecine Department, Regional Hospital, Bafoussam, Cameroon
- Cardiology Department, Central Hospital of Yaounde, Yaounde, Cameroon
| | | | | | | | - Michel Azizi
- Hypertension unit, Georges Pompidou European Hospital, AP-HP Centre, Paris, France
- INSERM, Centre d'Investigation Clinique 1418, Paris, France
- Cardiovascular Epidemiology Department, Université de Paris, Paris, France
| | | | - Marie Antignac
- Paris Cardiovascular Research Centre, INSERM U970, Université de Paris, Paris, France
- Department of Pharmacy, St Antoine Hospital, AP-HP Sorbonne Université, Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Centre, INSERM U970, Université de Paris, Paris, France
- Cardiovascular Epidemiology Department, Université de Paris, Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, Paris, France
- Paris-Sudden Death Expertise Center, Paris, France
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Botchway M, Davis RE, Appiah LT, Moore S, Merchant AT. The Influence of Religious Participation and Use of Traditional Medicine on Type 2 Diabetes Control in Urban Ghana. JOURNAL OF RELIGION AND HEALTH 2022; 61:1966-1979. [PMID: 33517523 DOI: 10.1007/s10943-021-01187-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
This study examined whether the frequency of participation in religious activities and seeking care from spiritual and other traditional medicine (TM) practitioners were associated with blood glucose (HbA1c) control among urban Ghanaians with type 2 diabetes mellitus (T2DM). Findings revealed that increased frequency of participation in religious activities was significantly associated with decreased HbA1c levels, whereas increased use of TM practitioners was significantly associated with increased HbA1c levels. These findings suggest that strategically integrating religious activities into disease management plans for Ghanaians with T2DM who identify as being religious may be a viable intervention mechanism.
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Affiliation(s)
- Marian Botchway
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- Eck Institute for Global Health, University of Notre Dame, 4143 Jenkins and Nanovic Halls, Notre Dame, IN, 46556, USA.
| | - Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Lambert T Appiah
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Spencer Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Health & Society Group, Wageningen University & Research, De Leeuwenborch, Hollandseweg 1, 6707, KN, Wageningen, Netherlands
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Nakwafila O, Mashamba-Thompson T, Godi A, Sartorius B. A Cross-Sectional Study on Hypertension Medication Adherence in a High-Burden Region in Namibia: Exploring Hypertension Interventions and Validation of the Namibia Hill-Bone Compliance Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4416. [PMID: 35410095 PMCID: PMC8998252 DOI: 10.3390/ijerph19074416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/17/2022]
Abstract
In Namibia, the prevalence of hypertension among women and men aged 35−64 years is high, ranging from 44% to 57%. In this study, we aimed to determine adherence and predictors to antihypertensive therapy in Khomas region, Namibia. A cross-sectional study was performed to consecutively sample 400 patients from urban and peri-urban settings in Namibia. Results were validated using the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Crude associations between predictors of adherence and compliance were tested using the Pearson chi-square test. A multivariable logistic regression analysis was then performed on adherence variables found to be significant to adjust for confounders, and the results are presented as adjusted odds ratios (aOR) with 95% confidence intervals. A total of 400 patients participated in this study. The participants’ mean age and standard deviation were Mean ± SD = 48.9 ± 12.5. In this study, 351 (87.7%) patients were estimated to have good adherence. Education, employment, and the presence of other chronic diseases were associated with adherence. Following multivariate adjustment, the following factors were significantly associated and are therefore predictors of adherence (95%CI, p < 0.005): receiving enough medication at last check-up until next one (OR = 5.44, CI 1.76−16.85), lack of encouragement from family and friends (OR = 0.11 (0.03−0.42)), and attendance of follow-ups on schedule (OR = 8.49, CI = 3.82−18.85). The success of hypertension therapy is dependent on the healthcare systems and healthcare professionals in supplying enough medication, support of friends/family, and maintaining scheduled follow-ups. A combination of interventions using low-cost mobile technology led by healthcare professionals could be endorsed. To fully practice universal access to medication, public and private hospitals in Namibia should collaborate.
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Affiliation(s)
- Olivia Nakwafila
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa; (T.M.-T.); (B.S.)
- Department of Public Health, University of Namibia, Oshakati 15001, Namibia
| | - Tivani Mashamba-Thompson
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa; (T.M.-T.); (B.S.)
- Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Anthony Godi
- Department of Biostatistics, University of Ghana, Accra P.O. Box LG 13, Ghana;
| | - Benn Sartorius
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa; (T.M.-T.); (B.S.)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK
- Department of Health Metrics Sciences, University of Washington, Seattle, WA 98195, USA
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10
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Aferu T, Mamenie Y, Mulugeta M, Feyisa D, Shafi M, Regassa T, Ejeta F, Hammeso WW. Attitude and practice toward traditional medicine among hypertensive patients on follow-up at Mizan–Tepi University Teaching Hospital, Southwest Ethiopia. SAGE Open Med 2022; 10:20503121221083209. [PMID: 35310931 PMCID: PMC8928343 DOI: 10.1177/20503121221083209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/08/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Traditional medicine has been used for the management of common mild conditions such as headache, diarrhea, and common cold as well as in the treatment of chronic diseases including hypertension. The usage of this medicine is regarded as acceptably safe with most Ethiopian people. Attitude and practices toward traditional medicine are crucial elements of hypertension control and its favorable outcome expectation. This study aimed at assessing the attitude and practice toward traditional medicine among hypertensive patients on follow-up at Mizan–Tepi University Teaching Hospital, Southwest Ethiopia. Method: Facility-based cross-sectional study was conducted from 1st December 2020 to 30th December 2020 among 173 hypertensive patients. A consecutive sampling technique was used to select study participants. Data were collected through interviewer-administered structured questionnaire and analyzed using Statistical Package for the Social Sciences software version 23. Multivariable logistic regression analysis was done to identify the independent predictors of patients’ attitude toward traditional medicine and their traditional medicine use at a p value ⩽0.05. Results: Eighty-seven (50.29%) of the total 173 approached patients were found to have good attitude toward traditional medicine. Ninety-seven (56.07%) participants had used traditional medicine at least once in their lifetime and 45 (46.39%) patients used traditional medicine and modern medicine concomitantly. Participants’ residence (adjusted odds ratio = 2.79, confidence interval = 1.01–7.74, p-value = 0.049) and educational status (adjusted odds ratio = 1.76, confidence interval = 1.61–5.09, p-value = 0.032) had significant association with attitude toward traditional medicine, while patients’ age (adjusted odds ratio = 1.43, confidence interval = 1.32–4.96, p-value = 0.039), residence (adjusted odds ratio = 2.18, confidence interval = 1.10–4.32, p-value = 0.025), and occupation (adjusted odds ratio = 3.38, confidence interval = 1.55–7.38, p-value = 0.002) had significant association with their traditional medicine use. Conclusion: Half of the study participants had good attitude toward traditional medicine, and nearly, one-fourth of the participants had practiced traditional medicine along with modern medicine. Health service providers should be aware of traditional medicine use and advise patients on the dosing of traditional medicine.
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Herb-drug interactions: Perception and revelations of nurses in primary healthcare clinics, South Africa. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Is the Association between Herbal Use and Blood-Pressure Control Mediated by Medication Adherence? A Cross-Sectional Study in Primary Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412916. [PMID: 34948526 PMCID: PMC8702107 DOI: 10.3390/ijerph182412916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/23/2022]
Abstract
Herbs have been used worldwide for many health conditions as an alternative treatment, including hypertension. Their use might affect the use of conventional medications, as well as blood-pressure control. This study aims to determine whether the potential associations between herb use and high blood pressure in hypertensive patients was mediated by medication adherence. A cross-sectional study was conducted using questionnaires and available medical databases at a primary care clinic of a tertiary hospital in Chiang Mai, Thailand. The data were collected from 450 patients with essential hypertension. Drug adherence was assessed by the Morisky Green Levine Medication Adherence Scale. The history of herbs used in the past three months was obtained. The goal of controlled blood pressure was defined in accordance with the Thai guidelines on the treatment of hypertension. Of the total 450 patients, 42% had high adherence. Nearly 18% reported herb use in the past three months. High medication adherence was strongly associated with blood-pressure control when adjusted for age, gender, education, the presence of comorbidities, and herb use (aOR 26.73; 95% CI 8.58–83.23; p < 0.001). The association between herb use and blood-pressure control did not achieve statistical significance (p = 0.143). However, the adjusted odds ratio of the association between herb use and blood-pressure control was diluted from 0.67 to 0.83 when adding the factor of medication adherence to the model. In conclusion, herb use was associated with poor medication adherence, which was in turn associated with poor blood-pressure control. Assessing this information contributes to appropriate exploration and counseling.
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Kifle ZD, Yimenu DK, Kidanu BB. Complementary and alternative medicine use and its associated factors among hypertensive patients in Debre Tabor General Hospital, Ethiopia. Metabol Open 2021; 12:100132. [PMID: 34632358 PMCID: PMC8493576 DOI: 10.1016/j.metop.2021.100132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hypertensive patients have been using complementary and alternative medicine (CAM) to meet their primary healthcare needs within Ethiopia. The use of plant-based medicine is not only common rather it is also a culturally accredited practice, among the people of Ethiopia. However, studies conducted on the prevalence and correlates of herbal medicine (HM) use among hypertensive patients are lacking. Thus, this study aimed to assess CAM use and its associated factors among hypertensive patients. METHODS An institutional-based cross-sectional study was conducted on 450 hypertensive patients, visiting the hypertensive care service of Debre Tabor General Hospital from November 1 to December 28, 2020. Interview-guided self-administered questionnaires were used for data collection. Statistical Package for the Social Sciences (SPSS) software version 24.0 was used for data analysis. Univariate and multivariate logistic regression was computed to identify associated factors of CAM use (age, sex, religion, residence, marital status, educational level, monthly income, presence of HTN complication, duration of HTN, and family history of HTN). RESULTS Out of the 450 hypertensive patients, 275 (67.8%) participants used complementary and alternative medicine. Herbal medicines used among hypertensive patients were M. stenoptela 105 (62.9%), O. lamiifolium 81 (48.5%), C. aurea 62 (37.1%), R. nepalensis 44 (26.3%), M. piperata 36 (21.6%), H. abyssinica 24 (14.4%), T. schimperi 19 (11.4%), R. abyssinicus 15 (9.0%), and T. foenumgraecum 9 (5.4%). Majority of CAM users 202 (73.5) did not discuss with health professionals about their CAM use. Families and friends 91 (33.1%) were the frontline source of information about CAM use. In a multivariate analysis, female gender patients over 45 years old, rural residence, higher educational level, high average monthly income, presence of complications, greater than 5 years duration of hypertension (HTN), and having a family history of HTN were the independent predictors of CAM use. CONCLUSION The prevalence of CAM use among hypertensive patients was high 275 (67.8%). Factors associated with CAM use are similar to those observed in previous studies, but further research is required to further clarify the opportunities and challenges correlated to CAM use in Ethiopia.
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Affiliation(s)
- Zemene Demelash Kifle
- University of Gondar, College of Medicine and Health Sciences, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia
| | - Dawit Kumilachew Yimenu
- University of Gondar, College of Medicine and Health Sciences, School of Pharmacy, Department of Pharmaceutics and Social Pharmacy, Gondar, Ethiopia
| | - Birhanu Berihun Kidanu
- University of Gondar, College of Veterinary Medicine and Animal Sciences, Department of Veterinary Pharmacy, Gondar, Ethiopia
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Kretchy IA, Boadu JA, Kretchy JP, Agyabeng K, Passah AA, Koduah A, Opuni KFM. Utilization of complementary and alternative medicine for the prevention of COVID-19 infection in Ghana: A national cross-sectional online survey. Prev Med Rep 2021; 24:101633. [PMID: 34777985 PMCID: PMC8575551 DOI: 10.1016/j.pmedr.2021.101633] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/28/2021] [Accepted: 11/07/2021] [Indexed: 12/24/2022] Open
Abstract
82.5% of all participants reported CAM use during the COVID-19 pandemic period. 69.1% of CAM users intended it for COVID-19 infection prevention. Commonly used CAM include vitamins, spiritual healing/prayer, minerals and herbals. Age, sex and COVID-19 illness perception significantly predicted CAM use.
Complementary and alternative medicine (CAM) use is widespread and has played critical roles in preventing infections, including previous coronaviruses. This study sought to document current practices in the use of CAM for the prevention of COVID-19 disease in Ghana. An anonymous electronic survey was conducted from February 1, 2021 to April 30, 2021. Data on demographic characteristics, basic clinical information, illness perceptions about COVID-19, and CAM use during the pandemic period were generated. While about 82.5% (986/1195) of the participants used CAM during the COVID-19 period, 69.1% (681/986) of CAM users intented it for COVID-19 infection prevention. Vitamin supplements (88.1%, 869/986), spiritual healing/prayer (23.3%, 230/986), mineral supplements (22.3%, 220/986), botanical/herbal medicines (22.2%, 219/986), and diet therapy (19.4%, 191/986) were the main types of CAM used. From the adjusted binary logistic regression model, current age (aOR: 1.03, 95%CI: 1.01–1.05), sex (aOR: 1.41, 95%CI: 1.02–1.95), participants’ perceptions of consequences (aOR: 1.10, 95%CI: 1.04–1.17), identity (aOR: 1.15, 95%CI: 1.06–1.25) and concerns about COVID-19 (aOR: 0.91, 95%CI: 0.85–0.97) were statistically significant predictors of CAM use. These results suggest the need for appropriate public health policy on COVID-19 and CAM use in addition to directing further research initiatives toward an optimized COVID-19 prevention scheme using clinically validated CAM treatments. Research to validate the clinical efficacy of these products, especially the herbs, for COVID-19 prevention while isolating lead compounds that could be optimized and used for the treatment and prevention of COVID-19 is also recommended.
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Affiliation(s)
- Irene A Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Joseph A Boadu
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - James-Paul Kretchy
- Department of Physician Assistantship Studies, School of Medicine and Health Sciences, Central University, Miotso, Accra, Ghana
| | - Kofi Agyabeng
- Department of Mathematics, KU Leuven, Leuven, Belgium
| | - Alfred A Passah
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Kwabena F M Opuni
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
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Joachimdass RJ, Subramaniam K, Sit NW, Lim YM, Teo CH, Ng CJ, Yusof AS, Loganathan A. Self-management using crude herbs and the health-related quality of life among adult patients with hypertension living in a suburban setting of Malaysia. PLoS One 2021; 16:e0257336. [PMID: 34506588 PMCID: PMC8432735 DOI: 10.1371/journal.pone.0257336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/28/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine the prevalence of crude herbs' use in the self-management of hypertension and the health-related quality of life (HRQOL) in patients with hypertension. METHODS This cross-sectional study was performed among patients with hypertension attending a government health clinic. Socio-demographic characteristics, lifestyle modifications, medical history and predictors of crude herbs users were obtained. The diversity of crude herbs used was assessed using a modified international complementary and alternative medicine questionnaire (I-CAM-Q) and the HRQOL was assessed using the SF36 instrument. RESULTS Out of the 294 patients recruited, 52.4% were female, 41.5% were Malay and 38.8% were within the 60 to69 age category. The prevalence of crude herbs users was 30.6% and the most common herbs used were pegaga (Centella asiatica), peria (Momordica charantia) and betik (Carica papaya). Using the regression analysis, significantly higher odds of using crude herbs are noted among Malay or Indian patients who have these characteristics: attained secondary education, experienced falls or muscle pain, and had systolic blood pressure of more than 140 mmHg. There was no significant difference in HRQOL domains between the crude herb users and non-users (p>0.05). CONCLUSION Besides taking allopathic medications, certain patients with hypertension use crude herbs as a form of self-management. Although patients are adamant about integrating crude herbs as a form of self-management, the effects of doing so have not been properly investigated. This implies that the healthcare staff members need to communicate with the patients regarding the use of crude herbs together with conventional drugs.
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Affiliation(s)
| | | | - Nam Weng Sit
- Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Yang Mooi Lim
- Department of Pre-Clincal Science, Universiti Tunku Abdul Rahman, Sungai Long, Malaysia
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Chin Hai Teo
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Sanuade OA, Dodoo FNA, Koram K, de-Graft Aikins A. Explanatory models of stroke in Ghana: perspectives of stroke survivors and their caregivers. ETHNICITY & HEALTH 2021; 26:697-719. [PMID: 30922062 DOI: 10.1080/13557858.2018.1557116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
Objective: This study examines explanatory models (EMs) of stroke and its complications among people living with stroke, and their caregivers, in two urban poor communities in Accra (Ga Mashie) and Korle Bu Teaching Hospital (KBTH), Accra.Methods: Twenty-two stroke survivors and 29 caregivers were recruited from 2 urban poor communities in Accra and KBTH. Qualitative data were obtained using semi-structured interviews that lasted between 45 minutes and 2 hours. The interviews were audiotaped, transcribed and analysed thematically, informed by the concept of EMs of illness.Results: Participants referred to stroke as a sudden event and they expressed different emotional responses after the stroke onset. Stroke survivors and their caregivers attributed stroke with poor lifestyle practices, high blood pressure, unhealthy diet and dietary practices, supernatural causes, stress, family history, other chronic diseases, and delay in treatment of symptoms. While the stroke survivors associated stroke complications with physical disability and stigmatisation, the caregivers associated these with physical disability, behavioural and psychological changes, cognitive disability and death. These associations were mostly influenced by the biomedical model of stroke.Conclusion: The biomedical model of stroke is important for developing interventions that will be accepted by the stroke survivors and the caregivers. Nevertheless, sociocultural explanations of stroke need to be taken into consideration during delivery of medical information to the participants. This study proposes an integrated biopsychosociocultural approach for stroke intervention among the study participants.
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Affiliation(s)
| | | | - Kwadwo Koram
- The Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
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Azizah N, Halimah E, Puspitasari IM, Hasanah AN. Simultaneous Use of Herbal Medicines and Antihypertensive Drugs Among Hypertensive Patients in the Community: A Review. J Multidiscip Healthc 2021; 14:259-270. [PMID: 33568913 PMCID: PMC7868580 DOI: 10.2147/jmdh.s289156] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022] Open
Abstract
In various countries, approximately 80% of patients use herbal medicine, both in single form or in combination with antihypertensive drugs, for the treatment of hypertension. Therefore, this research summarized studies on the simultaneous use of herbal medicines and antihypertensive drugs among hypertensive patients in the community. A literature search was conducted on PubMed in April 2020, and the following keywords were used: “herbal medicines” and “antihypertensive patients.” In total, 15 of 263 articles were found to be eligible in the initial research. Results showed that studies were performed in different countries worldwide including America and those in Europe, Asia, and Africa between 1960 and 2020. The factors associated with the use of herbal medicines and antihypertensive drugs were age, gender, education level, income, and residence. Herbal medicines and antihypertensive drugs are simultaneously utilized primarily due to their safety and high efficacy. Herbal medicine is frequently recommended by friends or colleagues, herbalists, advertisements, and health workers. Garlic is the most common herbal medicine used along with antihypertensive drugs. The side effects of combination therapy with herbal medicines and prescription drugs for the management of antihypertension include shortness of breath and cough, ulcers, diarrhea, knee cramps, and abdominal discomfort. The lack of communication between patients and health care workers could cause an increase in the simultaneous use of herbal medicines and antihypertensive drugs. Therefore, effective communication among health care workers and appropriate care are important in preventing the side effects and other risks of combined therapy.
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Affiliation(s)
- Nur Azizah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia.,Muhammadiyah Kuningan Institute of Health Science, Cigugur-Kuningan, West Java, 45551, Indonesia
| | - Eli Halimah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Aliya Nur Hasanah
- Department of Pharmaceutical Analysis and Medicinal Chemistry, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
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Laar A, Amoah Ampah E, Fernandez Y, Senyo Amevinya G, Nortey P, Benyah F, Akamah J, Ambenne M, Lamptey P, Free C, Legido-Quigley H, Perel P. 'What the herbal medicine can do for me in a week, the orthodox does in a year': Perceived efficacy of local alternative therapies influences medication adherence in patients with atherosclerotic cardiovascular disease. Health Expect 2021; 24:444-455. [PMID: 33528881 PMCID: PMC8077140 DOI: 10.1111/hex.13185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 12/12/2022] Open
Abstract
Background There is strong evidence that anti‐platelet therapy, ACE inhibitors, beta‐blockers and statins are cost‐effective in reducing subsequent cardiovascular disease (CVD) events in patients with atherosclerotic cardiovascular disease (ACVD). In some settings, only a low proportion of people have access to these medications, and even lower adhere to them. The current study explored and presents data on the causes of poor adherence to orthodox medication and motivations for alternative therapies in patients with established atherosclerotic cardiovascular disease (ACVD). Methods The study was conducted among city‐dwelling adults with ACVD in Accra – Ghana's capital city. Eighteen interviews were conducted with patients with established ACVD. A follow‐up focus group discussion was conducted with some of them. The protocol was approved by two ethics review committees based in Ghana and in the United Kingdom. All participants were interviewed after informed consent. Analysis was done with the Nvivo qualitative data analysis software. Results We identified motivations for use of alternatives to orthodox therapies. These cover the five dimensions of adherence: social and economic, health‐care system, condition‐related, therapy‐related, and patient‐related dimensions. Perceived inability of an orthodox medication to provide immediate benefit is an important motivator for use of alternative forms of medication. Conclusions A multiplicity of factors precipitate non‐adherence to orthodox therapies. Perceived efficacy and easy access to local alternative therapies such as herbal and faith‐based therapies are important motivators.
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Affiliation(s)
- Amos Laar
- Department of Population, Family, & Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.,House of Mentoring and Research Resources (HM2R). Box LG 1099, University Post Office, Legon, Accra, Ghana
| | - Ernest Amoah Ampah
- House of Mentoring and Research Resources (HM2R). Box LG 1099, University Post Office, Legon, Accra, Ghana
| | - Yolanda Fernandez
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine. Keppel St, London, UK
| | - Gideon Senyo Amevinya
- Department of Population, Family, & Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.,House of Mentoring and Research Resources (HM2R). Box LG 1099, University Post Office, Legon, Accra, Ghana
| | - Priscillia Nortey
- Department of Epidemiology and Disease Control, School of Public Health Box LG 13, University of Ghana, Legon, Accra, Ghana
| | | | - Joseph Akamah
- Department of Medicine and Therapeutics, Divisions of Cardiology and Neurology, School of Medicine and Dentistry, University of Ghana, Korle-Bu, Ghana
| | - Marcella Ambenne
- House of Mentoring and Research Resources (HM2R). Box LG 1099, University Post Office, Legon, Accra, Ghana
| | - Peter Lamptey
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine. Keppel St, London, UK
| | - Caroline Free
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine Keppel St, London, UK
| | - Helena Legido-Quigley
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine. Keppel St, London, UK
| | - Pablo Perel
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine. Keppel St, London, UK
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Hypotensive and Antihypertensive Properties and Safety for Use of Annona muricata and Persea americana and Their Combination Products. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2020:8833828. [PMID: 33488751 PMCID: PMC7787783 DOI: 10.1155/2020/8833828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/22/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
Introduction In the management of hypertension (a cardiovascular disease and the leading metabolic risk factor in noncommunicable diseases) with herbal medicines, efficacy and safety are of uttermost concern. This study sought to establish hypotensive, antihypertensive, drug interaction, and safety for use of the aqueous leaf extracts of Annona muricata (AME), Persea americana (PAE), or their combination products (CAPE). Methodology. Systolic and diastolic blood pressure (SBP and DBP), mean arterial blood pressure (MAP), and heart rate (HR) were measured in normotensive Sprague-Dawley rats treated with 50-150 mg/kg of AME, PAE, or CAPE to establish a hypotensive effect. "Combination index" was calculated to establish interaction between AME and PAE. The antihypertensive effect of CAPE was established by measuring SBP, DBP, MAP, and HR in ethanol-sucrose- and epinephrine-induced hypertension. Full blood count, liver and kidney function tests, and urinalysis were determined in ethanol/sucrose-induced hypertension to establish safety for use. Results AME, PAE, and CAPE significantly (p ≤ 0.001) decreased BP in both normotensive and hypertensive animals. Effects of CAPE 1, CAPE 2, and CAPE 3 were synergistic (combination indices of 0.65 ± 0.07, 0.76 ± 0.09, and 0.87 ± 0.07, respectively). There was a significant decrease (p ≤ 0.01 - 0.001) in SBP and MAP with 100 mg/kg CAPE 1 and 75 mg/kg CAPE 2 treatment in hypertension as well as with nifedipine (p ≤ 0.001) treatment. Epinephrine-induced hypertension in anesthetized cats was significantly and dose-dependently inhibited (p < 0.05 - 0.001) by 25-100 mg/ml CAPE 1 and 37.5-75 mg/ml CAPE 2. CAPE administration had no deleterious effect (p > 0.05) on full blood count, liver and kidney function, and urine composition in hypertensive rats. Conclusion The aqueous leaf extracts of Annona muricata, Persea americana, and their combination products possess antihypertensive properties, with combination products showing synergism and safety with use.
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Moucheraud C, Phiri K, Hoffman RM. Health behaviours and beliefs among Malawian adults taking antihypertensive medication and antiretroviral therapy: A qualitative study. Glob Public Health 2021; 17:688-699. [PMID: 33471610 PMCID: PMC8289928 DOI: 10.1080/17441692.2021.1874468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In order to understand HIV-positive Malawian adults' experiences with hypertension management, we conducted qualitative interviews with 30 hypertensive adults who were also taking antiretroviral therapy. These interviews regarding hypertension management behaviours and beliefs were audio-recorded, transcribed, translated into English, and coded in Atlas.ti. Despite acknowledging the dangers of hypertension and the benefits of medication, many respondents missed their antihypertensive medication. Primary reasons included feeling healthy, health workers' advice to stop taking medicine when blood pressure normalised, side effects, and using herbs or non-prescription medicines to manage hypertension. Women highlighted difficulties with dietary modifications, and changes in their social relationships. Both men and women spoke about hypertension-related challenges with employment and household economics. These results suggest numerous challenges among adults managing hypertension and HIV in Malawi, and frequent suboptimal adherence to medication. We identified new key themes - the quality of adherence counselling for antihypertensive medication, the effects of hypertension on financial stability, and the role of social relationships in self-care - and encourage further investigation into these topics in low-income, high-burden countries.
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Affiliation(s)
- Corrina Moucheraud
- Department of Health Policy and Management, University of California Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Risa M Hoffman
- Division of Infectious Diseases, University of California Geffen School of Medicine, Los Angeles, CA, USA
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21
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Nagawa CS, Palakshappa JA, Sadasivam RS, Houston TK. Herbal or Dietary Supplement Use and Hypertensive Medications: Does the Combination Relate to Medication Adherence and Blood Pressure Control? J Altern Complement Med 2020; 27:168-175. [PMID: 33296255 DOI: 10.1089/acm.2020.0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Medication nonadherence contributes to poor blood pressure control and increases cardiovascular disease risk in patients with hypertension. Identifying modifiable risk factors for low or nonadherence to antihypertensive medication is needed. Studies that have examined the relationship between herbal or dietary supplement (HDS) use and antihypertensive medication nonadherence provide inconsistent findings. Data from the National Health and Nutrition Examination Survey were used to examine the association between HDS use, current use of prescribed antihypertensive medication, and blood pressure status. Methods: The study sample included hypertensive adults (n = 5,478) who have been told by a health professional to take prescribed medication for their health condition. Respondents were classified as either HDS users or HDS nonusers. Depending on the kind of supplement used, HDS users were further divided into three mutually exclusive groups: hypertension HDS users, nonhypertension HDS users, and those who used both kinds of supplements. Supplements groupings were based on reports in the literature. Blood pressure status definition was based on Eighth Joint National Committee (JNC 8) recommendations. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were obtained from logistic models. Results: Overall HDS use prevalence was 62%. Current medication use did not significantly differ between patients reporting no HDS use and those reporting HDS use (aOR: 1.45; 95% CI: 0.78-2.69). No observable differences were found in current medication use between patients reporting no HDS use and those taking nonhypertension HDS or both kinds of supplements. Use of hypertension HDS was associated with improved blood pressure (aOR: 1.90; 95% CI: 1.07-3.36) compared with no HDS use. Conclusion: In a nationally representative U.S. sample, HDS use did not compromise current use of prescribed medication and was associated with improved blood pressure control. More research is needed to better understand why HDS use is associated with better blood pressure control.
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Affiliation(s)
- Catherine S Nagawa
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jessica A Palakshappa
- Learning Health Systems, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Thomas K Houston
- Learning Health Systems, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Tangkiatkumjai M, Boardman H, Walker DM. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther 2020; 20:363. [PMID: 33228697 PMCID: PMC7686746 DOI: 10.1186/s12906-020-03157-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. METHODS A literature search was performed on Pubmed, ScienceDirect and EMBASE. KEYWORDS 'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. RESULTS 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). CONCLUSIONS Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.
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Affiliation(s)
- Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand
| | - Helen Boardman
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, UK
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Alidu L, Grunfeld EA. 'What a dog will see and kill, a cat will see and ignore it': An exploration of health-related help-seeking among older Ghanaian men residing in Ghana and the United Kingdom. Br J Health Psychol 2020; 25:1102-1117. [PMID: 32656938 DOI: 10.1111/bjhp.12454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 06/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health care utilization rates are lower among men; however, little is known about how men's health care utilization is affected by migration. The aim of this study was to explore health-related help-seeking decisions among older Ghanaian men residing in the United Kingdom and in Ghana. METHODS Twenty-six men aged 50 years or over were recruited from community locations within two large cities in the UK and Ghana. Face-to-face semi-structured interviews were undertaken to explore the illness and help-seeking experiences of older men. RESULTS Help-seeking experiences differed among the Ghanaian men living in the UK and in Ghana. Three themes were identified that impacted on help-seeking decisions: (1) pluralistic approaches to managing health and illness and (2) perceptions of formal health services in Ghana and UK and (3) financial constraints and masculinity norms as barriers to help-seeking. CONCLUSION This is the first study to look at help-seeking decisions among older men residing in the UK and Ghana. Findings highlight how older migrant men's explanatory models of their health encompass enduring faith-based beliefs around causation of illness and approaches to management, as well as the use of pluralistic approaches to managing health. This study supports the call for culturally sensitive community-based interventions to increase engagement and facilitate improved health outcomes for migrant populations, particularly older men.
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Affiliation(s)
- Lailah Alidu
- Population Evidence and Technology, University of Warwick Medical School, Coventry, UK
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Lee JW, Hyun MK, Lee JH. Determinants of concurrent use of Biomedicine and Korean Medicine on the hypertension patients: a cross-sectional study. Integr Med Res 2020; 10:100429. [PMID: 32904209 PMCID: PMC7452361 DOI: 10.1016/j.imr.2020.100429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/04/2020] [Accepted: 05/15/2020] [Indexed: 12/01/2022] Open
Abstract
Background This study assessed the utilization of biomedicine and Korean Medicine (KM) among hypertension patients. Methods The study was a cross-sectional analysis conducted using the Korean National Health and Nutrition Examination Survey (KNHANES), which is a nationwide survey conducted every year for a representative Korean population. The use of outpatient healthcare services for hypertension patients was analyzed, and the usage determinants adjusted by the demographic and health status variables were identified. A chi-square test and logistic regression analysis were used for statistical analysis using R (version 3.6.0). Results Among 3320 hypertension patients, 208 patients (6.27%, Weighted%: 5.99%) used the biomedicine and KM concurrently. Multivariable regression analyses revealed hypertension patients who were obese (OR: 1.417, CI: 1.007–1.995) and had an experience of sickness (OR: 2.323, CI: 1.561–3.457) to be more likely to use biomedicine and KM concurrently. Conclusion The utilization rate and determinants of the concurrent use of biomedicine and KM were identified in patients with hypertension. Although the overall usage rate was not high, the health care patterns of healthcare consumers need to be understood. Therefore, further studies on its effectiveness and safety are recommended.
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Affiliation(s)
- Jang Won Lee
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Ji Hyun Lee
- Hanjoong Hospital of Korean Medicine, Bucheon, Republic of Korea
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Alhassan A, Siakwa M, Kumi-Kyereme A, Wombeogo M. Barriers to and Facilitators of Nurses' Political Participation in Ghana. Policy Polit Nurs Pract 2020; 21:29-42. [PMID: 31955659 DOI: 10.1177/1527154419899602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
All aspects of nursing practice are regulated by politics and affected by changes in public policy. For that reason, nurses need to be active in the political process through which they may influence public policies on health. However, nurses’ participation in political activities in many countries is either low or moderate at best. Studies that explore political participation among nurses are rare in Africa. We conducted this study to identify factors that may enhance or hinder nurses’ political participation. Through a cross-sectional survey, we collected data from 225 registered nurses sampled from three hospitals and two nursing training schools in Tamale, Ghana, using a structured questionnaire. We analyzed the data using descriptive statistics and correlations. The most frequently reported barriers to political participation were having little free time, lack of trust in politicians, fear of conflict/confrontation, lack of educational preparation, and lack of access to the right connections. The major facilitators of political participation were identified as availability of free time and money, civic skills, personal interest in politics, self-belief and confidence, and a strong party affiliation. These findings call for integration of political content into the nursing education curriculum and for professional nursing organizations to create opportunities for their members to learn about the political process.
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Affiliation(s)
| | | | | | - Michael Wombeogo
- Department of Nursing, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
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Complementary and Alternative Medicine Use for Primary Dysmenorrhea among Senior High School Students in the Western Region of Ghana. Obstet Gynecol Int 2019; 2019:8059471. [PMID: 31885598 PMCID: PMC6899296 DOI: 10.1155/2019/8059471] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/30/2019] [Accepted: 10/26/2019] [Indexed: 11/26/2022] Open
Abstract
Background Dysmenorrhea is a major gynaecological complaint among females who have reached menarche. It is one of the major causes of absenteeism of females from schools and at the workplaces resulting in loss of productive working hours and work efficiency. Owing to socioeconomic and cultural differences, females from different backgrounds perceive and manage dysmenorrhea differently. Little is known about the use of complementary and alternative medicines (CAM) in the management of this condition by females in senior high schools in Ghana. Thus, this study sought to assess the use of CAM in the management of dysmenorrhea among female students in two senior high schools in Ghana. Methods A school-based cross-sectional study using a quantitative approach was conducted on a total of 478 female students attending Archbishop Porter Girl's Secondary School and Mporhor Senior High School. Information on the sociodemographic characteristics, lay representations of dysmenorrhea, pain intensity and severity, quality of life, self-management, and the use of CAM in the management of dysmenorrhea were obtained. The data were analysed using SPSS. Results 79.3% of the students used some form of CAM to manage dysmenorrhea. Of CAM users, 32% were utilizing mind-body medicine such as endurance and relaxation, 31% used the whole and alternative medicine such as the hot water therapy, 15% used biological-based medicine such as herbal products, and 22% used the manipulative and body-based systems such as exercises. Various CAM methods and products were perceived to be effective in relieving the pain and discomfort associated with dysmenorrhea in about 90% of the participants who used them. Significant associations were reported for pain severity and quality of life (QoL). Conclusions This study has demonstrated that the female students experiencing dysmenorrhea employ various CAM remedies in its management. Therefore, there is the need for education on the right management of dysmenorrhea to ensure that safe and efficacious CAM products and methods are used by adolescent female students.
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Nyaaba GN, Agyemang C, Masana L, de-Graft Aikins A, Beune E, Larrea-Killinger C, Stronks K. Illness representations and coping practices for self-managing hypertension among sub-Saharan Africans: A comparative study among Ghanaian migrants and non-migrant Ghanaians. PATIENT EDUCATION AND COUNSELING 2019; 102:1711-1721. [PMID: 30992171 DOI: 10.1016/j.pec.2019.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Hypertension (HTN) control is a major obstacle among sub-Saharan African populations partly due to poor self-management. We explored and compared how persons' social and physical context shapes their illness representations regarding HTN and the coping strategies they develop and adapt to mitigate challenges in self-managing HTN. METHODS A cross sectional multisite qualitative study using semi-structured interviews among 55 Ghanaians with HTN living in The Netherlands and urban and rural Ghana. A thematic approach was used in data analysis. RESULTS Family HTN history, personal experiences with HTN and outcomes of using biomedical and traditional treatments shaped participants' illness representations and coping strategies. Migrants and urban non-migrants modified medication schedules and integrated taking medication into daily routine activities to cope with experienced side effects of taking antihypertensive medication while rural non-migrants used traditional remedies and medicines to mitigate experienced medication side effects and/or in search for a cure for HTN. CONCLUSION Contextual factors within participants' social and physical environments shape their illness representations and coping strategies for HTN though interactive phrases. PRACTICE IMPLICATIONS Health professionals should harness the relationships within peoples' social and physical environments, encourage implementation of family-wide behavioural changes and involve family and communities in HTN treatment to enhance patients' self-management of HTN.
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Affiliation(s)
- Gertrude Nsorma Nyaaba
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Barcelona Institute for Global Health (IS Global), University of Barcelona, Barcelona, Spain.
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Lina Masana
- Barcelona Institute for Global Health (IS Global), University of Barcelona, Barcelona, Spain; Medical Anthropology Research Centre-URV Tarragona, Spain
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Erik Beune
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | | | - Karien Stronks
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Debrah AB, Buabeng KO, Donnir G, Akwo Kretchy I. A caregiver perspective of complementary and alternative medicine use among patients with schizophrenia and bipolar disorders. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2018.1546097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Akosua Bema Debrah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Kwame Ohene Buabeng
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Gordon Donnir
- The Psychiatry Unit, Komfo Anokye Teaching Hospital/School of Medical Sciences, College of Health Sciences, KNUST, Kumasi, Ghana
| | - Irene Akwo Kretchy
- Department of Clinical Pharmacy and Pharmacy Practice School of Pharmacy, University of Ghana, Accra, Ghana
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de-Graft Aikins A. Health psychology in Ghana: A review of the multidisciplinary origins of a young sub-field and its future prospects. J Health Psychol 2018; 23:425-441. [PMID: 29502454 DOI: 10.1177/1359105317752805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article presents a historical overview of psychology applied to health and health psychology in Ghana. A brief history of health, illness and healthcare in Ghana is introduced. Then, the history of psychology in Ghana is presented, with signposts of the major turns in the field in relation to psychology and other disciplines applied to health and the emergence of health psychology as a sub-field. Selected health psychology studies are reviewed to highlight ideological trends in the field. Finally, future prospects are considered in terms of how the sub-field can transition into an established critical field with unique contributions to make to global health psychology.
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James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Glob Health 2018; 3:e000895. [PMID: 30483405 PMCID: PMC6231111 DOI: 10.1136/bmjgh-2018-000895] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 12/31/2022] Open
Abstract
Background The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region. Methods We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken. Results Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers. Conclusion TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Queensland, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Identifying strengths and weaknesses of the integration of biomedical and herbal medicine units in Ghana using the WHO Health Systems Framework: a qualitative study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:286. [PMID: 30348173 PMCID: PMC6196414 DOI: 10.1186/s12906-018-2334-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/24/2018] [Indexed: 11/14/2022]
Abstract
Background The use of herbal medicines in developing countries has been increasing over the years. In Ghana, since 2011, the government has been piloting the integration of herbal medicine in 17 public hospitals. However, the strengths and the weaknesses of the integration have not been fully explored. The current study sought to examine the strengths and weaknesses of the integration using the WHO health systems framework. Methods This study used qualitative, exploratory study design involving interviews of 25 key informants. The respondents had experience in conducting herbal medicine research. Two key informants were medical herbalists practising in hospitals piloting the integration in Ghana. We used Framework analysis to identify the perspectives of key informants in regards to the integration. Results Key informants mostly support the integration although some noted that the government needs to support scale-up in other public hospitals. Among the strengths cited were the employment of medical herbalists, utilization of traditional knowledge, research opportunities, and efficient service delivery by restricting the prescription and use of fake herbal medicine. The weaknesses were the lack of government policies on implementing the integration, financial challenges because the National Health Insurance Scheme does not cover herbal medicine, poor advocacy and research opportunities, and lack of training of conventional health practitioners in herbal medicine. Conclusions Researchers view the integration of the two healthcare systems–biomedicine, and herbal medicine– positively but it has challenges that need to be addressed. The integration could offer more opportunities for researching into herbal medicine. More training for conventional health professionals in herbal medicine could increase the chances of better coordination between the two units. Additionally, strong advocacy and publicity is needed to educate more people on the integration and the utilization of the services. Electronic supplementary material The online version of this article (10.1186/s12906-018-2334-2) contains supplementary material, which is available to authorized users.
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Obirikorang Y, Obirikorang C, Acheampong E, Odame Anto E, Gyamfi D, Philip Segbefia S, Opoku Boateng M, Pascal Dapilla D, Brenya PK, Amankwaa B, Adu EA, Nsenbah Batu E, Gyimah Akwasi A, Amoah B. Predictors of Noncompliance to Antihypertensive Therapy among Hypertensive Patients Ghana: Application of Health Belief Model. Int J Hypertens 2018; 2018:4701097. [PMID: 30018819 PMCID: PMC6029446 DOI: 10.1155/2018/4701097] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/12/2018] [Accepted: 06/02/2018] [Indexed: 11/22/2022] Open
Abstract
This study determined noncompliance to antihypertensive therapy (AHT) and its associated factors in a Ghanaian population by using the health belief model (HBM). This descriptive cross-sectional study conducted at Kintampo Municipality in Ghana recruited a total of 678 hypertensive patients. The questionnaire constituted information regarding sociodemographics, a five-Likert type HBM questionnaire, and lifestyle-related factors. The rate of noncompliance to AHT in this study was 58.6%. The mean age (SD) of the participants was 43.5 (±5.2) years and median duration of hypertension was 2 years. Overall, the five HBM constructs explained 31.7% of the variance in noncompliance to AHT with a prediction accuracy of 77.5%, after adjusting for age, gender, and duration of condition. Higher levels of perceived benefits of using medicine [aOR=0.55(0.36-0.82),p=0.0001] and cue to actions [aOR=0.59(0.38-0.90),p=0.0008] were significantly associated with reduced noncompliance while perceived susceptibility [aOR=3.05(2.20-6.25), p<0.0001], perceived barrier [aOR=2.14(1.56-2.92), p<0.0001], and perceived severity [aOR=4.20(2.93-6.00),p<0.0001] were significantly associated with increased noncompliance to AHT. Participant who had completed tertiary education [aOR=0.27(0.17-0.43), p<0.0001] and had regular source of income [aOR=0.52(0.38-0.71), p<0.0001] were less likely to be noncompliant. However, being a government employee [aOR=4.16(1.93-8.96), p=0.0002)] was significantly associated increased noncompliance to AHT. Noncompliance to AHT was considerably high and HBM is generally reliable in assessing treatment noncompliance in the Ghanaian hypertensive patients. The significant predictors of noncompliance to AHT were higher level of perceived barriers, susceptibility, and severity. Intervention programmes could be guided by the association of risk factors, HBM constructs with noncompliance to AHT in clinical practice.
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Affiliation(s)
- Yaa Obirikorang
- Department of Nursing, Faculty of Health and Allied Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Enoch Odame Anto
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Daniel Gyamfi
- Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, KNUST, Ghana
| | - Selorm Philip Segbefia
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Michael Opoku Boateng
- Department of Nursing, Faculty of Health and Allied Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
- Department of Nursing, Kintampo Municipal Hospital, Kintampo, Ghana
| | - Dari Pascal Dapilla
- Department of Nursing, Faculty of Health and Allied Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
- Department of Nursing, Kintampo Municipal Hospital, Kintampo, Ghana
| | - Peter Kojo Brenya
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Bright Amankwaa
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Evans Asamoah Adu
- Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, KNUST, Ghana
| | - Emmanuel Nsenbah Batu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | | | - Beatrice Amoah
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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Kretchy IA, Okere HA, Osafo J, Afrane B, Sarkodie J, Debrah P. Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana: Implications for integrative healthcare. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 14:380-8. [PMID: 27641609 DOI: 10.1016/s2095-4964(16)60273-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary and alternative medicine (TM-CAM) remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine. METHODS A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana. RESULTS Participants' knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as well as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream allopathic healthcare in Ghana through improving knowledge, training as well as addressing concerns of safety and efficacy. These findings are discussed under the themes: the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants. CONCLUSION The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration, practitioners' understanding of TM-CAM must be improved, with specific attention to issues of safety, regulation and evidence-based practice of TM-CAM products and services in Ghana.
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Affiliation(s)
- Irene A Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Harry A Okere
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Joseph Osafo
- Department of Psychology, School of Social Studies, College of Humanities, University of Ghana, Legon, Ghana
| | - Barima Afrane
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Joseph Sarkodie
- Department of Pharmacognosy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Philip Debrah
- Department of Pharmaceutics and Microbiology, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
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Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:9493807. [PMID: 29849738 PMCID: PMC5937420 DOI: 10.1155/2018/9493807] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/06/2018] [Accepted: 02/18/2018] [Indexed: 12/16/2022]
Abstract
In resource-poor countries where access to infertility care is limited, women may turn to traditional medicine to achieve motherhood. It is unknown whether Sierra Leonean women with such condition use herbal medicine. This study investigates the prevalence and factors associated with herbal medicine use among women seeking care for infertility. This was a questionnaire-based cross-sectional study conducted among women seeking care for infertility at various clinics within Freetown, Sierra Leone. Data analysis included Chi-square tests and logistic regression. Out of the 167 women that participated, 36.5% used herbal medicine for infertility treatment. Women with no formal (AOR 4.03, CL: 1.38-11.76, p = 0.011), primary education (AOR: 6.23, CL: 2.02-19.23, p = 0.001) and those that visited a traditional medicine practitioner (AOR: 20.05, CL: 2.10-192.28, p = 0.009) as well as women suffering from other reproductive health problems (AOR: 2.57, CL: 1.13-5.83, p = 0.024) were more likely to use herbal medicines. Friends and family (n = 57, 96.7%) were the main influencers of herbal medicine use. Only (n = 12) 19.7% of users disclosed their status to their healthcare provider. Over half (n = 32, 52.5%) could not remember the name of the herb they used. Luffa acutangula (n = 29, 100%) was the herbal medicinal plant users could recall. Herbal medicine use among women seeking care for infertility in Freetown is common. Healthcare providers should be aware of the potential dyadic use of herbal and allopathic medicines by their patients and be knowledgeable about commonly used herbal remedies as well as being proactive in communicating the potential risks and benefits associated with their use.
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Rashidi Y, Manaflouyan H, Pournaghi Azar F, Nikniaz Z, Nikniaz L, Ghaffari S. Knowledge, attitude and practice of Iranian hypertensive patients regarding hypertension. J Cardiovasc Thorac Res 2018; 10:14-19. [PMID: 29707172 PMCID: PMC5913687 DOI: 10.15171/jcvtr.2018.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/18/2018] [Indexed: 01/09/2023] Open
Abstract
Introduction: This study aimed at evaluating knowledge and awareness of hypertension and the risk factors for hypertension among hypertensive patients.
Methods: In this study, 110 hypertensive patients were enrolled and filled out two self-administered questionnaires. The first questionnaire was about the demographic characteristics and the second one was about the knowledge (n = 10), attitude (n = 9) and practice (n = 8). The internal consistency and the stability of the questionnaires were approved. The Mann-Whitney U test and Kruskal-Wallis and Spearman correlation coefficient were used for statistical analysis.
Results: Seventy-three percent of participants know the normal range of hypertension. Most of the participants truly knew that stress (87.3%), obesity (70.9%) and aging (48.2%) are risk factors for hypertension. About 60% of participants knew the complications of uncontrolled hypertension. About 82.7% of participants believed that after adaptation of body to hypertension, there is no need to use antihypertensive drug. About 13.6% of participants measured their blood pressure daily and 11.8% of them measured it once a month. The educational level of participants was significantly associated with knowledge score (P = 0.01). There was a significant correlation between knowledge (P < 0.001) and attitude and also attitude and practice (P < 0.001) scores.
Conclusion: These findings have important implications for developing proper and continuous self-management hypertension education programs in Iran which should mostly emphasize on the practical information about control and prevention programs.
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Affiliation(s)
- Yaseen Rashidi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hesam Manaflouyan
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Pournaghi Azar
- Iranian Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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James PB, Kamara H, Bah AJ, Steel A, Wardle J. Herbal medicine use among hypertensive patients attending public and private health facilities in Freetown Sierra Leone. Complement Ther Clin Pract 2018; 31:7-15. [PMID: 29705483 DOI: 10.1016/j.ctcp.2018.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/21/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown. METHODS AND MATERIALS We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. RESULTS Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider. CONCLUSION There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Halimatu Kamara
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia; Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, Brisbane, QLD 4006, Australia.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia.
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Ibrahim IR, Hassali MA, Saleem F, Al Tukmagi HF, Dawood OT. Use of complementary and alternative medicines: a cross-sectional study among hypertensive patients in Iraq. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2017. [DOI: 10.1111/jphs.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Inas Rifaat Ibrahim
- Social and Administrative Pharmacy; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - Mohamed Azmi Hassali
- Social and Administrative Pharmacy; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences; University of Baluchistan; Quetta Pakistan
| | - Haydar F. Al Tukmagi
- Department of Clinical Pharmacy; College of Pharmacy; University of Baghdad; Baghdad Iraq
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Smith-Cavros E, Avotri-Wuaku J, Wuaku A, Bhullar A. "All I Need Is Help to Do Well": Herbs, Medicines, Faith, and Syncretism in the Negotiation of Elder Health Treatment in Rural Ghana. JOURNAL OF RELIGION AND HEALTH 2017; 56:2129-2143. [PMID: 28265784 DOI: 10.1007/s10943-017-0378-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This qualitative research sought answers to questions about how elders in Agate, Ghana, coped with the challenges of illness in a rural village and in particular how they negotiated treatment for their illnesses within a flawed and limited healthcare system. In our study, 22 of 28 interviewees used all methods available to them (biomedical approaches [doctors and/or hospitals and/or doctor-prescribed medications], herbs, over-the-counter medicines [i.e., acetaminophen painkillers], and faith-based methods [praying/fasting/laying of hands/holy food and/or water]) in attempts to heal their illnesses. A syncretism existed in the negotiation of treatment options. All participants in our study used some form of what we term "Treatment Blending" (TBL), the use by a single participant of more than one of the aforementioned treatment methods for illness. Our research also revealed a widespread use of multiple spiritual systems (at the same time) and practitioner overlap (visiting a doctor, a traditional healer, and/or Christian pastor). Elders, in multiple cases, demonstrated the daily practice of one religion while seeking healing through another framework. TBL among our participants was a reflection of the lives elders lead in which illness and healing cannot be separated from the spiritual, the idea of an omnipresent God who is the ultimate "doctor," and ancient African traditions of herbs and rituals that possess deeper meaning for both physical and psychological healing and well-being. This ran parallel with the syncretism of religion itself in Ghana and suggests possible related paths through which to improve the healthcare system for elders in rural Ghana utilizing local faith-based groups and the elders themselves to assist.
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Affiliation(s)
- Eileen Smith-Cavros
- Nova Southeastern University, Fort Lauderdale, FL, USA.
- Department of Conflict Resolution Studies, Nova Southeastern University, Fort Lauderdale, FL, USA.
| | - Joyce Avotri-Wuaku
- Nova Southeastern University, Fort Lauderdale, FL, USA
- Department of Conflict Resolution Studies, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Albert Wuaku
- Religious Studies, Department of the School of International and Public Affairs (SIPA), Florida International University, Miami, FL, USA
| | - Amal Bhullar
- Nova Southeastern University, Fort Lauderdale, FL, USA
- Department of Biological Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA
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Sirois FM, Riess H, Upchurch DM. Implicit Reasons for Disclosure of the Use of Complementary Health Approaches (CHA): a Consumer Commitment Perspective. Ann Behav Med 2017; 51:764-774. [PMID: 28432577 PMCID: PMC5650948 DOI: 10.1007/s12160-017-9900-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Disclosure of the use of complementary health approaches (CHA) is an important yet understudied health behavior with important implications for patient care. Yet research into disclosure of CHA has been atheoretical and neglected the role of health beliefs. PURPOSE Using a consumer commitment model of CHA use as a guiding conceptual framework, the current study tests the hypotheses that perceived positive CHA outcomes (utilitarian values) and positive CHA beliefs (symbolic values) are associated with disclosure of CHA to conventional care providers in a nationally representative US sample. METHODS From a sample of 33,594 with CHA use information from the 2012 National Health Interview Survey (NHIS), a subsample of 7348 who used CHA within the past 12 months was analyzed. The 2012 NHIS is a cross-sectional survey of the non-institutionalized US adult population, which includes the most recent nationally representative CHA use data. RESULTS The 63.2% who disclosed CHA use were older, were less educated, and had visited a health care provider in the past year. Weighted logistic regression analyses controlling for demographic variables revealed that those who disclosed were more likely to report experiencing positive psychological (improved coping and well-being) and physical outcomes (better sleep, improved health) from CHA and hold positive CHA-related beliefs. CONCLUSIONS CHA users who perceive physical and psychological benefits from CHA use and who hold positive attitudes towards CHA are more likely to disclose their CHA use. Findings support the relevance of a consumer commitment perspective for understanding CHA disclosure and suggest CHA disclosure as an important proactive health behavior that warrants further attention.
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Affiliation(s)
- Fuschia M Sirois
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK.
| | - Helene Riess
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA, 90095-1772, USA
| | - Dawn M Upchurch
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA, 90095-1772, USA
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Herbal and Alternative Medicine Use in Tanzanian Adults Admitted with Hypertension-Related Diseases: A Mixed-Methods Study. Int J Hypertens 2017. [PMID: 28634545 PMCID: PMC5467304 DOI: 10.1155/2017/5692572] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Hypertension is increasingly common in sub-Saharan Africa where traditional medicine use is also common. We conducted a hospital-based, mixed-methods study to determine prevalence, pattern, and correlates of herbal and alternative medicine use in Tanzanian adults hospitalized with hypertension. Methods A standardized questionnaire was administered. In-depth interviews were performed on a subset of participants. Factors associated with herbal medicine use were determined by logistic regression. The association between traditional medicine uses and allopathic medication adherence was determined using ordinal logistic regression. Qualitative data were analyzed according to grounded theory. Results Of 213 adults enrolled, 52 (24.4%) reported using herbs during the previous month and 47 (22.1%) reported concurrent use of herbs and allopathic medicines. Lower educational level, nonprofessional employment, and lack of health insurance were significantly associated with herbal medicine use. Alternative medicines use was not associated with lower medication adherence. Qualitative interviews identified several important themes including reasons for herbal medicine use. Conclusion The use of traditional medicines is very common among patients with hypertension. Adults from low socioeconomic status, those with misunderstandings about hypertension, and those without health insurance were more likely to take herbs. Open, nonjudgmental communication between healthcare workers and patients regarding use of traditional medicines must be encouraged in Africa.
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Lulebo AM, Mapatano MA, Mutombo PB, Mafuta EM, Samba G, Coppieters Y. Prevalence and determinants of use of complementary and alternative medicine by hypertensive patients attending primary health care facilities in Kinshasa, Democratic Republic of the Congo: a cross-sectional study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:205. [PMID: 28390416 PMCID: PMC5385009 DOI: 10.1186/s12906-017-1722-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 04/04/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND In the Democratic Republic of the Congo the control of hypertension is poor, characterized by an increasing number of reported cases of hypertension related complications. Poor control of hypertension is associated with non-adherence to antihypertensive medication. It is well established that the use of complementary and alternative medicine is one of the main factors of non-adherence to antihypertensive medication. The aim of this study is to determine the prevalence and factors associated with the use of complementary and alternative medicine. METHODS A cross-sectional study was carried out at the Kinshasa Primary Health-care (KPHC) facilities network in November 2014. A structured interview questionnaire was administrated to a total of 280hypertensive patients. Complementary and alternative medicine were defined according to the National Institute of Health classification as a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine. Data were summarized using proportion and mean (with standard deviation). The student's t test and χ2 test were used respectively for mean and proportion comparison. Logistic regression analysis identified determinants of the use of complementary and alternative medicine. RESULTS The prevalence of use of complementary and alternative medicine was 26.1% (95% CI: 20.7% - 31.8%).Determinants of use of complementary and alternative medicine included misperception about hypertension curability (OR = 2.1; 95%CI: 1.1-3.7) and experience of medication side effects (OR = 2.9; 95%CI: 1.7-5.1). CONCLUSION The use of CAM for hypertensive patients is a major problem; antihypertensives with fewer side effects must be emphasized. Religious leaders must become involved in the communication for behavioral change activities to improve the quality of life for hypertensive patients.
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Abstract
BACKGROUND Self-medication is commonly practised by patients, underpinned by health beliefs that affect their adherence to medication regimens, and impacting on treatment outcomes. OBJECTIVES This review explores the scope of self-medication practices among people with hypertension, in terms of the scale of use, types of medication and influencing factors. METHOD A comprehensive search of English language, peer-reviewed literature published between 2000 and 2014 was performed. Twenty-seven studies met the inclusion criteria; 22 of these focused on complementary and alternative medicines (CAMs). RESULTS Anti-hypertensive medications are listed among the 11% of products that patients reportedly obtain over-the-counter (OTC) for self-medication. On average, 25% of patients use CAMs, mostly herbs, to lower blood pressure. Recommendations by family, friends and neighbours are the most influential factors for self-medication with CAMs. Faith in treatment with CAMs, dissatisfaction with conventional medicine and the desire to reduce medication costs are also cited. Most (70%) patients with hypertension take OTC medicines to treat minor illnesses. The concurrent use of anti-hypertensive medications with analgesics and herbal medicines is commonly practised. The sociodemographic profile of patients engaging in self-medication differs markedly in the articles reviewed; self-medication practices cannot be attributed to a particular profile. Low disclosure of self-medication is consistently reported. CONCLUSION This review highlights a high proportion of people with hypertension practise self-medication. Further studies are needed to assess the impact of self-medication with OTC and anti-hypertensive medications on hypertension treatment. Health professionals involved in hypertension management should be mindful of any types of self-medication practices.
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Affiliation(s)
- Riana Rahmawati
- Graduate School of Health, Discipline of Pharmacy, The University of Technology Sydney, Sydney, New South Wales, Australia.,Pharmacology Department, Faculty of Medicine, Islamic University of Indonesia, Yogyakarta, Indonesia
| | - Beata V Bajorek
- Graduate School of Health, Discipline of Pharmacy, The University of Technology Sydney, Sydney, New South Wales, Australia.,Department of Pharmacy, Royal North Shore Hospital, Sydney, New South Wales, Australia
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Alidu L, Grunfeld EA. Gender differences in beliefs about health: a comparative qualitative study with Ghanaian and Indian migrants living in the United Kingdom. BMC Psychol 2017; 5:8. [PMID: 28320474 PMCID: PMC5359821 DOI: 10.1186/s40359-017-0178-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/08/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is a well-established association between migration to high income countries and health status, with some groups reporting poorer health outcomes than the host population. However, processes that influence health behaviours and health outcomes across minority ethnic groups are complex and in addition, culture ascribes specific gender roles for men and women, which can further influence perspectives of health. The aim of this study was to undertake a comparative exploration of beliefs of health among male and female Ghanaian and Indian migrants and White British participants residing in an urban area within the UK. METHODS Thirty-six participants (12 each Ghanaian, Indian and White British) were recruited through community settings and participated in a semi-structured interview focusing on participant's daily life in the UK, perceptions of their own health and how they maintained their health. Interviews were analyzed using a Framework approach. RESULTS Three super ordinate themes were identified and labelled (a) beliefs about health; (b) symptom interpretation and (c) self-management and help seeking. Gender differences in beliefs and health behaviour practices were apparent across participants. CONCLUSIONS This is the first study to undertake a comparative exploration of health beliefs among people who have migrated to the UK from Ghana and India and to compare with a local (White British) population. The results highlight a need to consider both cultural and gender-based diversity in guiding health behaviours, and such information will be useful in the development of interventions to support health outcomes among migrant populations.
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Affiliation(s)
- Lailah Alidu
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Elizabeth A. Grunfeld
- Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, England, UK
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Tahir I, Khan MR, Shah NA, Aftab M. Evaluation of phytochemicals, antioxidant activity and amelioration of pulmonary fibrosis with Phyllanthus emblica leaves. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:406. [PMID: 27776518 PMCID: PMC5078946 DOI: 10.1186/s12906-016-1387-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 10/12/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND In the present study the antioxidant potential of a methanol extract of Phyllanthus emblica leaves (PELE) was determined by in vitro methods as well as by an in vivo animal model, along with HPLC-DAD screening for phyto-constituents. METHODS The in vitro antioxidant potential of PELE was assessed by scavenging of DPPH, nitric oxide and anti-lipid peroxidation assays. For in vivo evaluation, a 60-day experimental plan was followed in which Sprague Dawley rats were administered with 1 mL/kg of CCl4 (CCl4 : DMSO + Olive oil; 30 % v/v) alone or with different doses of PELE (200, 400 mg/kg p.o.). Silymarin (100 mg/kg) as standard drug was also administered to CCl4 treated rats. HPLC-DAD analysis was performed to quantify polyphenolic phytochemicals. RESULTS PELE exhibited an appreciable in vitro antioxidant activity and scavenged the DPPH radical (IC50 = 39.73 ± 2.12 μg/mL) and nitric oxide (IC50 = 39.14 ± 2.31 μg/mL) while for anti-lipid peroxidation moderate antioxidant activity was noticed. Reduced levels of antioxidant enzyme activities viz., superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and reduced glutathione (GSH) whereas enhanced levels of total extractable proteins, lipid peroxides (TBARS), nitrite and H2O2 were induced by CCl4 administration in lungs of rat. Co-administration of PELE to rats exhibited a dose dependent decline in the oxidative injuries induced in these parameters. Histopathological damages such as disrupted alveoli, infiltration of macrophages and modified architecture of Clara cells was reversed to the normal state with co-administration of PELE. HPLC-DAD analysis indicated the presence of gallic acid, rutin, kaempferol and caffeic acid in the PELE. CONCLUSION The findings of this study demonstrate that presence of polyphenolics and other active constituents in PELE might play a significant role in repairing the pulmonary damages instigated with CCl4.
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Affiliation(s)
- Irsa Tahir
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Muhammad Rashid Khan
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Naseer Ali Shah
- Department of Biosciences, COMSATS Institute of Information Technology, Islamabad, Pakistan
| | - Maryam Aftab
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
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Prevalence and Correlates of Complementary and Alternative Medicine Use among Hypertensive Patients in Gondar Town, Ethiopia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:6987636. [PMID: 27843480 PMCID: PMC5097805 DOI: 10.1155/2016/6987636] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/08/2016] [Accepted: 10/03/2016] [Indexed: 11/22/2022]
Abstract
Background. Complementary and alternative medicine (CAM) therapies are being widely used by hypertensive patients worldwide. However, evidences regarding CAM use by hypertensive patients in Ethiopia are limited. This study aimed at assessing prevalence and correlates of CAM use among hypertensive patients attending ambulatory clinic at Gondar University Referral Hospital (GURH), Ethiopia. Methods. A cross-sectional study was employed on 423 patients visiting GURH. Descriptive statistics and bivariate and multivariate logistic regression tools were used to analyze/come up with the prevalence and correlates of CAM use. Results. The prevalence of CAM use in our study was found to be 67.8% and herbal based medicine was the most commonly utilized CAM therapies. Majority of CAM users (70.2%) did not disclose CAM use for their physician. However, nearly half of CAM users (48.4%) were satisfied with the result of CAM use. Conclusions. The higher prevalence of CAM use among hypertensive patients coupled with a very low disclosure rate to their health care providers can have a marked potential to cause ineffective hypertensive management and adverse effects due to CAM use. Health care providers should be open to discussing the use of CAM with their patients as it will lead to better health outcome.
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Gyasi RM, Asante F, Yeboah JY, Abass K, Mensah CM, Siaw LP. Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana. Int J Qual Stud Health Well-being 2016; 11:29667. [PMID: 27018431 PMCID: PMC4808739 DOI: 10.3402/qhw.v11.29667] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 11/14/2022] Open
Abstract
The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of one's health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, New Territories, Hong Kong SAR.,Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;
| | - Felix Asante
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Yaw Yeboah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Martins RR, Duarte Farias A, Russel Martins R, Gouveia Oliveira A. Influence of the use of medicinal plants in medication adherence in elderly people. Int J Clin Pract 2016; 70:254-60. [PMID: 26799730 DOI: 10.1111/ijcp.12773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the relationship between the use of medicinal plants and medication adherence in elderly people. METHODS Observational, cross-sectional study of elderly residents in Cuité-PB, Northeastern Brazil, through a household survey. A stratified proportional and systematic random sample of 240 elders was interviewed in their homes and the use of pharmaceutical medicines and of medicinal plants was assessed by direct examination. The association of medication adherence with socio-demographic, clinical, medication and use of medicinal plants was analysed with multiple logistic regression. RESULTS The results showed that medication non-adherence increases with use of herbal medicines (adjusted odds ratio 2.022, 95% CI 1.059-3.862, p = 0.03), as well as with the number of different medicinal plants used (adjusted odds ratio 1.937, 95% CI 1.265-2.965, p = 0.002). CONCLUSION/INTERPRETATION This study provides first-hand evidence that the use of herbal medicines is associated with poor medication adherence. Given the high frequency of the use of herbal medicines, further research into the mechanisms of this association is justified.
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Affiliation(s)
- R R Martins
- Pharmacy Department, Federal University of Rio Grande do Norte, Natal, Brazil
| | - A Duarte Farias
- Pharmacy Department, Federal University of Campina Grande, Campina Grande, Brazil
| | - R Russel Martins
- Department of Social Sciences, Federal University of Semi-Arido, Mossoró, Brazil
| | - A Gouveia Oliveira
- Pharmacy Department, Federal University of Rio Grande do Norte, Natal, Brazil
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Ibrahim IR, Hassali MA, Saleem F, Al Tukmagi HF. A qualitative insight on complementary and alternative medicines used by hypertensive patients. J Pharm Bioallied Sci 2016; 8:284-288. [PMID: 28216951 PMCID: PMC5314826 DOI: 10.4103/0975-7406.199349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: The self-treatment with complementary and alternative medicines (CAMs) in chronic diseases is portraying an expanding trend worldwide. Yet, little is known concerning patients’ motives to use CAM in the control of blood pressure. Objective: This study aims to explore the self-use of CAM in the management of hypertension and explore patients’ attitudes, perceived benefits, and disclosure to the physician. Materials and Methods: A qualitative technique was adopted and face-to-face interviews, using a validated interview guide, were carried out among twenty hypertensive patients. A purposive sampling method was used to recruit patients at Al-Karama Teaching Hospital in Baghdad; the capital of Iraq; from January to April 2015. All the interviews were audio-recorded, then transcribed verbatim and examined for thematic relationships. Results: Three major themes were identified through thematic content analysis of the interviews. These encompassed patients’ understanding of CAM; experience and perceived benefits; and communication with the doctors. The use of CAM was prevalent among the majority of the respondents. The most commonly used therapies were biological-based practices (herbal remedies, special diet, vitamins, and dietary supplements); traditional therapies (Al-Hijama or cupping); and to a less extent of manipulative body-based therapies (reflexology). Factors influencing the use of CAM were traditions, social relationships, religious beliefs, low-cost therapy, and safety of natural products. Conclusion: The use of CAM was common as a practice of self-treatment among hypertensive patients in Iraq. This was underpinned by the cultural effects, social relationships, religious beliefs, and the perception that natural products are effective and safe. Understanding patients’ usage of CAM is of great importance as long as patient's safety and interaction with the standard prescribed treatment are major concerns.
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Affiliation(s)
- Inas Rifaat Ibrahim
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Haydar F Al Tukmagi
- Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq
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Hughes GD, Aboyade OM, Beauclair R, Mbamalu ON, Puoane TR. Characterizing Herbal Medicine Use for Noncommunicable Diseases in Urban South Africa. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:736074. [PMID: 26557865 PMCID: PMC4629029 DOI: 10.1155/2015/736074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/16/2015] [Indexed: 01/10/2023]
Abstract
Economic challenges associated with noncommunicable diseases (NCDs) and the sociocultural outlook of many patients especially in Africa have increased dependence on traditional herbal medicines (THMs) for these diseases. A cross-sectional descriptive study designed to determine the prevalence of and reasons for THM use in the management of NCDs among South African adults was conducted in an urban, economically disadvantaged area of Cape Town, South Africa. In a cohort of 1030 participants recruited as part of the existing Prospective Urban and Rural Epidemiological (PURE) study, 456 individuals were identified. The overall prevalence of THM use was 27%, of which 61% was for NCDs. Participants used THM because of a family history (49%) and sociocultural beliefs (33%). Hypertensive medication was most commonly used concurrently with THM. Healthcare professionals need to be aware of the potential dualistic use of THM and conventional drugs by patients, as this could significantly influence health outcomes. Efforts should be made to educate patients on the potential for drug/herb interactions.
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Affiliation(s)
- Gail D. Hughes
- South African Herbal Science and Medicine Institute (SAHSMI), Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
| | - Oluwaseyi M. Aboyade
- South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville 7535, South Africa
| | - Roxanne Beauclair
- The South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch 7602, South Africa
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP114, 9000 Gent, Belgium
| | - Oluchi N. Mbamalu
- School of Pharmacy, University of the Western Cape, Bellville 7535, South Africa
| | - Thandi R. Puoane
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
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50
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Lulebo AM, Mutombo PB, Mapatano MA, Mafuta EM, Kayembe PK, Ntumba LT, Mayindu AN, Coppieters Y. Predictors of non-adherence to antihypertensive medication in Kinshasa, Democratic Republic of Congo: a cross-sectional study. BMC Res Notes 2015; 8:526. [PMID: 26427798 PMCID: PMC4591704 DOI: 10.1186/s13104-015-1519-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/21/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Hypertension remains a public health challenge worldwide. In the Democratic Republic of Congo, its prevalence has increased in the past three decades. Higher prevalence of poor blood pressure control and an increasing number of reported cases of complications due to hypertension have also been observed. It is well established that non-adherence to antihypertensive medication contributes to poor control of blood pressure. The aim of this study is to measure non-adherence to antihypertensive medication and to identify its predictors. METHODS A cross-sectional study was conducted at Kinshasa Primary Health-care network facilities from October to November 2013. A total of 395 hypertensive patients were included in the study. A structured interview was used to collect data. Adherence to medication was assessed using the Morisky Medication Scale. Covariates were defined according to the framework of the World Health Organization. Logistic regression was used to identify predictors of non-adherence. RESULTS A total of 395 patients participated in this study. The prevalence of non-adherence to antihypertensive medication and blood pressure control was 54.2 % (95 % CI 47.3-61.8) and 15.6 % (95 % CI 12.1-20.0), respectively. Poor knowledge of complications of hypertension (OR = 2.4; 95 % CI 1.4-4.4), unavailability of antihypertensive drugs in the healthcare facilities (OR = 2.8; 95 % CI 1.4-5.5), lack of hypertensive patients education in the healthcare facilities (OR = 1.7; 95 % CI 1.1-2.7), prior experience of medication side effects (OR = 2.2; 95 % CI 1.4-3.3), uncontrolled blood pressure (OR = 2.0; 95 % CI 1.1-3.9), and taking non-prescribed medications (OR = 2.2; 95 % CI 1.2-3.8) were associated with non-adherence to antihypertensive medication. CONCLUSION This study identified predictors of non-adherence to antihypertensive medication. All predictors identified were modifiable. Interventional studies targeting these predictors for improving adherence are needed.
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Affiliation(s)
- Aimée M Lulebo
- Department of Epidemiology and Bio-statistics, Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, PO Box 11850, Kinshasa, DR Congo.
| | - Paulin B Mutombo
- Department of Epidemiology and Bio-statistics, Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, PO Box 11850, Kinshasa, DR Congo.
| | - Mala A Mapatano
- Department of Epidemiology and Bio-statistics, Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, PO Box 11850, Kinshasa, DR Congo.
| | - Eric M Mafuta
- Department of Epidemiology and Bio-statistics, Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, PO Box 11850, Kinshasa, DR Congo.
| | - Patrick K Kayembe
- Department of Epidemiology and Bio-statistics, Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, PO Box 11850, Kinshasa, DR Congo.
| | - Lisa T Ntumba
- Programme National Multisectoriel de Lutte contre le VIH, Ministère de la Santé, Kinshasa, DR Congo.
| | - Alain N Mayindu
- Department of Epidemiology, Bio-statistics and Occupational Health, Mc Gill University, Montreal, QC, Canada.
| | - Yves Coppieters
- Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.
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