Abstract
BackgroundAlthough over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events.MethodsA cross-sectional telephone survey was conducted among Hong Kong Chinese adults in 2011 (n = 1100) with informed verbal consent. Stepwise logistic regression of demographic, attitudinal and behavioral variables was used to determine factors associated with past-year adverse events.ResultsOf study respondents, 71.7% (789/1100) reported past-year COTC use and 2.3% (25/1100) reported at least one COTC-related adverse event in the past year. Of the 27 adverse events cases reported among COTC users, the most common were allergic reactions (n = 11) dizziness (n = 5), and gastro-intestinal problems (n = 4). Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2).Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7). Package labels were also felt to be unclear by 42.9% of COTC users. A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals.ConclusionsDespite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.
Highlights
Over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events
The majority of respondents were aware that COTC can have side effects and can interact with Western drugs, only about half were aware that COTC could interact with herbal Traditional Chinese Medicine (TCM) concoctions or that COTC overdosing is possible
There were no significant differences in knowledge levels between COTC users and non-users
Summary
Over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events. The use of complementary and alternative medicine has been increasing worldwide in recent decades. In response to increasing popularity of complementary medicine, the World Health Organization has outlined a framework of action for greater integration of traditional medicine/complementary and alternative medicine into national health care systems [2]. Components of this World Health Organization Traditional Medicine Strategy included the regulation of herbal medicines and the promotion of rational traditional medicine use by consumers. In East Asian cultures, Traditional Chinese Medicine (TCM), as a form of complementary medicine, has long been commonplace for treating a spectrum of illnesses [3]. By 2002, TCM exports from China were reported to be as high as 100 million USD per year [10,11]
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