Abstract
Introduction The majority of the population in developing countries including Ethiopia still relies on traditional medicines (TMs). Patients with chronic illness like diabetes mellitus (DM) are dissatisfied with conventional medicines and thus are more likely to simultaneously use herbal medicines (HMs). However, such practice could result in potential herb-drug interaction. This study aimed to identify the commonly used HMs among patients with DM and determine the magnitude of concomitant use of herbal and conventional antidiabetic medicines. Method A health facility-based cross-sectional study design was employed using both quantitative and qualitative data collection methods to determine the magnitude of concomitant use. Patients with DM and prescribers from four public hospitals were the study population for the quantitative and qualitative study, respectively. Simple descriptive statistics were used to describe variables for the quantitative data, and content analysis had been conducted manually for qualitative data. Result Out of 791 respondents, 409 (51.7%) used traditional medicine at least once in their life time, and 357 (45.1%) used traditional medicine in the last six months prior to data collection. A majority (288 (80.7%)) of the respondents used HMs after starting the conventional antidiabetic medicines within the last six months. Moringa stenopetala, Thymus vulgaris, Trigonella foenum-graecum, Nigella sativa, and Allium sativum were among the frequently mentioned HMs. Prescribers were requesting patients' HM use when they saw sign of liver toxicity and skin disease, and they were not documenting their history in the patient's chart. Conclusion Concomitant use of herbal and conventional antidiabetic medicines was a common practice. Cognizant of its potentially serious herb-drug interactions, efforts should be made to improve awareness and knowledge of healthcare providers about HM potential effects. Further studies on dose, frequency, duration, and modes of interaction are recommended.
Highlights
Traditional medicines (TMs) cover a heterogeneous spectrum of ancient to new-age approaches to prevent or treat disease. ey include the use of herbal medicines (HMs), spiritual healing, and practices such as bone setting [1]
TMs were used for age-related chronic diseases such as hypertension and diabetes mellitus (DM)
Literature showed that patients with DM who were dissatisfied with conventional medicine were more likely to use HM to enhance the effect of conventional treatment [8]
Summary
Traditional medicines (TMs) cover a heterogeneous spectrum of ancient to new-age approaches to prevent or treat disease. ey include the use of herbal medicines (HMs), spiritual healing, and practices such as bone setting [1]. Simultaneous use of herbal and conventional medicines may result in potentially serious herb-drug interactions leading to negative effect on patient outcomes [4]. John’s wort (SJW) significantly increases the apparent clearance of gliclazide [11]; administration of Ginkgo biloba extract increased hepatic clearance of insulin and oral hypoglycemic agents, resulting in an increased glucose level [12] Adverse effects such as hypoglycemia and lactic acidosis were detected among patients with diabetes who were taking herbal antidiabetic products in China [13]. Information on most commonly used HM and extent of concomitant use with conventional medicines in DM is scanty. is study aimed to determine the extent of concomitant use of herbal and conventional antidiabetic medicines and to identify the commonly used HMs among patients with DM
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