Evaluation of use of herbal medicines among ambulatory hypertensive patients attending a secondary health care facility in Nigeria

Abstract

The aim was to evaluate use of herbal medicine among hypertensive patients. The study was carried out at a secondary health care facility in Maiduguri, Nigeria, between April and June 2007. Pretested questionnaires were administered to 500 ambulatory hypertensive patients attending the hypertension clinic after giving consent. Demographic data of respondents, information on reasons for use, sources of herbal medicines, co-administration with allopathic agents, effects observed, steps taken when adverse effects were observed and reasons for discontinuation of herbal medicines were obtained. Data were analysed using descriptive statistics and chi2 at a significance level of P < 0.05. One hundred and twenty respondents were found to be using herbal medicines. Increased age was associated with increased use of herbal medicines (P < 0.05). Co-administration of herbal medicines with antihypertensive agents was done by 47.5% respondents, out of which herbs with antihypertensive activity were used by 33.33%. The majority of respondents, 71.15%, were using herbal medicines unbeknownst to their physicians. Clinically evident adverse effects due to co-administration of herbal medicines and allopathic agents were reported by 21.04% of the respondents. Side effects observed (3.79%), improvement in clinical conditions (3.03%), perceived inefficacy of the herbal medicine (1.52%) and instructions by the health care provider (21.15%) were reasons given for discontinuation of the herbal medicines. Reasons given for preferring herbal medicines were combinations of perceived failure of allopathic medicines (31.73%), relatively high cost of allopathic medicine (23.08%), socio-cultural practices/herbal knowledge (20.19%), poor accessibility to medical facilities (19.23%), safety concerns (9.62%) and uncaring attitudes of hospital staff when attending to respondents (6.73%). Herbal medicines were often co-administered with allopathic agents by hypertensive patients, and health care givers need to be vigilant and include questions about use of herbal medicines when taking a patient's drug medication history.