Abstract
BackgroundThe use of herbal supplements in the United States has become increasingly popular. The prevalence of herbal use among primary care patients varies in previous studies; the pattern of herbal use among urban racially/ethnically diverse primary care patients has not been widely studied. The primary objectives of this study were to describe the use of herbs by ethnically diverse primary care patients in a large metropolitan area and to examine factors associated with such use. The secondary objective was to investigate perceptions about and patterns of herbal use.MethodsData for a cross-sectional survey were collected at primary care practices affiliated with the Southern Primary-care Urban Research Network (SPUR-Net) in Houston, Texas, from September 2002 to March 2003. To participate in the study, patients had to be at least 18 years of age and visiting one of the SPUR-Net clinics for routine, nonacute care. Survey questions were available in both English and Spanish.ResultsA total of 322 patients who had complete information on race/ethnicity were included in the analysis. Overall, 36% of the surveyed patients (n = 322) indicated use of herbs, with wide variability among ethnic groups: 50% of Hispanics, 50% of Asians, 41% of Whites, and 22% of African-Americans. Significant factors associated with an individual's herbal use were ethnicity other than African-American, having an immigrant family history, and reporting herbal use by other family members. About 40% of survey respondents believed that taking prescription medications and herbal medicines together was more effective than taking either alone. One-third of herbal users reported using herbs on a daily basis. More Whites (67%) disclosed their herbal use to their health-care providers than did African-Americans (45%), Hispanics (31%), or Asians (31%).ConclusionsRacial/ethnic differences in herbal use were apparent among this sample of urban multiethnic adult primary care patients. Associated factors of herbal use were non-African-American ethnicity, immigrant family history, and herbal use among family members. Whereas Hispanics and Asians reported the highest rates of herbal use, they were the least likely to disclose their use to health-care professionals. These findings are important for ensuring medication safety in primary care practices.
Highlights
The use of herbal supplements in the United States has become increasingly popular
The proportions of herbal users varied across racial/ ethnic groups, with use being reported by 50% of Hispanics, 50% of Asians, 41% of Whites, and 22% of AfricanAmericans
Hispanics and Asians reported the highest rates of herbal use (50%), and African Americans reported the lowest (22%)
Summary
The use of herbal supplements in the United States has become increasingly popular. The prevalence of herbal use among primary care patients varies in previous studies; the pattern of herbal use among urban racially/ethnically diverse primary care patients has not been widely studied. The use of complementary and alternative medicine (CAM) in the United States gained greater popularity in the 1990s. Two national telephone surveys of 1,539 and 2,005 adults, respectively, demonstrated an increasing trend in the use of CAM, including relaxation techniques, herbal medicine, massage, chiropractic, and acupuncture[1,2]. The use of these unconventional treatments rose from 33.8% in 1990 to 42.1% in 1997 These surveys found that use of herbal medicine within the past year increased from 2.5% in 1990 to 12.1% in 1997[2]. CAM use was found to be more frequent among females, persons 35 to 49 years of age, persons of ethnicities other than African-American, persons who were college educated, and persons whose annual income was greater than $50,000[2]. In a separate study conducted in the 1990s, the American Botanical Council estimated that one-third of the nation's adults use herbal remedies[3]
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