Abstract
BackgroundClinical history-taking can be employed as a standardized approach to elucidate the use of herbal medicines and their linked suspected adverse drug reactions (ADRs) among hospitalized patients. We sought to identify herbal medicines nominated by Ugandan inpatients; compare nomination rates by ward and gender; confirm the herbs’ known pharmacological properties from published literature; and identify ADRs linked to pre-admission use of herbal medicines.MethodsProspective cohort of consented adult inpatients designed to assess medication use and ADRs on one gynaecological and three medical wards of 1790-bed Mulago National Referral Hospital. Baseline and follow-up data were obtained on patients’ characteristics, including pre-admission use of herbal medicines.ResultsFourteen percent (26/191) of females in Gynaecology nominated at least one specific herbal medicine compared with 20 % (114/571) of inpatients on medical wards [20 % (69/343) of females; 20 % (45/228) of males]. Frequent nominations were Persea americana (30), Mumbwa/multiple-herb clay rods (23), Aloe barbadensis (22), Beta vulgaris (12), Vernonia amygdalina (11), Commelina africana (7), Bidens pilosa (7), Hoslundia opposita (6), Mangifera indica (4), and Dicliptera laxata (4). Four inpatients experienced 10 suspected ADRs linked to pre-admission herbal medicine use including Commelina africana (4), multiple-herb-mumbwa (1), or unspecified local-herbs (5): three ADR-cases were abortion-related and one kidney-related.ConclusionsThe named herbal medicines and their nomination rates generally differed by specialized ward, probably guided by local folklore knowledge of their use. Clinical elicitation from inpatients can generate valuable safety data on herbal medicine use. However, larger routine studies might increase the utility of our method to assess herbal medicine use and detect herb-linked ADRs. Future studies should take testable samples of ADR-implicated herbal medicines for further analysis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1125-x) contains supplementary material, which is available to authorized users.
Highlights
Clinical history-taking can be employed as a standardized approach to elucidate the use of herbal medicines and their linked suspected adverse drug reactions (ADRs) among hospitalized patients
Our study aimed to identify the herbal medicines nominated by Ugandan inpatients; compare the nomination rates by ward and gender; confirm the herbs’ known pharmacological properties from published literature; and identify suspected adverse drug reactions (ADRs) linked to preadmission use of herbal medicines
Mumbwa, which are clay rods constituted with one or more local herbs, received the highest number of citations on the Gynaecological ward (GYN); patients were seldom aware of the specific herbs that were compounded in these clay rods
Summary
Clinical history-taking can be employed as a standardized approach to elucidate the use of herbal medicines and their linked suspected adverse drug reactions (ADRs) among hospitalized patients. We sought to identify herbal medicines nominated by Ugandan inpatients; compare nomination rates by ward and gender; confirm the herbs’ known pharmacological properties from published literature; and identify ADRs linked to pre-admission use of herbal medicines. Examples of plants used traditionally to procure abortion, whose uterotonic properties have been formally tested and confirmed, include: Bidens pilosa L., Commelina africana L., Desmodium barbatum (L.) Benth, Manihot esculenta Crantz, Ocimum suave Klilld., Oldenlandia corymbosa L., and Vernonia amygdalina Delile [3, 7]. Other uses of herbs in folk medicine have been reported, some being confirmed by formal testing of the herbs’ pharmacological activity. Dicliptera laxata has antimicrobial [11], anti-inflammatory and antinociceptive properties [12]; traditionally, its roots are chewed as a cough remedy and for stomach pain while its leaf extract is drunk to treat fever, headache, rashes and itching [11, 13]
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