Abstract
Practices described as traditional medicine may coexist with formalized, science-based medicine. In this context, the present study aimed to verify the profile of the elderly who consumed herbal medicines concomitantly with medications and to identify suspected adverse drug reactions (ADRs) in the Brazilian Amazon (Macapá, Amapá). The study was carried out in two steps: a cross-sectional study (structured questionnaire) and a clinical study (pharmacotherapeutic follow-up). Out of 208 participants, 78.8% were female with age between 60 and 69 years (58.7%), 59.1% used herbal medicines concurrently with medications, and 40.9% did not report use of herbal medicine. Losartan was the most used medication, and Lippia alba (Mill.) N.E. Br was the most common herbal medicine used. The total prevalence of suspected ADRs, among the elderly who answered the structured questionnaire, was 41.3%, with 27.4% being in the elderly who used herbal medicines and medications, and 13.9% being in the elderly who used only medications. Meanwhile, the total prevalence of suspected ADRs was 71.0% among the elderly patients who underwent pharmacotherapeutic follow-up, 60.5% in elderly who used herbal medicines and medications, and 10.5% in elderly who used only medications. The most reported ADR symptoms were related to disorders that affect the nervous system (38.4%) in the structured questionnaire and related to digestive disorders (36.4%) in the pharmacotherapeutic follow-up. The probability associated with the occurrence of a given ADR in the face of a set of demographic, socioeconomic, and clinical variables was estimated; the results showed that, in the studied population, only sex (p = 0.030) had an influence on the occurrence of ADR. The prevalence of ADRs with probable causality was high in this study population, but it was only sex-related, although more prevalent in the elderly who consume herbal medicines.
Highlights
Herbal medicines are widely used in healthcare worldwide, mainly in local communities that have a long history of their use in traditional medicine, defined by World Health Organization (WHO) as “the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness” [1]
This study showed that in a region of the Brazilian Amazon (Macapa, Amapa), the elderly people who consume the most herbal medicines are younger, female, of low-income, and literate
The prevalence of adverse drug reactions (ADRs) with probable causality was high in this study population, but it was only sex-related, more prevalent in the elderly who consume herbal medicines
Summary
Herbal medicines are widely used in healthcare worldwide, mainly in local communities that have a long history of their use in traditional medicine, defined by World Health Organization (WHO) as “the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness” [1]. In Brazil, traditional medicine was historically built from a combination of knowledge and practices of different peoples, especially indigenous groups, Europeans, and Africans [2, 3]. The phytomedicine (the use of herbal medicines with therapeutic properties) in the Brazilian Amazon has emerged from a long historical tradition of using products from nature for curing diseases. Many countries have practices described as traditional medicine which may coexist with formalized, science-based, and institutionalized systems of medical practice represented by biomedicine, here defined as the hegemonic medical system based on the principles of Western science, where both are considered as complementary [4,5,6]
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