Abstract

In recent years, there has been a renewed interest in the use of herbal medicines. Quality control and safety are two critical principles to be considered in the production process of herbal medicines. This review study aimed to investigate the condition of the countries other than Iran in terms of observing the safety principles, quality control, and meeting the standard of herbal drug use. In this systematic review, references were selected using the search terms "health-care quality" and "challenges of herbal medicine usage" from the databases "Web of Science" and "PubMed" published between 2000 and 2019. To select the resources among the selected literature, confirmation was accomplished by two researchers and Cohen’s kappa coefficient (κ). The selected papers were classified based on publication year, journal, country, reference standards, regulation, toxicity evaluation, quality control, efficacy, safety, and adverse effects in herbal medicine. From 1532 retrieved papers, 27 papers with an estimated Cohen’s kappa coefficient of 0.81 were confirmed and included in the study. Based on the analysis, the main findings of the papers were thematically classified into seven subcategories as follows: reference standards in herbal medicine, regulation of herbal medicinal products, toxicity evaluation for herbal products, quality control of herbal medicine, efficacy, adverse effects of herbal medicine, and safety. Given the significance of the effects of herbal medicines on health care quality, it is essential to codify guidelines on the proper use of these drugs.

Highlights

  • Herbal medicines are currently considered the oldest and most commonly used medical system worldwide [1]

  • 2148 references on the herbal medicines interactions published during 2007-2010 were reviewed The herbal medicines interactions network allows the clinical practitioners to keep themselves updated about the possible herbal medicines adverse effects based on the latest information

  • The herbal drugs platform would assist the pharmaceutical companies in the discovery of herbal medicines

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Summary

Introduction

Herbal medicines are currently considered the oldest and most commonly used medical system worldwide [1]. A large proportion of the population in developing and developed countries tend to rely on the herbal medicines for their primary healthcare. More than 90% of people in Africa, 70% in India, 70% in Germany, 48% in Australia, 70% in Canada, 42% in America, 39% in Belgium, and 76% in France meet their healthcare needs by using herbal medicines [2,3,4,5,6]. The study and identification of herbal medicines require less time and cost [3]. The global herbal medicines market enjoyed an annual growth rate of over 15% [7] and the global trade of herbal products is expected to reach $70 million in the United States by 2050 [3]

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