Prevalence of and factors associated with utilization of herbal medicines among outpatients in primary health centers in Cambodia

Abstract

BackgroundTraditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia.MethodsA cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers purposively selected from Phnom Penh, Kampong Cham and Siem Reap. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. I-CAM-Q was used to measure TCAM use. A multivariate logistic regression model was constructed to identify factors associated with herbal medicine use.ResultsIn total, 1602 patients were included in this study, of whom 77.7% were female, and 51.2% were recruited from urban primary health centers with a mean age of 46.5 years (SD = 15.2). Of total, 27.0% reported at least one consultation with a TCAM provider in the past 12 months. The most common modality of TCAM used was herbal medicine (89%). Herbs were obtained at drug or folk stores (36.9%), from herbalists directly (28.5%) or from their own gardens (18.6%). Of herb users, 55.2% reported that herbs were somewhat helpful. After adjustment, herb users were significantly more likely to be female (AOR = 1.42, 95% CI = 1.12–2.67), have completed less schooling (AOR = 0.66, 95% CI = 0.45–0.96), were unemployed or homemakers (AOR = 0.23, 95% CI = 0.13–0.52) and have a gastrointestinal illness (AOR = 0.49, 95% CI = 0.39–0.62).ConclusionsHerbal medicines are broadly used among chronic disease patients in Cambodia. Understanding TCAM use in the general population will support health care practitioners and policy makers to make informed decisions about the use of TCAM. Integration of TCAM into the primary health system should be further explored.

<p>The use of herbal medicines among chronic disease patients in Thailand: a cross-sectional survey</p>

“…Several studies20–22 found that being a woman and younger or older age were associated with herbal medicine use, while in this study only in bivariate analysis women had a higher prevalence of herbal medicine use than men had, and no age differences were found. This study found that having completed primary education increased the odds for herbal medicine use, while in a community survey in Turkey22 higher education was positively and among chronic disease patients in Cambodia16 was negatively associated with herbal medicine use. Consistent with some studies on traditional and complementary medicine utilization,17,19 this study found that rural residence increased the odds for herbal medicine use.…”

“…Findings show a high prevalence of past 12-month herbal medicine use (35.9%) among chronic disease patients in Thailand, higher than in Lao PDR (21.3%)17 and Malaysia (24.9%), and lower than in Vietnam (43.6%),20 Cambodia (44.5%),16 and Myanmar (53.2%) 19. This high prevalence of past 12 month herbal medicine use among chronic disease patients in Thailand confirms findings of lifetime, 12-month and past 3-month herbal medicine use in different study populations in Thailand: hospital patients 28.6%,7 gynaecologic cancer patients 27.0%,10 cancer patients treated with radiotherapy past-12-month use of 31.1%,11 diabetes patients past 3-month use of 20.1%,12 and 42% taking herbal medicine together with modern medication,32 chronic kidney disease patients past 12-month use of 27.3%,13 and among persons living with HIV lifetime use of 32% 14.…”

“…The prevalence of past 12-month herbal medicine use among chronic disease patients in Cambodia was 44.5%,16 in Lao PDR 21.3%,17 in Malaysia 24.9%,18 Myanmar 53.2%,19 and Vietnam 43.6% 20. Factors associated with herbal medicine use may include sociodemographic and well-being factors.…”

“…Factors associated with herbal medicine use may include sociodemographic and well-being factors. Sociodemographic factors include, women,21,22 younger or older age,20–22 higher socioeconomic status,21,22 lower education,16 married,21 and urban residence 20. Well-being factors include, perceived poor health status,20,21 neither poor nor good quality of life,16 anxiety,23 depression,23 multiple chronic conditions,20,22 arthritis,23 hypertension,16 and gastrointestinal diseases 16…”

Prevalence of complementary and alternative medicine (CAM) use in Brazil

“…The use of medicinal plants for health treatment, cure or even disease prevention can be considered one of the oldest forms of medical practice [1]. Even today, the use of medicinal plants or other alternative practices can be the only therapeutic resources for many communities and ethnic groups, especially in developing countries [2][3][4].…”