Concomitant Use of Herbal and Conventional Medicines among Patients with Diabetes Mellitus in Public Hospitals of Addis Ababa, Ethiopia: A Cross‐Sectional Study

Abstract

Introduction. The majority of the population in developing countries including Ethiopia still relies on traditional medicines (TMs). Patients with chronic illness like diabetes mellitus (DM) are dissatisfied with conventional medicines and thus are more likely to simultaneously use herbal medicines (HMs). However, such practice could result in potential herb-drug interaction. This study aimed to identify the commonly used HMs among patients with DM and determine the magnitude of concomitant use of herbal and conventional antidiabetic medicines. Method. A health facility-based cross-sectional study design was employed using both quantitative and qualitative data collection methods to determine the magnitude of concomitant use. Patients with DM and prescribers from four public hospitals were the study population for the quantitative and qualitative study, respectively. Simple descriptive statistics were used to describe variables for the quantitative data, and content analysis had been conducted manually for qualitative data. Result. Out of 791 respondents, 409 (51.7%) used traditional medicine at least once in their life time, and 357 (45.1%) used traditional medicine in the last six months prior to data collection. A majority (288 (80.7%)) of the respondents used HMs after starting the conventional antidiabetic medicines within the last six months. Moringa stenopetala, Thymus vulgaris, Trigonella foenum-graecum, Nigella sativa, and Allium sativum were among the frequently mentioned HMs. Prescribers were requesting patients’ HM use when they saw sign of liver toxicity and skin disease, and they were not documenting their history in the patient’s chart. Conclusion. Concomitant use of herbal and conventional antidiabetic medicines was a common practice. Cognizant of its potentially serious herb-drug interactions, efforts should be made to improve awareness and knowledge of healthcare providers about HM potential effects. Further studies on dose, frequency, duration, and modes of interaction are recommended.

The Use and Potential Interactions of Herbal Medicines among Diabetic Patients in Saudi Arabia: A Cross-sectional Study

“…Interestingly, most of the patients used herbal medicines without informing their physician. This occurrence was similar to an Ethiopian study where it was reported that slightly more than a third of patients informed their physicians about using such products [34]. This occurrence in our study may be a result of participant's demographics but it cannot be determined unless it is further investigated.…”

“…On the other hand, 17.4% of Ethiopian patients used thyme while in our study only 4.5% patients used it. Despite the difference in proportion of patients, it could be said that our findings are in line with the results of [34]. Our study report that almost half of patients (47.6%) consumed green tea while in a Nigerian study, the figure was 0.9% [33].…”

“…In our study, Fenugreek was used by a quarter of diabetic patients while in the study involving Ethiopian patients, its use was documented in very few patients (7.3%) [34]. Besides, our study reported a third of patients who used black seeds and garlic while a study by [34] reported 6.6% and 5.6% of patients who used black seeds and garlic, respectively. On the other hand, 17.4% of Ethiopian patients used thyme while in our study only 4.5% patients used it.…”

“…A cross-sectional self-administered survey was developed, based on a thorough review of the literature and previous research instruments [33,34]. The survey was reviewed by an internal medicine consultant and two diabetic specialist pharmacists for content validity.…”

Prehospital Use of Herbal Medicine in the Southwestern Ethiopia: Prevalence, Associated Factors and Safety Concern

“…Over last few decades, the use of herbal medicine has been increased especially in developing countries including . This resurgence of public interest in herbal medicine has been linked to a number of factors particularly, the various claims on the e cacy or effectiveness of plant medicines, the consumer choice for natural remedies and greater interest for alternative medicine, the misconception that herbal products are superior to synthetic products, the belief that herbal remedies may be effective in treating certain ailments that have proved to be ineffective or inadequate with conventional drugs, the high cost and side effects of most modern drugs, the patients' beliefs that their health care professionals do not accurately identify the problem; so they feel that herbal remedies are an alternative, and a move to self-medication (10)(11)(12)(13).These claims and perceptions have ampli ed the continued use of herbal medicines among consumers, even concomitantly with modern medicines despite the potential harmful drug interactions with collective undesirable effects of increased toxicity and decreased e cacy (14)(15)(16)(17)(18)(19).…”