Polypharmacy Meets Polyherbacy: Pharmaceutical, Over-the-counter, and Natural Health Product Use Among Canadian Adults

Votova, Kristine; Blais, Régis; Penning, Margaret J.; Maclure, Malcolm

doi:10.17269/cjph.104.3695

Cited by 12 publications

(9 citation statements)

References 28 publications

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“…One potential reason for the popularity of herbal products (especially self‐made herbs) might be the lower costs of these products in comparison with conventional medication. The use of herbal products is increasing in many other countries such as the USA and Canada . ‘Polyherbacy’, a new term, has been coined to describe the use of multiple herbal products .…”

Section: Discussionmentioning

confidence: 99%

“…The use of herbal products is increasing in many other countries such as the USA 16 and Canada. 10 'Polyherbacy', a new term, has been coined to describe the use of multiple herbal products. 23 In a cross-sectional study, Bjerrum et al found that 38.5% of older adults on the US-Mexico border used polypharmacy, whereas 16.2% used polyherbacy.…”

Section: Polypharmacy In Very Old Peoplementioning

confidence: 99%

“…The prevalence of polypharmacy is increasing with advancing age. 10 Previous studies found that sociodemographic factors (e.g. age, gender, income and education), 11 diseases (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Polypharmacy among nonagenarians/centenarians in rural China

Yang²,

Luo³

et al. 2014

Internal Medicine Journal

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Section: Discussionmentioning

confidence: 99%

Section: Polypharmacy In Very Old Peoplementioning

confidence: 99%

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Polypharmacy among nonagenarians/centenarians in rural China

Yang²,

Luo³

et al. 2014

Internal Medicine Journal

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“…The majority of older adults, approximately three quarters of geriatric patients (Anderson 2010), suffer from multiple chronic conditions and are consequently prescribed multiple medications (Lorgunpai et al 2014). Polypharmacy describes an individual's use of multiple medications; however, a uniform definition for polypharmacy has not yet been set (Votova et al 2013). "Polypharmacy" is usually defined as the concurrent use of five or more medications (Hoffmann et al 2011), whereas "excessive polypharmacy" refers to the simultaneous use of more than ten prescribed medications (Jyrkkä et al 2012).…”

Section: Definitions and Epidemiology Of Polypharmacy And Polyherbacymentioning

confidence: 99%

Ageism in Medication Use in Older Patients

Fialová

Kummer²,

Držaić³

et al. 2018

International Perspectives on Aging

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Medications and doses are often similarly prescribed to older and younger adult patients (Somers 2016). This is a problem that must be viewed as ageist, because pharmacological studies have shown for decades that many medications act differently in older and younger people due to the physiological and pathological changes that accompany ageing. Many medications have different efficacy and safety profiles in younger and older age groups (American Geriatrics Society (AGS) 2015; Fialová and Onder 2009; Pazan et al. 2016). For this reason, treating older adults the same as younger adults when prescribing medication, without respecting age-specific needs in terms of such issues as individual dose adjustments, geriatric drug forms, and geriatric medication management, can be seen as a form of ageism. Among older adults, the selection of medication, dosing schedules, and combined drug regimens, as well as appropriate follow-up and management of medication treatment, should always be age-specific and highly individualized. Unfortunately, this is not a common clinical practice (Fialová and Onder 2009; Petrovic et al. 2016).

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“…Many pharmaceutical drugs are derived directly from both natural and traditional remedies distributed around the world [ 4 ]. A considerable consequence resulting from polypharmacy or polyherbacy is the potential for drug–herb interactions to occur among various products [ 5 , 6 ]. The use of multiple medications and herbs can lead to adverse consequences, particularly for elderly people and cancer patients [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Polyherbacy in Ambulatory Visits to Traditional Chinese Medicine Clinics in Taiwan

Lin

Chang

et al. 2015

IJERPH

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Patients with a polyherbal prescription are more likely to receive duplicate medications and thus suffer from adverse drug reactions. We conducted a population-based retrospective study to examine the items of Chinese herbal medicine (CHM) per prescription in the ambulatory care of traditional Chinese medicine (TCM) in Taiwan. We retrieved complete TCM ambulatory visit datasets for 2010 from the National Health Insurance database in Taiwan. A total of 59,790 patients who received 313,482 CHM prescriptions were analyzed. Drug prescriptions containing more than five drugs were classified as polyherbal prescriptions; 41.6% of patients were given a polyherbal prescription. There were on average 5.2 ± 2.5 CHMs: 2.3 ± 1.1 compound herbal formula items, and 3.0 ± 2.5 single Chinese herb items in a single prescription. Approximately 4.6% of patients were prescribed 10 CHMs or more. Men had a lower odds ratio (OR) among polyherbal prescriptions (OR = 0.96, 95% confidence interval [CI] 0.92–0.99), and middle-aged patients (35–49 years) had the highest frequency of polyherbal prescription (OR = 1.19, 95% CI = 1.13–1.26). Patients with neoplasm, skin and subcutaneous tissue disease, or genitourinary system disease were more likely to have a polyherbal prescription; OR = 2.20 (1.81–2.67), 1.65 (1.50–1.80), and 1.52 (1.40–1.64), respectively. Polyherbal prescription is widespread in TCM in Taiwan. Potential herb interactions and iatrogenic risks associated with polyherbal prescriptions should be monitored.

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Polypharmacy Meets Polyherbacy: Pharmaceutical, Over-the-counter, and Natural Health Product Use Among Canadian Adults

Cited by 12 publications

References 28 publications

Polypharmacy among nonagenarians/centenarians in rural China

Polypharmacy among nonagenarians/centenarians in rural China

Ageism in Medication Use in Older Patients

Prevalence of Polyherbacy in Ambulatory Visits to Traditional Chinese Medicine Clinics in Taiwan

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