Prevalence, expenditures, and associated factors of purchasing non-prescribed Chinese herbal medicine in Taiwan

Abstract

Background and aims Purchasing Chinese herbal medicine (CHM) without a physician’s prescription may have adverse effects on health. However, the recent status of purchasing non-prescribed CHM and the associated factors are not completely understood. We aimed to report the prevalence of purchasing CHM and associated factors. Methods Using data from the 2017 Taiwan Survey of Family Income and Expenditure, we identified 16,528 individuals (householders) aged 18 years and older. Sociodemographic factors, expenditures on medical services and health behaviours were compared between people with and without a history of purchasing non-prescribed CHM by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in a multiple logistic regression analysis. Results The one-year prevalence of purchasing non-prescribed CHM was 74.8% in Taiwan. In addition to sociodemographics, marital status (OR 2.14, 95% CI 1.88–2.44), the use of traditional Chinese medicine (OR 3.62, 95% CI 3.30–3.97), the purchasing of non-prescribed biochemical medications (OR 3.09, 95% CI 2.75–3.48), the purchasing of health foods (OR 2.59, 95% CI 2.33–2.86), the use of folk therapy (OR 2.27, 95% CI 1.95–2.64), and a high level of expenditure on alcohol (OR 3.79, 95% CI 3.29–4.36) were strongly correlated with purchasing non-prescribed CHM. Conclusion The one-year prevalence of purchasing non-prescribed CHM is very high in Taiwan and is correlated with sociodemographics, health behaviours, and the utilization of medical care. The interaction of non-prescribed CHM with physician-prescribed herbal medicine and biomedical medications requires more attention.

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“…21 , 22 An analysis of data from the 2017 Taiwan Survey of Family Income and Expenditure reported that approximately 78.4% of the general population used TCM in that year. 23 Evidence also shows that the general population has turned to TCM during the COVID-19 pandemic, with one survey from Hong Kong conducted from November to December 2020 revealing that traditional, complementary and integrative medicine was commonly used there for COVID-19 prevention and treatment. 24 An animal study has indicated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes hyperinflammation in senescent cells, increases the expression of viral entry proteins and reduces antiviral gene expression, 25 which indirectly explains the high mortality rates of older adults with chronic disease who contract SARS-CoV-2 infection.…”

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“…The cause of these findings is not fully understood. One possible explanation is high-income patients who receive adjuvant CHM treatment may tend to seek and can afford more complementary and alternative medicine therapies, as well as having better health behaviors ( 22 ). Healthcare resources are often difficult to access in rural areas.…”

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“…These physicians have a high level of expertise and integration in both Western medicine and TCM to provide patients with comprehensive care. Tai Ji and the purchase of non-prescribed CHM were not included in the clinical settings of TCM medical care and they were not covered in the national medical insurance in Taiwan [ 23 , 37 ]. Although the purchase of non-prescribed CHM is not illegal in Taiwan, TCM physicians and government discourage people to visit CHM store.…”

“…In this study, we defined the purchase of non-prescribed CHM as people purchased CHM without physician’s prescription and this phenomenon has been reported in the previous study [ 23 , 37 ]. Only physician prescribed CHM was considered as part of TCM in this study.…”