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

Abstract

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.

The trends of utilization in traditional Chinese medicine in Taiwan from 2000 to 2010

“…[ 1 ] Herbs are being used by 75% of the people in the world for their basic healthcare needs. [ 2 ] Medical doctors should know about patients’ use of CAM concurrently when taking their medical history, because the frequency of CAM use has greatly increased. [ 3 ] This increase is due to both the interest of patients in CAM for seeking help as well as exploration of the effectiveness of various therapies and interventions by researchers.…”

The Evaluation of Professional Divisions of Traditional Chinese Medicine in Taiwan through Patient Visit Records of 2012

“…Studies have revealed that the most commonly used ICD-9-CM codes for NHI TCM claims were related to the “Diseases of the Respiratory System” [ 21 , 30 , 31 ]. Most patients who “shop” towards TCMPs seek treatment for respiratory diseases (44.7%), followed by sprains and injuries (44.0%) [ 32 ], and these patients also attended otolaryngology clinics (known as ENT clinics) and Western medicine physical therapy clinics [ 32 ].…”

Pharmacokinetic and pharmacodynamic herb–drug interactions of common over‐the‐counter pain medications

“…In Taiwan, it was estimated that approximately 10% of the population regularly utilizes traditional or complementary medicines (Shih et al, 2009); similar numbers were observed in China (14%) (Aw et al, 2019), Malaysia (21.5%) (Kaur et al, 2019), South Korea (25.4%) (Park et al, 2021) and India (13%) (Pengpid & Peltzer, 2021); and approximately 70% of the physicians in Japan regularly prescribe Kampo drugs for their patients (Yamakawa et al, 2013). Among health conditions, pain relief has consistently been the main reason for self‐medication, using either OTC drugs (Perrot et al, 2019) or herbal remedies (Lin et al, 2015).…”