Reasons why Thai patients with chronic kidney disease use or do not use herbal and dietary supplements

Abstract

BackgroundDespite a high prevalence of herbal and dietary supplement use (HDS) in pre-dialysis patients, the reasons are unknown as to why they decide to use HDS. Objectives of the cross-sectional and qualitative studies were to determine reasons for the use and non-use of HDS in Thai patients with chronic kidney disease (CKD).MethodsThis prospective study recruited 421 patients with stage 3–5 CKD from two kidney clinics in Thailand, and 357 were followed up regarding their HDS use over 12 months. Patients receiving renal replacement therapy at baseline were excluded. Participants were interviewed at baseline and in the twelfth month regarding their HDS use, and reasons for their use or non-use of HDS. Among HDS users, 16 patients were enrolled in a qualitative study and were interviewed using eight-open ended questions about reasons for HDS use. Descriptive and thematic analyses were performed.ResultsThirty-four percent of patients with CKD consistently used HDS over the 12 months and 17% of all patients intermittently took them during the follow-up period. At baseline, family or friends’ recommendation was the most common reason for HDS use (35%), followed by having a perception of benefits from using HDS (24%). During the follow-up period, perceived benefits of HDS was a frequently reported reason for either continuing with HDS use (85%) or starting to use HDS (65%). Negative experience from using HDS influenced patients to stop using them (19%). Although the main reason for non-use of HDS was trust in a doctor or effectiveness of conventional medicine (32%), doubt about the benefits from HDS or concerns about negative effects were frequently reported reasons for non-use (23%). Doctor’s recommendations to avoid using HDS were the main influence for non-users (19%) and for those who had stopped using HDS (23%). The media and patients’ social network had an impact on HDS use.ConclusionsPatients who perceived benefits from HDS use were more likely to use HDS, whilst non-users had negative attitudes towards HDS. Health professionals therefore should educate patients and their relatives about the risks and benefits from using HDS.

Use of complementary and alternative medicine by patients with end-stage renal disease on haemodialysis in Trinidad: A descriptive study

“…The benefits of CAM reported by other investigators are that CAM is ‘natural’ and ‘safe’ [64], is effective [60], has fewer adverse effects [64], and allows a feeling of control, coping, and adjustment [65]. …”

Relation of Complementary‐Alternative Medicine use with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage

“…On the other hand, a recent study from Turkey established that only 21.6% of physicians asked their patients about CAM use . In a study from Thailand, major reasons for non‐use or discontinuation of CAMs and informing physicians about CAM use were trust in physician or effectiveness of conventional medicine …”

“…National Institute of Health (NIH) and National Committee on Complementary Alternative Medicine (NCCAM) defined CAMs as a ‘broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period’ . Herbal products were defined as materials derived from plants or produced from dietary ingredients …”

Qualitative exploration of pharmacist care for herbal and dietary supplement users in Thai community pharmacies

“…Many individuals use HDS to prevent or treat diseases, or enhance the effects of conventional therapies . The use of HDS is generally driven by the motivation to have more control over one's health . Although some HDS have been shown to be effective in certain health conditions, many of the products lack clinical evidence .…”

“…Of these HDS users, 58.4% consumed herbal medicines to treat illnesses, whereas 65.3% made use of dietary supplements to enhance their well‐being. Moreover, the consumption of HDS was also reported to be common in Thai patients with chronic diseases who were also using modern medicines . This pattern of consumption poses a potential problem because prescribed medicines may interact with the HDS, and thus may cause treatment failure or toxicity .…”