Use of Herbal Medicine by Elderly Hispanic and Non‐Hispanic White Patients

Zeilmann, Carla A.; Dole, Ernest J.; Skipper, Betty J.; McCabe, Melvina; Dog, Tieraona Low; Rhyne, Robert L.

doi:10.1592/phco.23.4.526.32117

Cited by 58 publications

(31 citation statements)

References 8 publications

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“…[12][13][14][15][16][17][18][19] We carried out a multistage qualitative study using focus groups, in-depth interviews, and a video vignette to investigate processes of communication about TM/CAM. The 5 stages of the design were (1) focus groups composed of clinic staff and community key informants; (2) interviews of patients being seen in clinic; (3) interviews of clinicians in the same clinics; (4) an analytic focus group of clinicians from other clinics; and (5) refl ective interviews of community members and patients being seen in the clinics using a video vignette ( Figure 1 displays an overview of the study design).…”

Section: Designmentioning

confidence: 99%

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Shelley¹,

Sussman²,

Williams³

et al. 2009

The Annals of Family Medicine

205

156

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PURPOSE Although high rates of traditional medicine and complementary and alternative medicine (TM/CAM) use have been well documented, there has been less attention to the factors infl uencing communication between patients and their primary care clinicians about TM/CAM. Such communication can be important in anticipating possible drug-herb interactions and in assuring agreement about therapeutic plans. METHODSWe used sequential, multistage, qualitative methods, including focus groups, in-depth interviews, and a video vignette, to explore communication about TM/CAM between patients and their primary care clinicians. The study was conducted in RIOS Net (Research Involved in Outpatient Settings Network), a Southwestern US practice-based research network, situated largely in Hispanic and American Indian communities where TM/CAM is an important part of self-care. RESULTSOne hundred fourteen patients, 41 clinic staff members, and 19 primary care clinicians in 8 clinic sites participated. The degree and nature of TM/ CAM communication is based on certain conditions in the clinical encounter. We categorized these fi ndings into 3 themes: acceptance/nonjudgment, initiation of communication, and safety/effi cacy. Perceived clinician receptivity to and initiation of discussion about TM/CAM strongly infl uenced patients' decisions to communicate; perceived clinician expertise in TM/CAM was less important. Clinicians' comfort with patients' self-care approaches and their level of concern about lack of scientifi c evidence of effectiveness and safety of TM/CAM infl uenced their communication about TM/CAM with patients. CONCLUSIONS Specifi c communication barriers limit patient-clinician communication about TM/CAM. Clinicians who wish to communicate more effectively with their patients about these topics and better integrate the types of care their patients use can change the communication dynamic with simple strategies designed to overcome these barriers. INTRODUCTIONT he use of traditional, complementary, and alternative medicine is widespread, 1-4 although most users of traditional medicine and complementary and alternative medicine (TM/CAM) 2 also use allopathic care. 3 There are numerous studies, however, documenting a lack of communication in the conventional care setting between patients and their primary care clinicians about patients' use of TM/CAM. [5][6][7] Patient-centered communication is an evolving construct unifi ed by a set of core values defi ned by Epstein et al as a set of strategies (or a "way of being") designed to enhance a sense of partnership in the patient-clinician 8 Applied to TM/CAM use, patient-centered communication can be important because it may (1) result in closer agreement between the clinician and patient about treatment plans, (2) reduce misunderstandings between patients and clinicians, (3) uncover potential herb-drug interactions, (4) strengthen the quality of the patient-clinician relationship, and (5) provide an opportunity to discuss specifi c TM/CAM modalities with high-qu...

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Section: Designmentioning

confidence: 99%

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Shelley¹,

Sussman²,

Williams³

et al. 2009

The Annals of Family Medicine

205

156

View full text Add to dashboard Cite

show abstract

“…15 Over one-half (52.0%) of the patients purchased their herbs in drugstores or groceries, where pharmacists would be available, but none of them received any herb information from the pharmacist. 17 Another study found that more practicing pharmacists, compared with pharmacy students, felt that pharmacists should not become practitioners of CAM (26.6% vs 0.0%). 18 This underscores the need for physicians to recognize an even greater responsibility to provide their patients with reliable information about herbs and to be particularly cognizant of the need to do so for their Hispanic population.…”

mentioning

confidence: 99%

Use of Herbal Remedies by Hispanic Patients: Do They Inform Their Physician?

Howell¹,

Kochhar

Saywell³

et al. 2006

The Journal of the American Board of Family Medicine

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“…Based on the initial literature search identifying the most commonly used herbal medicines as well as available data regarding commonly used herbals in patients with medical conditions frequently seen in hospice, 37 herbal medicines and supplements were included in the survey (Table 2). 16,[23][24][25][26][27][28][29][30][31] Participants were asked to rate their agreement on a scale of 1 to 5 (with a score of 1 equivalent to strongly disagree to 5 meaning strongly agree) for each medicine regarding four areas: high potential for use in hospice patients, high potential for serious adverse effects, high potential for serious drug interactions, and recommendation to include the medication on a list that hospice nurses ask about on every admission. In addition, participants were given the opportunity to list other herbals or supplements not included in the 37 medications that should be considered, as well as to state other general concerns regarding herbal use in hospice patients.…”

Section: Methodsmentioning

confidence: 99%

Soliciting an Herbal Medicine and Supplement Use History at Hospice Admission

Holmes

Kaiser

Jackson

et al. 2010

Journal of Palliative Medicine

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Background: Reconciling medication use and performing drug utilization review on admission of a patient into hospice care are essential in order to safely prescribe medications and to prevent possible adverse drug events and drug-drug interactions. As part of this process, fully assessing herbal medicine and supplement use in hospice patients is crucial, as patients in hospice may be likely to use these medications and may be more vulnerable to their potential adverse effects. Objective: Our purpose was to identify herbals, vitamins, and supplements that should be routinely assessed on every hospice admission because of their higher likelihood of use or higher risk of adverse effects or drug interactions. Methods: Experts in the fields of palliative medicine, pharmacy, and alternative medicine were asked to complete a Web-based survey on 37 herbals, vitamins, supplements, and natural products, rating likelihood of use, potential for harm, and recommendation to include it on the final list on a scale of 1 to 5 (least to most likely to agree). Results: Twenty experts participated in the survey. Using a cutoff of 3.75 for inclusion of a medication on the final list, 12 herbal medicines were identified that should be routinely and specifically assessed on hospice admission. Conclusions: Although assessing all herbal medicine use is ideal, thorough detection of herbals may be challenging. The list of herbals and supplements identified by this survey could be a useful tool for medication reconciliation in hospice and could aid in identifying potentially harmful medication use at the end of life.

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Use of Herbal Medicine by Elderly Hispanic and Non‐Hispanic White Patients

Abstract: As approximately half of the elderly patients stated that they used herbal medicines, health care providers should be knowledgeable about herbal remedies and provide reliable information to their patients about them in a nonjudgmental manner.

Cited by 58 publications

References 8 publications

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Use of Herbal Remedies by Hispanic Patients: Do They Inform Their Physician?

Soliciting an Herbal Medicine and Supplement Use History at Hospice Admission

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