Lack of communication on chronic disease patients’ herbal supplement use concerning: Saudi study

In many cultures, including Saudi Arabia, the use of herbal supplements is deeply rooted in traditional medicine practices. Patients with chronic diseases often resort to herbal supplements either as complementary or alternative therapies alongside conventional treatments. Reasons for this may include perceived effectiveness, cultural beliefs, accessibility and sometimes, dissatisfaction with mainstream medical treatments. 

A concerning trend is has emerged among patients with chronic diseases: the widespread use of herbal supplements without proper consultation with healthcare providers. Potential health implications of this trend include interaction with conventional prescription medications, which is particularly critical for chronic disease patients who are often on multiple medications. Herbal supplements can interfere with drug absorption, metabolism or excretion, leading to reduced efficacy or more severe side effects.

Such patients may also delay or avoid seeking evidence-based treatments recommended by healthcare professionals, resulting in disease progression, complications or poorer health outcomes. Additionally, the quality and safety of herbal supplements can vary widely, with a risk of contamination, adulteration or mislabelling. Some herbal products may contain harmful substances or incorrect dosages, posing health risks, especially for vulnerable populations such as chronic disease patients.

Other negative outcomes include mild to severe allergic reactions and side effects, or a financial burden brought on by prolonged herbal supplement use — especially if these products are not covered by health insurance and need to be purchased out-of-pocket.

Analysing Alkharj​

The aforementioned study, conducted between February and June 2019, aimed to delve into the beliefs, awareness, usage patterns and associated factors concerning herbal supplement use among chronic disease patients. Conducted as a cross-sectional analysis of 533 participants with an average age of 53.6 years, the research involved face-to-face interviews with patients attending various outpatient clinics across different hospitals in Alkharj.

The most commonly used herbal supplements among chronic disease patients in Alkharj included ginger, mint and cumin, each with its purported health benefits. Chronic disease sufferers, particularly those with conditions like diabetes mellitus and hypertension, were found to be frequent users of such supplements. However, the indiscriminate use of these supplements, often without medical oversight, could pose potentially significant health risks, such as adverse events and drug interactions.

Supplemental statistics​

Chronic diseases such as diabetes mellitus, hypertension and hyperlipidaemia were found to be prevalent among the studied patients, with many turning to herbal supplements as an adjunct to their prescribed medications. The study subsequently revealed that 63.1% of patients with chronic diseases in Alkharj were using at least one herbal supplement.

The belief in the healing power of herbal supplements was strong among patients, with 63.7% expressing confidence in their efficacy. However, the majority (73%) were unaware of the potential risks associated with herbal supplement use, including adverse events and drug interactions.

Additionally, despite the widespread use of herbal supplements, there was a notable lack of communication between patients and healthcare providers regarding their usage. A staggering 89% of patients admitted to not consulting their healthcare providers before taking herbal supplements, and over 81% to not discussing their usage patterns with them.

Similarly, healthcare providers were found to seldom inquire about herbal supplement use during patient consultations, with more than 89% of patients reporting no such discussion with their healthcare providers.

The researchers also identified factors such as gender, the number of chronic diseases and the presence of hyperlipidaemia as associated with herbal supplement use among the patients. Female patients were found to be more likely to use herbal supplements than male patients, and patients with multiple chronic diseases or hyperlipidaemia were also more inclined towards herbal supplement use.

Cautious conclusion​

The researchers stated that while herbal supplements may offer potential benefits, their use must be approached with caution, especially among chronic disease patients.

At the same time, they acknowledged the study’s limitations, including a risk of recall bias common in cross-sectional studies, as participants’ responses could not be independently verified. Secondly, because the study was done in a specific area of Saudi Arabia, it may not be representative of the country on the whole (though most of the herbal supplements included in the study are common in Saudi Arabian population).

Thirdly, as this was a cross-sectional study, no causal implications could be inferred. Fourthly, the study was conducted with “a convenient sampling technique that may limit the external validity of the obtained results, as replicating results is a major concern encounter” in the context of this method. Lastly, researcher bias may have occurred during the data compilation phase.

Still, the study underscored the pressing need for enhanced awareness and communication between patients and healthcare providers regarding herbal supplement use, especially among those with chronic diseases. By fostering open dialogue and providing informed guidance, healthcare professionals can mitigate potential risks and ensure the safe and effective management of chronic conditions.

These findings serve as a crucial foundation for developing targeted interventions and educational initiatives aimed at promoting safe and responsible herbal supplement usage within the chronic disease patient population. Moreover, the study emphasises the importance of ongoing research and vigilance in monitoring trends and factors influencing herbal supplement consumption to safeguard patient health and well-being.

Source: PLOS ONE​

“​Beliefs, awareness, use, and factors associated with herbal supplements usage among patients with chronic diseases–A cross-sectional insight from Alkharj, Saudi Arabia​”​

https://doi.org/10.1371/journal.pone.0295116​

Authors: Ahmed A. Albassam, et al​.

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