Management of Adverse Experiences from the Use of Herbal Medicines in Consumers’ Perspectives
Article Sidebar
Main Article Content
Abstract
Objective: To explain management of adverse experiences (AEs) following use of herbal medicines in the perspective of consumers. Methods: A multiple case study was undertaken in Wangmai sub-district, Na Yai Am district, Chantaburi province during March/April 2017. In-depth interviews were employed as the method of data collection. Nine participants who had had AEs were selected by criterion sampling. Results: Key informants perceived the AEs during a course of herbal medicine treatment by self-diagnosing the observed bodily abnormalities using their own experiences. Some of the herbal users did not know that the experience was an adverse reaction to herbal medicine that it may also be called “Sai” symptom. The informants identified suspected herbal medicines from (i) ruling-out other potential causes other than suspected herbal medicines (ii) a recovery after cessation of suspected herbal medicines and (iii) the return of the symptoms after re-administration of the herbals. Managements of AEs were (a) taking no action if symptoms were mild and that herbal medicines were believed to be safe (b) self-care including dose moderation or discontinuation, sleeping, drinking a lot to increase excretion, or taking laural clock vine (Thunbergia laurifolia) to excrete toxins (c) seeking advice/care at sub-district health promoting hospital or drugstore and (d) performing both self-care and care-seeking behaviors Conclusion: Consumers of herbal medicine were at risk of adverse events. Therefore, effective surveillance systems for herbal medicines by promoting the report of adverse events by consumer and/or healthcare professional in primary care should be set-up for improving herbal medicine safety.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
2. Global Industry Analysts. Losing appeal of chemical remedies and growing consumer interest in herbal medicine and supplements drives market growth [online]. 2017 [cited Nov 11, 2017]. Available from: www.strategyr.com/MarketResearch/Herbal_Supplements_and_Remedies_Market_Trends.asp.
3. Office of the National Economic and Social Develop ment Board. The fifth national economic and social development plan (1982-1986) [online]. 1982 [cited Apr 9, 2016]. Available from: www.thaipublica.org/ wp-content/uploads/2014/10/ The Fifth National Economic and Social Development Plan pdf.
4. National Drug Committee. List of herbal medicinal products A.D.2006 [online]. 2006 [cited Apr 9, 2016]. Available from: drug.fda.moph.go.th:81/nlem .in.th/sites/default/files/binder3.pdf.
5. Office of The National Economic and Social Deve lopment Board. The tenth national economic and social development plan (2007-2011) [online]. 2007 [cited Apr 9, 2016]. Available from: www.plan.su.ac.th/2014 /Document/strategyPlan/ plan_part2.pdf.
6. Ministry of Public Health. The national master plan for herbal medicine development 2017–2021 [on line]. 2016 [cited Jul 12, 2017]. Available from: www.dtam.moph.go.th/images/download/dl0021/MasterPlan-Thaiherb.pdf.
7. World Health Organization. WHO guidelines on safety monitoring of herbal medicines in pharmaco vigilance systems [online]. 2004 [cited Apr 11, 2016 ]. Available from: apps.who.int/medicine docs/docu ments/s7148e/s7148e.pdf.
8. Saokaew S, Suwankesawong W, Permsuwan U, Chaiyakunapruk N. Safety of herbal products in Thailand: an analysis of report in the Thai Health Product Vigilance Center Database from 2000 - 2008. Drug Saf 2011;34:339-50.
9. Ministry of Public Health. Report on the results of Thai Traditional Medicine [online]. 2016 [cited Apr 11, 2016]. Available from: 203.157.81.35/mis/ttm.
10. World Health Organization. General guidelines for methodologies on research and evaluation of traditional medicine [online]. 2000 [cited Apr 11, 2016]. Available from: apps.who.int/iris/bitstream/ 10665/66783/1/WHO_EDM_TRM_2000.1.pdf.
11. World Health Organization. WHO safety of medicines A guide to detecting and reporting adverse drug reactions [online]. 2002 [cited Apr 11, 2016]. Available from: apps.who.int/iris/bitstream/ 10665/67378/1/WHO_EDM_QSM_2002.2.pdf.
12. Chantavanich S. Qualitative research methodology. 23rd ed.Bangkok: Chulalongkorn University Printing House; 2016.
13. Department of Medical Science, Ministry of Public Health. Steroids [online]. 2003 [cited Nov 11, 2017 ]. Available from: testkit.dmsc.moph.go.th/page-view/125.
14. Wang Mai Sub-district Administrative Organization. History of the administrative organization Wangmai [online]. 2014 [cited Nov 11, 2017]. Available from: www.wangmaichan.go.th/general1.php.
15. Schimmer BP, Parker KL. Adrenocorticotropic hor mone; adrenocortical steroids and their synthetic analogs; Inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 10th ed. New York: McGraw Hill; c2001. p. 1666-67.
16. Plengchai S. Prevalence of adverse events from drugs and heath products in patients with chronic disease at community in Selaphum, Roi-Et. Isan Journal of Pharmaceutical Sciences 2015;11 Suppl :33-42.
17. Sawanpanyalerd P, Suwankesawong W. Health product vigilance system in Thailand. Nonthaburi: National Office of Buddhism; 2016.
18. Suwankesawong W. Report on adverse events from herbal products/traditional medicines during 2006 -2015. Medicinal and Health Product Bulletin 2016;19:88-96.
19. Liew PM, Yong YK. Stachytarpheta jamaicensis (L.) Vahl: from traditional usage to pharmacological evidence. Evid Based Complement Alternat Med 2015; 2016:1-7.
20. Witthawaskul P, Panthong A, Kanjanapothi D, Taesothikul T, Lertprasertsuke N. Acute and sub acute toxicities of the saponin mixture isolated from Schefflera leucantha Viguier. Journal of Ethnophar macol 2003;89: 115-21.
21. Asare GA, Gyan B, Bugyei K, Adjei S, Mahama R, Addo P, et al. Toxicity potentials of the nutraceu tical Moringa oleifera at supra-supplementation levels. Journal of Ethnopharmacol 2012;139:265-72.
22. Sethi N, Nath D, Shukla SC, Dyal R. Abortifacient activity of a medicinal plant Moringa oleifera in rats. Anc Sci Life 1988;7:172-4.
23. Stohs SJ, Hartman MJ. Review of the safety and efficacy of Moringa oleifera. Phytother Res. 2015; 29: 796-804.
24. Phanthawimol W. Effect of dietary supplement with Moringa oleifera lam leaf extract on low density lipoprotein cholesterol reduction in hypercholeste rolemic patient: A pilot study [master thesis]. Bangkok: Chulalongkorn University; 2011.
25. Health Product Vigilance Center. Spontaneous reports of adverse drug reaction 2014. Nonthaburi: Graphic and design; 2015.
26. Soksawatmakhin S. Effectiveness of Ganoderma lucidum extract to level of fatigue and quality of life in chronic fatigue syndrome patients [master thesis]. Chiang Rai: Mae Fah Luang University; 2013.
27. Mateo DC, Pazzi F, Munoz FJD, Martinez JPM, Olivares PR, Gusi N, et al. Ganoderma lucidum improves physical fitness in women with fibromyalgia. Nutr Hosp 2015;32:2126-35.
28. Pramod S, Nirmala G, Subir B, Dushant G, Manoj G. Recent advances on the phytochemical and pharmacological profile of plant Helicteres isora Linn. International Research Journal of Pharmacy 2012; 3:14-7.
29. Medlineplus. Alfalfa [online]. 2017 [cited Sep 9, 2017 Available from: medlineplus.gov/druginfo/nat ural/19.html#Safety.
30. Walji R, Boon H, Barnes J, Austin Z, Welsh S, Baker GR. Consumers of natural health products: natural-born pharmacovigilantes?. BMC Comple ment Altern Med 2010;10:1-10.
31. Rehan HS, Chopra D, Kakkar AK. Physician’s guide to pharmacovigilance: terminology and causa lity assessment. Eur J Intern Med 2009;20:3-8.
32. Department for Development of Thai Traditional and Alternative Medicine, Ministry of Public Health. Herbal detox guide for the public. 2nd ed. Nontha buri: Department for Development of Thai Traditio nal and Alternative Medicine Ministry of Public Health; 2011.
33. The Allergy, Asthma, And Immunology Association of Thailand. Clinical practice guidelines for anaphy laxis [online]. 2017 [cited Nov 21, 2017]. Available from: www.allergy.or.th/2016/resources_guideline .php.
34. Ulrich EE. Quantifying adverse drug event occur rence and post-adverse drug event behaviors in terms of Andersen model of health care utilization constructs; predisposing characteristics, enabling resources, and need factors [dissertation]. Michi gan: Michigan University; 2014.
35. Barnes J, Mills SY, Abbot NC, Willoughby M, Ernst E. Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: face-to-face interviews with 515 users of herbal remedies. Br J Clin Pharmacol 1998; 45: 496-500.
36. World Health Organization. Frequently asked questions about the use of cohort event monitoring (CEM) for active pharmacovigilance in TB treat ment [online]. 2015
[cited Sep 11, 2017]. Available from: www.who.int/tb/challenges/frequentlyasked questionsoncohorteventmonitoring_10042015.pdf.
37. Trifirò G, Pariente A, Coloma PM, Kors JA, Polime ni G, Miremont-Salamé G, et al. Data mining on electronic health record data bases for signal detection in pharmacovigilance: which events to monitor?. Pharmacoepidemiol Drug Saf 2009; 18 :1176-84.
