Epidemic of Inappropriate Health Products and Associated Adverse Events among Chronic Disease Patients in Border Area, Wieng Kan District, Chiang Rai Province

Abstract

Objective: To survey distribution of inappropriate health products and associated adverse events (AE) among patients with chronic diseases living along the border area in Wieng Kan District, Chiang Rai Province. Methods: The study was a cross-sectional descriptive study. The subjects were 292 patients with chronic diseases who were fifteen years old or over selected by simple random sampling from the registration lists of patients with chronic diseases in Wieng Kan Hospital. The researchers visited the subjects’ homes and individually interviewed them using a questionnaire. Sixteen research assistants, who were community health volunteers, were interpreters during the interview with ethnic groups. Data collected were demographic data, and ethnicity, health products including medication and dietary supplements being used at present or previously, type of products, label, and AE. Results: Most subjects were females (174 or 59.9%) with mean age of 62.65±12.18 years old. Two hundred and eleven subjects had hypertension (72.3%). Ethnics of the subjects were Lanna (100 or 31.4%), followed by Hmong (74 or 25.3%). Forty subjects currently or previously used modern medicines that were dangerous drugs and specially controlled drugs distributed in the community (40/292, 13.7%; 95%CI 10.0%-18.2%). The use of drugs was most prevalent in Hmong Hill Tribe (37 from 40 patients or 92.5%). The study found drug products with labels in Chinese and Vietnamese. The drugs most used were dexamethasone acetate 0.75 mg together with piroxicam 10 mg having trade names and labels in Chinese (17/40, 42.5%). The study identified AEs in 5 cases (5/40 or12.5%. 95%CI 4.2%-26.8%) which all experienced edema. Use of inappropriate traditional medicine was identified in nine patients (9/292, 2.3% 95%CI 1.4%-5.8%).Ethnicity used this products most was Hmong Hill Tribe (4/9, 44.4%). The researcher also found herbal products with the label in Burmese. The most commonly used traditional product was Derris Scanden in combination with ginseng drink (4/9, 44.4%). One patient developed AE (1/9, 11.1% 95%CI 0.3%-48.2%) i.e., Cushing‘s syndrome, edema, hyperglycemia, and renal failure after using a Thai traditional powder. Eleven subjects used dietary supplements (11/292, 3.8% 95%CI 1.9-6.6). One patient (1/11, 9.1% 95%CI 0.2%-41.3%) developed AE with dizziness and vomiting. Conclusion: The study identified the use inappropriate modern medicines including dangerous drugs, specially controlled drugs, traditional medicines, and dietary supplements in Weing Kan District. A number of products were found with foreign language labels including Chinese, Vietnamese, and Burmese. Moreover, severe AEs were found. Ethnicity most used the products was Hmong Hill. Therefore, various measures, surveillance network, and solutions to these problems should be set up.