title: Use and toxicity of complementary and alternative medicines among emergency department patients.
abstract: OBJECTIVE
  To determine the prevalence and type of complementary and alternative medicines (CAM) used by ED patients, to identify patient subgroups more likely to use CAM, the conditions for which they were taken, and the prevalence of side-effects and toxicity associated with CAM use.
  
  
  METHODS
  This was an analytical cross-sectional survey of patients at a large tertiary referral ED. Consenting patients completed a specifically designed study questionnaire, in their preferred language if required. Information was collected on CAM use on the day of presentation and within the previous week and previous year.
  
  
  RESULTS
  Four hundred and four patients were enrolled (participation rate 97.1%). Fifty (12.4%, 95% CI 9.4, 16.1) patients had taken a CAM on the day of presentation, 203 (50.2%, 95% CI 45.3, 55.2) within the previous week and 275 (68.1%, 95% CI 63.2, 72.5) within the previous year. CAM users were significantly younger, better educated and more likely to be female than non-CAM users (P < 0.01). 103 different CAM had been taken for a wide variety of reasons. Side-effects were experienced in 53 of the 1182 CAM courses taken (side-effect rate of 4.5%). One patient presented suffering specifically from CAM toxicity.
  
  
  CONCLUSIONS
  Complementary and alternative medicines are used by a considerable proportion of ED patients. The potential for side-effects, toxicity and interaction with traditional medication indicates the need for consideration of CAM use in patient assessment.
authors.affiliation: Department of Emergency Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia. david.taylor@mh.org.au
authors.forename: David McD
authors.initials: DM
authors.lastname: Taylor
authors.forename: Nicola
authors.initials: N
authors.lastname: Walsham
authors.forename: Simone E
authors.initials: SE
authors.lastname: Taylor
authors.forename: LuFee
authors.initials: L
authors.lastname: Wong
mesh_terms: D017677:Age Distribution; D001007:Anxiety / Q000139:chemically induced; D018680:Cholinergic Antagonists / Q000506:poisoning; D000529:Complementary Therapies / Q000009:adverse effects* / Q000706:statistics & numerical data*; D003288:Contusions / Q000139:chemically induced; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000009:adverse effects / Q000706:statistics & numerical data; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013921:Thrombocytopenia / Q000139:chemically induced; D014739:Victoria / Q000453:epidemiology
chemical_list: D018680:Cholinergic Antagonists