title: Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad.
abstract: BACKGROUND
  The increasing global popularity of herbal remedies requires further investigation to determine the probable factors driving this burgeoning phenomenon. We propose that the users' perception of efficacy is an important factor and assessed the perceived efficacy of herbal remedies by users accessing primary health facilities throughout Trinidad. Additionally, we determined how these users rated herbal remedies compared to conventional allopathic medicines as being less, equally or more efficacious.
  
  
  METHODS
  A descriptive cross-sectional study was undertaken at 16 randomly selected primary healthcare facilities throughout Trinidad during June-August 2005. A de novo, pilot-tested questionnaire was interviewer-administered to confirmed herbal users (previous or current). Stepwise multiple regression analysis was done to determine the influence of predictor variables on perceived efficacy and comparative efficacy with conventional medicines.
  
  
  RESULTS
  265 herbal users entered the study and cited over 100 herbs for the promotion of health/wellness and the management of specific health concerns. Garlic was the most popular herb (in 48.3% of the sample) and was used for the common cold, cough, fever, as 'blood cleansers' and carminatives. It was also used in 20% of hypertension patients. 230 users (86.8%) indicated that herbs were efficacious and perceived that they had equal or greater efficacy than conventional allopathic medicines. Gender, ethnicity, income and years of formal education did not influence patients' perception of herb efficacy; however, age did (p = 0.036). Concomitant use of herbs and allopathic medicines was relatively high at 30%; and most users did not inform their attending physician.
  
  
  CONCLUSIONS
  Most users perceived that herbs were efficacious, and in some instances, more efficacious than conventional medicines. We suggest that this perception may be a major contributing factor influencing the sustained and increasing popularity of herbs. Evidence-based research in the form of randomized controlled clinical trials should direct the proper use of herbs to validate (or otherwise) efficacy and determine safety. In the Caribbean, most indigenous herbs are not well investigated and this points to the urgent need for biomedical investigations to assess the safety profile and efficacy of our popular medicinal herbs.
authors.affiliation: Department of Para-Clinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago. yuriclem@yahoo.com
authors.forename: Yuri N
authors.initials: YN
authors.lastname: Clement
authors.forename: Jamie
authors.initials: J
authors.lastname: Morton-Gittens
authors.forename: Luke
authors.initials: L
authors.lastname: Basdeo
authors.forename: Alexander
authors.initials: A
authors.lastname: Blades
authors.forename: Marie-Joanna
authors.initials: MJ
authors.lastname: Francis
authors.forename: Natalie
authors.initials: N
authors.lastname: Gomes
authors.forename: Meer
authors.initials: M
authors.lastname: Janjua
authors.forename: Adelle
authors.initials: A
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D008517:Phytotherapy / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014300:Trinidad and Tobago