title: The prevalence of herbal medicine home use and concomitant use with pharmaceutical medicines in Jamaica.
abstract: BACKGROUND
  The work described in this paper aimed to study the prevalence of herbal medicine use in treating illness and concomitant use with pharmaceutical medicines in Jamaica.
  
  
  METHODS
  A survey using a structured questionnaire was administered by a trained interviewer to randomly selected adults in systematically selected households within randomly selected urban and rural clusters. Categorical data analysis was performed using Stata version 10 software.
  
  
  RESULTS
  91.4%(372/407) of selected people agreed to participate. 72.6%(270/372) self-medicated with herbs within the previous year. Commonly treated were illnesses of the respiratory system (RS, 77.8%(210/270)), gastro-intestinal tract (GIT, 53.3%(144/270)) and health maintenance using tonics (29.6%(80/270)). 26.7%(72/270) of respondents used pharmaceuticals concomitantly with medicinal plants. Commonly treated were illnesses of the RS (20.4%(55/270)), GIT (13.7%(37/270)) and hypertension (10.0%(27/270)). 19.4% (14/72) of physicians knew of such practices. There was significant association of herb use with/without drugs with age (p<0.001), employment status (p<0.001), religion (p=0.004), gender (p=0.02) and educational level (p=0.031). Thus prevalence of herb use alone was greatest amongst people aged 35-44 and 45-54 years; those employed; Rastafarians; those without health insurance; males and people who had completed secondary education. Whilst prevalence of concomitant herb-drug use was greater amongst people aged 65 years and older; those retired; those of religions other than Rastafarians and Christians, females and people who had attained primary education and below.
  
  
  CONCLUSIONS
  Self-medication with herbs in Jamaica is highly prevalent and highest for self-limiting conditions of the RS, GIT and health maintenance with tonics. Concomitant herb and drug use is highest for self-limiting conditions of the RS, GIT and hypertension, and the use of combined therapy highlights the need for investigations on potential drug-herb interactions. Physicians have limited awareness and knowledge of such concomitant usage, further highlighting the need for increased dialogue with patients, knowledge of medicinal plants and their uses and a heightened pharmacovigilance to avoid adversities that may arise from potential drug-herb interactions.
authors.affiliation: Natural Products Institute, University of the West Indies, Mona, Kingston 7, Jamaica.
authors.forename: David
authors.initials: D
authors.lastname: Picking
authors.forename: Novie
authors.initials: N
authors.lastname: Younger
authors.forename: Sylvia
authors.initials: S
authors.lastname: Mitchell
authors.forename: Rupika
authors.initials: R
authors.lastname: Delgoda
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001364:Awareness; D003142:Communication; D003466:Cultural Characteristics; D064420:Drug-Related Side Effects and Adverse Reactions; D004522:Educational Status; D004651:Employment; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D041743:Herb-Drug Interactions; D006801:Humans; D007563:Jamaica; D008297:Male; D008519:Medicine, Traditional / Q000706:statistics & numerical data*; D008875:Middle Aged; D004364:Pharmaceutical Preparations; D010817:Physician-Patient Relations; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use*; D010946:Plants, Medicinal; D012068:Religion and Medicine; D012651:Self Medication; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations; D028321:Plant Preparations