title: Evaluation of potential drug- herb interactions among a group of Palestinian patients with chronic diseases.
abstract: BACKGROUND
  The aim of this study was to find the prevalence of potential drug-herb interactions in patients with chronic diseases and identify factors associated with these interactions if present.
  
  
  METHODS
  The study was a questionnaire based cross-sectional study. It was conducted at a number of governmental primary healthcare centers which include outpatient clinics for chronic diseases between July and November 2013. Patients come to these clinics monthly or bimonthly to receive their medications for their chronic diseases free. The patients in this study were seen at these clinics and their medications were reported from the most recent prescription in their files.
  
  
  RESULTS
  A total of 400 patients agreed to be interviewed, 209 (52.3%) were females. The most commonly used medications were metformin, insulin, and enalapril. Among the patients, 237 (59.3%) were using 395 medicinal herbs. The most commonly used herbs were sage, anise and peppermint. In 51 out of the 237 cases (21.5%) at least one potential drug-herb interaction was found. Male patients were more likely to have potential drug-herb interactions. Patients with potential drug herb interactions were older, having a higher mean number of chronic diseases and medications (P-value < 0.05). Only 133 out of 237 (56.1%) users told their prescribers or pharmacists before using medicinal herbs.
  
  
  CONCLUSIONS
  Use of medicinal herbs is a common practice among Palestinian patients attending primary healthcare centers. A substantial proportion failed to disclose to their doctors or pharmacists about herbal products they used, therefore, the physicians and pharmacists are recommended to ask patients about the use of medicinal herbs to avoid any possible negative outcomes. Better counseling and communication between patients and healthcare providers is recommended.
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine. rawa_ramahi@najah.edu.
authors.forename: Rowa'
authors.initials: R
authors.lastname: Al-Ramahi
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine.
authors.forename: Nidal
authors.initials: N
authors.lastname: Jaradat
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine.
authors.forename: Ruba
authors.initials: R
authors.lastname: Shalalfeh
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine.
authors.forename: Sojoud
authors.initials: S
authors.lastname: Nasir
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine.
authors.forename: Yazan
authors.initials: Y
authors.lastname: Manasra
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine.
authors.forename: Ihab
authors.initials: I
authors.lastname: Shalalfeh
authors.affiliation: Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box (7), Nablus, Palestine.
authors.forename: Yasmen
authors.initials: Y
authors.lastname: Esam
mesh_terms: D002908:Chronic Disease / Q000188:drug therapy* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D008297:Male; D008877:Middle East / Q000453:epidemiology; D008517:Phytotherapy / Q000706:statistics & numerical data*; D010946:Plants, Medicinal