title: Prescription pattern of Chinese herbal products for heart failure in Taiwan: A population-based study.
abstract: BACKGROUND
  Certain Chinese herbal products (CHPs) may protect against the progression of heart failure (HF). However, there is a lack of research regarding the use of CHPs in patients with HF. The aims of this study were to analyze CHPs usage patterns in patients with HF and to identify the frequency and combination of CHPs most commonly used for HF.
  
  
  METHODS
  This retrospective, nationwide, population-based cohort study was conducted using a randomly sampled cohort of one million patients selected from the National Health Insurance Research Database (NHIRD) for the years 2000-2010 in Taiwan. CHP use and the top ten most frequently prescribed formulae and single herbs for treating HF were assessed, including total formulae number and average and frequency of prescriptions. Demographic characteristics, including sex and age at diagnosis of HF, were examined, together with existing comorbidities.
  
  
  RESULTS
  The cohort included 19,988 newly diagnosed AD patients, who were given CHP treatment for HF between 2000 and 2010. Among them, female patients (53.3%) and those over 65years old (63.9%) were more likely to use CM. After adjusting for demographic factors, HF patients suffering from coronary artery disease (CAD) were more likely to seek traditional Chinese medicine (TCM) treatment than those with non-TCM users (57.6% vs. 52.6%). Zhi-Gan-Cao-Tang (4.07%) and Danshen (5.13%) were the most frequent formula CHP and single CHP prescribed by TCM practitioners for treating HF, respectively.
  
  
  CONCLUSIONS
  Most people with HF who consumed CHPs used CHPs to supplement Yang-Qi, nourish the Ying-blood, and strengthen the heart spirit as complementary medicines to relieve HF-related symptoms, in addition to using standard anti-HF treatments. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines.
authors.affiliation: Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan; Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ming-Yen
authors.initials: MY
authors.lastname: Tsai
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wen-Long
authors.initials: WL
authors.lastname: Hu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Healthcare Service Research Center (HSRC), Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Che-Chen
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yi-Chiao
authors.initials: YC
authors.lastname: Lee
authors.affiliation: School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Shih-Yu
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan. Electronic address: hungyuchiang@gmail.com.
authors.forename: Yu-Chiang
authors.initials: YC
authors.lastname: Hung
authors.affiliation: Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan. Electronic address: yhchen@mail.cmu.edu.tw.
authors.forename: Yung-Hsiang
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003710:Demography; D018450:Disease Progression; D004365:Drugs, Chinese Herbal / Q000145:classification / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D002316:Cardiotonic Agents; D004365:Drugs, Chinese Herbal
keywords: Chinese herbal products; Couplet medicinal; Heart failure; Pharmaco-epidemiology; Prescription pattern