Consumption of medicinal plants and herbal medicines by children and adolescents with chronic conditions: a survey in a tertiary-care outpatient clinic
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2023.195406Keywords:
Medicinal plants , Herbal medicine , Phytotherapy, Pediatrics, Chronic diseaseAbstract
Objectives. Medicinal plants and herbal medicines are widely used worldwide. However, patients with chronic health conditions or their caregivers do not often disclose these practices to their healthcare providers, leading to potentially severe interactions with current treatments, especially in children. We aimed to describe the prevalence of the use of medicinal plants and herbal medicines by children and adolescents with chronic health conditions and whether their physicians were informed about it. Methods. We conducted a cross-sectional electronic survey on parents and caregivers of children and adolescents with chronic health conditions seen at a university, tertiary-care pediatric outpatient clinic. The common names of the plants cited by respondents were reviewed and Latin names of the species were provided whenever possible. Results. From 20,213 text messages sent in May and June 2021, 521 valid responses were obtained. The prevalence of the use of medicinal plants and herbal medicines was 34.6%, most without a medical prescription (self-medication), and few physicians (4.0%) were aware of it. The five most used species were: Mentha spicata L. (mint), Foeniculum vulgare Mill. (fennel), “cidreira” (a common name possibly corresponding to Cymbopogon citratus (DC.) Stapf, Melissa officinalis L. or Lippia alba (Mill.) N.E. Br. ex Britton & Wilson, P.), Matricaria chamomilla L. (German chamomile), and Plectranthus barbatus Andrews (boldo). Conclusions. The prevalence of the use of medicinal plants and herbal medicines by children and adolescents with chronic health conditions in a tertiary-care outpatient clinic was 34.6%, and only a few physicians were aware of it.
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References
WHO. WHO Traditional Medicine Strategy: 2014-2023. Genebra: World Health Organization; 2013. 78 p.
Izzo AA, Ernst E. Interactions Between Herbal Medicines and Prescribed Drugs. Drugs [Internet]. 2009 Sep;69(13):1777–98. Available from: http://link.springer.com/10.2165/11317010-000000000-00000
Marliére LDP, Ribeiro AQ, Brandão M das GL, Klein CH, Acurcio F de A. Utilização de fitoterápicos por idosos: resultados de um inquérito domiciliar em Belo Horizonte (MG), Brasil. Rev Bras Farmacogn [Internet]. 2008 Dec;18:754–60. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-695X2008000500021&lng=pt&nrm=iso&tlng=pt
Motta AO, Lima DCS, Vale CR. Survey on the use of medicinal plants in a elementary school at Goiania - GO [Portuguese]. Rev da Univ Val do Rio Verde [Internet]. 2016;14(1):629–46. Available from: http://www.periodicos.unincor.br/index.php/revistaunincor/article/view/2613
Eysenbach G. Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res [Internet]. 2004 Sep 29;6(3):e34. Available from: http://www.jmir.org/2004/3/e34/
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf [Internet]. 2009;42(2):377–81. Available from: http://dx.doi.org/10.1016/j.jbi.2008.08.010
Dergal JM, Gold JL, Laxer DA, Lee MSW, Binns MA, Lanct??t KL, et al. Potential Interactions between Herbal Medicines and Conventional Drug Therapies Used by Older Adults Attending a Memory Clinic. Drugs Aging [Internet]. 2002;19(11):879–86. Available from: http://link.springer.com/10.2165/00002512-200219110-00005
Phatak UP, Alper A, Pashankar DS. Complementary and Alternative Medicine Use in Children With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr [Internet]. 2019 Feb;68(2):157–60. Available from: https://journals.lww.com/00005176-201902000-00002
Bishop FL, Prescott P, Chan YK, Saville J, von Elm E, Lewith GT. Prevalence of Complementary Medicine Use in Pediatric Cancer: A Systematic Review. Pediatrics [Internet]. 2010 Apr 1;125(4):768–76. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1775
Mosavat SH, Heydari M, Hashempur MH, Dehghani SM. Use of complementary and alternative medicine among paediatric patients with hepatogastrointestinal diseases. East Mediterr Heal J [Internet]. 2018 Oct 1;24(10):1018–25. Available from: http://applications.emro.who.int/emhj/v24/10/EMHJ_2018_24_10_1018_1025.pdf
Nakano T, Shimojo N, Okamoto Y, Ebisawa M, Kurihara K, Hoshioka A, et al. The Use of Complementary and Alternative Medicine by Pediatric Food-Allergic Patients in Japan. Int Arch Allergy Immunol [Internet]. 2012;159(4):410–5. Available from: https://www.karger.com/Article/FullText/338936
Erlichman J, Salam A, Haber BA. Use of Complementary and Alternative Medicine in Pediatric Chronic Viral Hepatitis. J Pediatr Gastroenterol Nutr [Internet]. 2010 Apr;50(4):417–21. Available from: https://journals.lww.com/00005176-201004000-00014
Hughes R, Ward D, Tobin AM, Keegan K, Kirby B. The Use of Alternative Medicine in Pediatric Patients with Atopic Dermatitis. Pediatr Dermatol [Internet]. 2007 Mar;24(2):118–20. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1525-1470.2007.00355.x
Du Y, Wolf I-K, Zhuang W, Bodemann S, Knöss W, Knopf H. Use of herbal medicinal products among children and adolescents in Germany. BMC Complement Altern Med [Internet]. 2014 Dec 2;14(1):218. Available from: https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-14-218
Frawley JE, Anheyer D, Davidson S, Jackson D. Prevalence and characteristics of complementary and alternative medicine use by Australian children. J Paediatr Child Health [Internet]. 2017 Aug;53(8):782–7. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jpc.13555
Christopher G, Ozturk C. The prevalence and determinants of complementary medicine use for nigerian children in the Turkish Republic of Northern Cyprus. Niger J Clin Pract [Internet]. 2020;23(8):1053. Available from: http://www.njcponline.com/text.asp?2020/23/8/1053/291844
Hümer M, Scheller G, Kapellen T, Gebauer C, Schmidt H, Kiess W. Phytotherapie in der Kinderheilkunde. DMW - Dtsch Medizinische Wochenschrift [Internet]. 2010 May 5;135(19):959–64. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0030-1253683
Stampini V, Bortoluzzi S, Allara E, Amadori R, Surico D, Prodam F, et al. The use of Complementary and Alternative Medicine (CAM) among Italian children: A cross-sectional survey. Complement Ther Med [Internet]. 2019 Dec;47:102184. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0965229919306004
Adams D, Dagenais S, Clifford T, Baydala L, King WJ, Hervas-Malo M, et al. Complementary and Alternative Medicine Use by Pediatric Specialty Outpatients. Pediatrics [Internet]. 2013 Feb 1;131(2):225–32. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2012-1220
Italia S, Wolfenstetter SB, Teuner CM. Patterns of Complementary and Alternative Medicine (CAM) use in children: a systematic review. Eur J Pediatr [Internet]. 2014 Nov 30;173(11):1413–28. Available from: http://link.springer.com/10.1007/s00431-014-2300-z
Oren-Amit A, Berkovitch M, Bahat H, Goldman M, Kozer E, Ziv-Baran T, et al. Complementary and alternative medicine among hospitalized pediatric patients. Complement Ther Med [Internet]. 2017 Apr;31:49–52. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0965229916301352
Everett LL, Birmingham PK, Williams GD, Randall Brenn B, Shapiro JH. Herbal and homeopathic medication use in pediatric surgical patients. Pediatr Anesth [Internet]. 2005 Jun;15(6):455–60. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2005.01487.x
Crowe S, Lyons B. Herbal medicine use by children presenting for ambulatory anesthesia and surgery. Pediatr Anesth [Internet]. 2004 Nov;14(11):916–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2004.01353.x
Sharma AK, Kapoor VK, Kaur G. Herb–drug interactions: a mechanistic approach. Drug Chem Toxicol [Internet]. 2020 Mar 12;0(0):1–10. Available from: https://doi.org/10.1080/01480545.2020.1738454
Miller LG. Herbal Medicinals: Selected Clinical Considerations Focusing on Known or Potential Drug-Herb Interactions. Arch Intern Med [Internet]. 1998 Nov 9;158(20):2200. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinte.158.20.2200
Bhatt KM, Malhotra SD, Patel KP, Patel VJ. Drug utilization in pediatric neurology outpatient department: A prospective study at a tertiary care teaching hospital. J Basic Clin Pharm [Internet]. 2014;5(3):68. Available from: http://www.jbclinpharm.org/text.asp?2014/5/3/68/139729
Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol. 2005;29(7):755–8.
Yamada-Takeda M, Patel A, Fenton G. Energy Drink-Induced Breakthrough Seizure in a Patient on Valproic Acid—Considering Herbal Safety in Epilepsy. J Pharm Pract. 2019;32(5):485–7.
Haidar C, Jeha S. Drug interactions in childhood cancer. Lancet Oncol [Internet]. 2011;12(1):92–9. Available from: http://dx.doi.org/10.1016/S1470-2045(10)70105-4
Micromedex [Internet]. Fennel [Internet]. AltMedDex. 2017 [cited 2017 Apr 30]. Available from: http://psbe.ufrn.br/
Mahendran G, Verma SK, Rahman L-U. The traditional uses, phytochemistry and pharmacology of spearmint (Mentha spicata L.): A review. J Ethnopharmacol [Internet]. 2021 Oct;278:114266. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0378874121004931
Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press; 1996.
Santini F, Vitti P, Ceccarini G, Mammoli C, Rosellini V, Pelosini C, et al. In vitro assay of thyroid disruptors affecting TSH-stimulated adenylate cyclase activity. J Endocrinol Invest. 2003;26(10):950–5.
Brasil. Formulário de Fitoterápicos da Farmacopeia Brasileira. 2a. Brasília: Agência Nacional de Vigilância Sanitária (ANVISA); 2021. 223 p.
Kumar R, Arora R, Sarangi SC, Ganeshan N S, Agarwal A, Kaleekal T, et al. Pharmacodynamic and pharmacokinetic interactions of hydroalcoholic leaf extract of Centella asiatica with valproate and phenytoin in experimental models of epilepsy in rats. J Ethnopharmacol [Internet]. 2021;270(June 2020):113784. Available from: https://doi.org/10.1016/j.jep.2021.113784
Ogal M, Johnston SL, Klein P, Schoop R. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res [Internet]. 2021;26(1):1–9. Available from: https://doi.org/10.1186/s40001-021-00499-6
Carmona F, Pereira AMSAMS. Herbal medicines: old and new concepts, truths and misunderstandings. Brazilian J Pharmacogn [Internet]. 2013 Apr [cited 2014 Jun 6];23(2):379–85. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-695X2013000200026&lng=en&nrm=iso&tlng=en
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Copyright (c) 2023 Raquel Fernanda Beraldo Inacio, Ana Maria Soares Pereira, Fabio Carmona
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