Preoperative Use of Herbal Medicines and Vitamin Supplements

Abstract

There has been a definite increase in the popularity and use of complementary and alternative medicines, including herbal medicines, in the last ten years. The aim of this study was to determine the prevalence and patterns of use of herbal medicines and vitamin supplements by patients in the preoperative period. A questionnaire was offered to all patients attending the pre-admission clinics at St. Vincent's Hospital and Box Hill Hospital, Melbourne, over an eight-month period in 2002. In all, 1102 questionnaires were completed (91.8% response rate). The prevalence of herbal medicine use was 14.3%, with an average user age of 54.0 years and 61.4% female predominance. The five most popular herbs were Garlic, Evening Primrose, Gingko, St. John's Wort and Echinacea. The commonest reasons for herbal medicine use were acute and chronic medical conditions. 63.2% of patients had self-prescribed. 27.8% of herbal remedy users had informed the hospital doctors and 41.8% had notified their general practitioner. The prevalence of vitamin supplement use was 20.4%, with an average user age of 54.8 years and 66.2% female predominance. The five most popular vitamins were multivitamins, followed by vitamin B, C, E and D. The commonest reasons for vitamin use were maintenance of general well-being and health. The use of herbal medicines and vitamin supplements preoperatively by patients is common. Clinicians should endeavour to familiarize themselves with the more popular and significant herbal medications and, as part of the routine preoperative assessment, ask all their patients about their consumption of herbal remedies.

Use of Complementary Medicines by Cardiac Surgery Patients; Undisclosed and Undetected

“…As a result, perioperative CM use is not identified by most surgeons, anaesthetists and pharmacists and therefore products with the potential to induce adverse outcomes or drug interactions are unmanaged placing patients at risk. Complementary medicine usage detected in this study population was greater than previously reported in another Australian study of surgical patients and disclosure was worse with 56% of patients not telling any hospital staff about their use [20]. In comparison to a survey of people with cardiovascular disease in the United States, our study population had greater use of fish oil supplements (25% compared to 12%) and substantially less use of the herbal medicines echinacea (3% vs 34%), garlic (1% vs 23%), ginseng (0% vs 22%) and ginkgo biloba (3% vs 22%) suggesting a cultural difference in usage patterns [21].…”

“…Consistent with findings from studies of general surgical patients, there is little discussion about CMs between hospital medical staff and cardiac surgery patients [17,18,20]. This study extends the literature on patient disclosure and suggests that patients do not tell hospital staff about their use of CMs primarily because they are not asked or do not think it is important and not because they fear a negative response.…”

“…Despite these measures, no therapeutic substance is entirely risk free. In general, people do not discuss their use of complemenHeart, Lung and Circulation Use of Complementary Medicines by Cardiac Surgery Patients; Undisclosed and Undetected 2011;20:305-311 used vitamin supplements in the six weeks before surgery and 14% had used herbal medicines [20] Of these patients, only 28% had disclosed their use to hospital doctors. Use amongst cardiac surgery patients in Australia has not yet been explored.…”

Complementary and Alternative Drugs Use among Preoperative Patients: A Cross-Sectional Study in Italy

“…Compared to non-European countries, one study from China [19] reported higher prevalence, while five studies from the USA [10, 11, 13, 16, 20] and two from Canada [15, 21] reported lower prevalence. In a study carried out in USA [12], 12.9% of middle-aged and older cardiac patients confirmed vitamin use, 11.6% herbs and folk remedies use, and 3.6% use of homeopathy.…”

“…The lowest prevalence was reported in a survey conducted in a UK hospital setting [14] on 2723 patients: 4.8% of them took one or more herbal medications. Other surveys were conducted in USA [9–13, 16, 20], in Europe [17, 18], and Canada [15, 21]. To our knowledge, no studies on adult patients in preoperative period have been conducted in Italy.…”