The Prevalence of Natural Health Product Use in Patients with Acute Cardiovascular Disease
The Prevalence of Natural Health Product Use in Patients with Acute Cardiovascular Disease
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DOI：
10.1371/journal.pone.0019623
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发表时间：
2011-05-09
期刊：
影响因子：
3.7
通讯作者：
Ezekowitz, Justin A.
中科院分区：
文献类型：
--
作者：
Alherbish, Aws;Charrois, Theresa L.;Ezekowitz, Justin A.
背景：天然保健品（NHP）的使用可能对不良反应、药物相互作用和依从性有影响，但急性心血管疾病患者使用天然保健品的流行程度和确定这一信息的最佳方法尚不清楚。目的：确定确定NHP信息的最佳方法，以及急性心血管疾病人群中NHP的使用情况。方法：对2009年1月在阿尔伯塔大学医院连续住院的急性心血管疾病患者进行结构化访谈。根据加拿大卫生部对非传染性疾病的定义，通过结构化和开放式问题探讨了非传染性疾病的使用情况。审查了医疗记录，并将医生、护士和药剂师使用NHP的文件与金标准结构化访谈进行了比较。结果：共访谈88例患者（平均年龄62岁，标准差[SD 14]； 80%为男性；41%因急性冠状动脉综合征入院）。常见的合并症包括高血压（59%）、糖尿病（26%）和肾脏损害（19%）。NHP的使用很常见（78%的患者），75%的NHP使用者报告每天使用。非致病菌最常使用的类别是维生素和矿物质（73%），其次是草药产品（20%）、传统药物（包括中药）（9%）、顺势疗法制剂（1%）和其他产品（包括氨基酸、必需脂肪酸和益生菌）（35%）。在一个多变量模型中，只有年龄越大与NHP使用增加有关（OR为1.5 /年龄十分位数[95%CI 1.03 - 2.2]）。与访谈相比，NHP文件记录率最高的是药剂师历史（41%）。22%的患者被医生记录在案，19%被护士记录在案。结论：急性心血管疾病患者常使用NHP。然而，尽管NHP具有潜在的重要性，但卫生专业人员通常不将其视为药物概况的一部分。结构化访谈似乎是准确识别患者使用NHP的最佳方法。
Background: Natural health products (NHP) use may have implications with respect to adverse effects, drug interactions and adherence yet the prevalence of NHP use by patients with acute cardiovascular disease and the best method to ascertain this information is unknown.Objective: To identify the best method to ascertain information on NHP, and the prevalence of use in a population with acute cardiovascular disease. Methods: Structured interviews were conducted with a convenience sample of consecutive patients admitted with acute cardiovascular disease to the University of Alberta Hospital during January 2009. NHP use was explored using structured and open-ended questions based on Health Canada's definition of NHP. The medical record was reviewed, and documentation of NHP use by physicians, nurses, and pharmacists, compared against the gold-standard structured interview.Results: 88 patients were interviewed (mean age 62 years, standard deviation [SD 14]; 80% male; 41% admitted for acute coronary syndromes). Common co-morbidities included hypertension (59%), diabetes (26%) and renal impairment (19%). NHP use was common (78% of patients) and 75% of NHP users reported daily use. The category of NHP most commonly used was vitamins and minerals (73%) followed by herbal products (20%), traditional medicines including Chinese medicines (9%), homeopathic preparations (1%) and other products including amino acids, essential fatty acids and probiotics (35%). In a multivariable model, only older age was associated with increased NHP use (OR 1.5 per age decile [95%CI 1.03 to 2.2]). When compared to the interview, the highest rate of NHP documentation was the pharmacist history (41%). NHP were documented in 22% of patients by the physician and 19% by the nurse.Conclusions: NHP use is common in patients admitted with acute cardiovascular disease. However, health professionals do not commonly identify NHP as part of the medication profile despite its potential importance. Structured interview appears to be the best method to accurately identify patient use of NHP.