Lanski Steven L, Greenwald Michael, Perkins Amanda, Simon Harold K
Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia 30322, USA.
Pediatrics. 2003 May;111(5 Pt 1):981-5. doi: 10.1542/peds.111.5.981.
In recent years investigators have reported widespread use of alternative medicine. Some herbal therapies have potentially harmful side effects as well as adverse interactions with medications. Data are lacking on the use in children and caregiver understanding of these products.
To determine the reported use of herbal products among a pediatric emergency department population and to evaluate the caregivers' understanding and source of information concerning these products.
DESIGN/METHODS: A convenience sampling of pediatric emergency department patients and their caregivers occurred during a 3-month period in 2001. The interview consisted of 18 questions regarding the types of non-Food and Drug Administration-regulated herbal products and home remedies used, general product knowledge and sources of information used by the child's caregiver (including discussions with their child's primary physician).
One hundred forty-two (93%) of 153 families approached participated in the study. The mean patient age was 5.3 years (range: 3 weeks-18 years). Forty-five percent of caregivers reported giving their child an herbal product, and 88% of these caregivers had at least 1 year of college education. Of the children receiving these therapies, 53% had been given 1 type and 27% were given 3 or more in the past year. The most common therapies reportedly used were aloe plant/juice (44%), echinacea (33%), and sweet oil (25%). The most dangerous potential herbal and prescription medication combination reported was ephedra and albuterol in an adolescent with asthma. The most unusual products reportedly used included turpentine, pine needles, and cowchips. Of all people interviewed, 77% did not believe or were uncertain if herbal products had any side effects and only 27% could name a potential side effect. Sixty-six percent were unsure or thought that herbal products did not interact with other medications and only 2 people correctly named a drug interaction. Of the people who used these therapies, 80% reported either friends or relatives as their primary source of information. Only 45% of those giving their children herbal products report discussing the use with their child's primary health care provider.
Herbal and home therapies are commonly used in this pediatric population. An unexpectedly wide variety of products were reportedly given to this patient population. Caregivers reported limited knowledge regarding potential adverse medication interactions and side effects. Limited discussions with the child's primary health care provider were reported. It is therefore important for health care providers to have knowledge about herbal medications, to inquire about their use and to educate families about the risk/benefit as well as potential interactions these products may have with over-the-counter and prescription medications.
近年来，研究人员报告了替代医学的广泛使用情况。一些草药疗法可能具有有害的副作用，以及与药物的不良相互作用。关于这些产品在儿童中的使用情况以及护理人员对其的了解，目前缺乏相关数据。
确定儿科急诊科人群中报告的草药产品使用情况，并评估护理人员对这些产品的了解程度及其信息来源。
设计/方法：2001年在3个月的时间内，对儿科急诊科患者及其护理人员进行了便利抽样。访谈包括18个问题，涉及未受美国食品药品监督管理局监管的草药产品和家庭疗法的类型、一般产品知识以及儿童护理人员使用的信息来源（包括与孩子的初级医生的讨论）。
153个受访家庭中有142个（93%）参与了研究。患者的平均年龄为5.3岁（范围：3周 - 18岁）。45%的护理人员报告给孩子使用过草药产品，其中88%的护理人员至少接受过1年的大学教育。在接受这些疗法的儿童中，53%在过去一年中只使用过1种产品，27%使用过3种或更多产品。据报道，最常用的疗法是芦荟植物/果汁（44%）、紫锥菊（33%）和甜油（25%）。报告的最危险的潜在草药与处方药组合是一名患有哮喘的青少年使用麻黄和沙丁胺醇。据报道，最不寻常的产品包括松节油、松针和牛粪饼。在所有受访者中，77%不相信或不确定草药产品是否有任何副作用，只有27%能说出一种潜在的副作用。66%不确定或认为草药产品不会与其他药物相互作用，只有2人正确说出了一种药物相互作用。在使用这些疗法的人中，80%报告称朋友或亲戚是他们的主要信息来源。在给孩子使用草药产品的人中，只有45%报告曾与孩子的初级医疗保健提供者讨论过使用情况。
草药和家庭疗法在这个儿科人群中普遍使用。据报道，给这个患者群体使用的产品种类出人意料地广泛。护理人员报告称，他们对潜在的药物不良相互作用和副作用的了解有限。与孩子的初级医疗保健提供者的讨论也很有限。因此，医疗保健提供者了解草药药物知识、询问其使用情况并向家庭宣传这些产品可能与非处方药和处方药产生的风险/益处以及潜在相互作用非常重要。
