Levine Mitchell A H, Xu Shuang, Gaebel Katherine, Brazier Nicole, Bédard Michel, Brazil Kevin, Lohfeld Lynne, MacLeod Stuart M
Centre for Evaluation of Medicines, St. Joseph's Healthcare, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Am J Geriatr Pharmacother. 2009 Dec;7(6):383-92. doi: 10.1016/j.amjopharm.2009.12.003.
The self-reported use of natural health products (NHPs) (herbal products and vitamin and mineral supplements) has increased over the past decade in Canada. Because the elderly population might have comorbidities and concurrently administered medications, there is a need to explore the perceptions and behaviors associated with NHPs in this age group.
The goal of this study was to assess the use of NHPs in a cohort of older Canadian residents and the characteristics, perceptions, and behaviors associated with NHP use.
Survey participants aged > or = 60 years were randomly selected from telephone listings in the area of greater Hamilton, Ontario, Canada. Data were collected using a standardized computer-assisted telephone interview system. Self-reported data covering 7 domains were collected: (1) demographics; (2) self-reported 12-month NHP use; (3) reasons for NHP use; (4) self-reported 12-month prescription medication use; (5) expenditures on NHPs; (6) patient-reported adverse events and drug-NHP interactions; and (7) perceptions of physicians' attitudes regarding NHPs. Descriptive statistics were used to compare the characteristics of NHP users with those of nonusers and to assess the characteristics of NHP users across these 7 domains. Multivariate regression analysis was conducted to determine the demographic variables that might be associated with NHP user status.
Of 2528 persons identified as age > or = 60 years, 1206 (48%) completed the telephone interview. Six hundred sixteen of these respondents (51%) reported the use of > or = 1 NHP during the previous 12 months. On the initial univariate analysis, younger age and higher income were significantly associated with reporting NHP use (mean age, users vs nonusers, 71.1 vs 72.7 years, respectively; 95% CI, 1.02-1.06; P < 0.001; income more than Can $26,000 was 28% and 22% in users and nonusers, respectively; P = 0.028). One hundred seventy of 616 users (28%) used an NHP to treat the same condition for which they were concurrently receiving a prescription medication, and 43 (25%) had not informed their physicians about their NHP use. Patients' characteristics such as sex, education, smoking status, and self-reported health status did not differ significantly between users and nonusers. In individuals who regularly spent money to purchase NHPs (n = 394), the mean cost was $20.38/mo. NHP expenditure was not significantly associated with age, sex, or income.
Based on these findings, a substantial proportion of those Ontarians aged > or = 60 years reported NHP use, and there is a need for greater communication with physicians to avoid potential drug-NHP interactions.
在过去十年中，加拿大自我报告使用天然健康产品（NHPs，即草药产品以及维生素和矿物质补充剂）的情况有所增加。由于老年人群可能患有多种合并症且同时服用多种药物，因此有必要探究该年龄组中与使用NHPs相关的认知和行为。
本研究的目的是评估一组加拿大老年居民中NHPs的使用情况以及与NHPs使用相关的特征、认知和行为。
从加拿大安大略省大哈密尔顿地区的电话簿中随机选取年龄≥60岁的调查参与者。使用标准化的计算机辅助电话访谈系统收集数据。收集涵盖7个领域的自我报告数据：（1）人口统计学；（2）自我报告的12个月NHPs使用情况；（3）使用NHPs的原因；（4）自我报告的12个月处方药使用情况；（5）NHPs支出；（6）患者报告的不良事件和药物与NHPs的相互作用；（7）对医生关于NHPs态度的认知。使用描述性统计来比较NHPs使用者与非使用者的特征，并评估这7个领域中NHPs使用者的特征。进行多变量回归分析以确定可能与NHPs使用者状态相关的人口统计学变量。
在确定为年龄≥60岁的2528人中，1206人（48%）完成了电话访谈。这些受访者中有616人（51%）报告在过去12个月中使用了≥1种NHPs。在最初的单变量分析中，年龄较小和收入较高与报告使用NHPs显著相关（平均年龄，使用者与非使用者分别为71.1岁和72.7岁；95%CI，1.02 - 1.06；P < 0.001；收入超过26,000加元的使用者和非使用者分别为28%和22%；P = 0.028）。616名使用者中有170人（28%）使用NHPs来治疗他们同时正在接受处方药治疗的相同病症，并且43人（25%）未告知医生他们使用NHPs的情况。使用者和非使用者在性别、教育程度、吸烟状况和自我报告的健康状况等患者特征方面没有显著差异。在定期花钱购买NHPs的个体（n = 394）中，平均费用为每月20.38加元。NHPs支出与年龄、性别或收入没有显著关联。
基于这些发现，相当一部分年龄≥60岁的安大略省居民报告使用了NHPs，并且需要加强与医生的沟通以避免潜在的药物与NHPs相互作用。
