Department of Public Health Sciences, Division of Biostatistics, Penn State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
BMC Health Serv Res. 2011 Oct 19;11:279. doi: 10.1186/1472-6963-11-279.
Consumer use of herbal and natural products (H/NP) is increasing, yet physicians are often unprepared to provide guidance due to lack of educational training. This knowledge deficit may place consumers at risk of clinical complications. We wished to evaluate the impact that a natural medicine clinical decision tool has on faculty attitudes, practice experiences, and needs with respect to H/NP.
All physicians and clinical staff (nurse practitioners, physicians assistants) (n = 532) in departments of Pediatrics, Family and Community Medicine, and Internal Medicine at our medical center were invited to complete 2 electronic surveys. The first survey was completed immediately before access to a H/NP clinical-decision tool was obtained; the second survey was completed the following year.
Responses were obtained from 89 of 532 practitioners (16.7%) on the first survey and 87 of 535 (16.3%) clinicians on the second survey. Attitudes towards H/NP varied with gender, age, time in practice, and training. At baseline, before having an evidence-based resource available, nearly half the respondents indicated that they rarely or never ask about H/NP when taking a patient medication history. The majority of these respondents (81%) indicated that they would like to learn more about H/NP, but 72% admitted difficulty finding evidence-based information. After implementing the H/NP tool, 63% of database-user respondents indicated that they now ask patients about H/NP when taking a drug history. Compared to results from the baseline survey, respondents who used the database indicated that the tool significantly increased their ability to find reliable H/NP information (P < 0.0001), boosted their knowledge of H/NP (p < 0.0001), and increased their confidence in providing accurate H/NP answers to patients and colleagues (P < 0.0001).
Our results demonstrate healthcare provider knowledge and confidence with H/NP can be improved without costly and time-consuming formal H/NP curricula. Yet, it will be challenging to make providers aware of such resources.
消费者对草药和天然产品（H/NP）的使用正在增加，但由于缺乏教育培训，医生往往无法提供指导。这种知识的缺乏可能会使消费者面临临床并发症的风险。我们希望评估天然药物临床决策工具对教师态度、实践经验和 H/NP 相关需求的影响。
我们邀请了医疗中心儿科学、家庭医学和内科的所有医生和临床工作人员（护士从业者、医师助理）（n=532）完成了 2 项电子调查。第一项调查是在获得 H/NP 临床决策工具之前立即完成的；第二项调查是在次年完成的。
在第一项调查中，有 89 名（16.7%）医生和 535 名（16.3%）临床医生在第二项调查中做出了回应。对 H/NP 的态度因性别、年龄、实践时间和培训而异。在基线时，在获得基于证据的资源之前，近一半的受访者表示，他们在患者药物史采集过程中很少或从不询问 H/NP。这些受访者中的大多数（81%）表示他们希望更多地了解 H/NP，但 72%的人承认难以找到基于证据的信息。在实施 H/NP 工具后，63%的数据库用户受访者表示，他们现在在采集药物史时会询问患者有关 H/NP 的情况。与基线调查结果相比，使用数据库的受访者表示，该工具显著提高了他们找到可靠 H/NP 信息的能力（P <0.0001），提高了他们对 H/NP 的了解（p <0.0001），并增强了他们为患者和同事提供准确 H/NP 答案的信心（P <0.0001）。
我们的研究结果表明，在不增加昂贵和耗时的天然药物课程的情况下，可以提高医疗保健提供者对 H/NP 的知识和信心。然而，让提供者了解这些资源将是具有挑战性的。
