Koren Ronit, Zafrir Danieli Hadas, Doenyas-Barak Keren, Ziv-Baran Tomer, Golik Ahuva
Altern Ther Health Med. 2017 Jan;23(1):56-60.
Context • The use of complementary and alternative medicine (CAM) has been on the rise in the last decade. Subpopulations of patients with chronic diseases are at risk for adverse events and potential drug-herb interactions, among them dialysis patients. Objective • The study aimed to evaluate the prevalence of CAM consumption among dialysis patients and to search for potential interactions. Design • The study was cross-sectional, based on questionnaires. Setting • The study occurred in the hemodialysis unit at Assaf Harofeh Medical Center (Zeriffin, Israel). Participants • Participants were patients of the hemodialysis unit. Outcome Measures • The questionnaires obtained demographic data, information about a patient's medical history and use of prescription medication, and all relevant history of CAM use, including the interest of the medical team in the patient's use of supplements. Results • Eighty-four patients participated in the study. Eight patients (9.5%) had used CAM, 5 of whom were women (62.5%). Of the CAM consumers, 4 (50%) had more than 12 y of education vs 14 (8.4%) in the nonconsumer group (P = .061). Six of the consumers were professionals (75%) in comparison with 30 (39.5%) of the nonconsumers, although that difference was not statistically significant (P = .22). The CAM users' monthly incomes were significantly better than that of the nonconsumers (P = .01). No differences were found regarding smoking, alcohol consumption, or physical activity. The study found potential drug-herb interactions in 4 (50%) of the CAM consumers. Moderate potential interactions were found between Aloe vera and diuretics; Aloe vera and insulin; pyridoxine and calcium-channel blockers and diuretics; and niacin and statins. Those interactions had the potential to result in hypoglycemia, hyperglycemia, hypokalemia, and lower blood pressure. Conclusions • The study found a lower prevalence of CAM consumption in dialysis patients than had been found in other studies of the general population. Still, the unawareness of the harm and potential interactions and the lack of data sharing between the patients and caregivers might have had disastrous consequences. Therefore, caregivers need to inquire of their patients specifically about their use of CAM, especially for populations with chronic diseases, let alone patients undergoing dialysis.
背景 • 在过去十年中,补充和替代医学(CAM)的使用呈上升趋势。患有慢性病的亚人群面临不良事件和潜在药物与草药相互作用的风险,透析患者也在其中。
目的 • 本研究旨在评估透析患者中使用CAM的患病率,并寻找潜在的相互作用。
设计 • 本研究为横断面研究,基于问卷调查。
地点 • 研究在阿萨夫·哈罗费医疗中心(以色列泽里芬)的血液透析科进行。
参与者 • 参与者为血液透析科的患者。
观察指标 • 问卷获取了人口统计学数据、患者病史和处方药使用信息,以及所有相关的CAM使用史,包括医疗团队对患者使用补充剂的关注情况。
结果 • 84名患者参与了研究。8名患者(9.5%)使用过CAM,其中5名是女性(62.5%)。在使用CAM的患者中,4名(50%)接受教育超过12年,而非使用者中这一比例为14名(8.4%)(P = 0.061)。6名使用者为专业人员(75%),而非使用者中有30名(39.5%),尽管这一差异无统计学意义(P = 0.22)。使用CAM者的月收入明显高于非使用者(P = 0.01)。在吸烟、饮酒或体育活动方面未发现差异。研究在4名(50%)使用CAM的患者中发现了潜在的药物与草药相互作用。在芦荟与利尿剂、芦荟与胰岛素、吡哆醇与钙通道阻滞剂和利尿剂、烟酸与他汀类药物之间发现了中度潜在相互作用。这些相互作用可能导致低血糖、高血糖、低钾血症和血压降低。
结论 • 本研究发现透析患者中使用CAM的患病率低于其他针对普通人群的研究。然而,对危害和潜在相互作用的忽视以及患者与护理人员之间缺乏数据共享可能会产生灾难性后果。因此,护理人员需要特别询问患者是否使用CAM,尤其是对于患有慢性病的人群,更不用说正在接受透析的患者了。