Health Care Unit Alameda, Ministry of Health, Lisbon, Portugal.
CBIOS - Research Center for Biosciences & Health Technologies, Lisbon, Portugal.
Phytomedicine. 2018 Aug 1;47:1-11. doi: 10.1016/j.phymed.2018.04.040. Epub 2018 Apr 17.
Previous works showed patients preference for herbal substances (HS) although they also highlighted a discrepancy with physicians' adherence to HS and its recommendation.
HYPOTHESIS/PURPOSE: This study aimed to assess physician's perception and attitudes concerning the use of HS for their patients in a Family Medicine approach.
Observational cross-sectional exploratory study.
A questionnaire survey was applied to National Health System physicians; 113 questionnaires were distributed in the Greater Lisbon region.
80 valid questionnaires were received. The age of participants ranges from 29 to 64 with mean age of M ± SD:51.9 ± 10.0 years, mostly women (71.4%). Of these, 61.5% were unaware of traditional herbal medicinal products' (THMP) legal recognition and 67.3% of the difference between THMP and well-established use medicines. Absence of accordance between use and knowledge of herbal medicines (HM)/herbal products (HP) (p = 0.025) can be related to lack of Phytotherapy knowledge perception based on the nonexistence of specific training reported by 94.0% of physicians. Through factor analysis, three dimensions were obtained: Factor1, Use''; Factor2, Autonomy''; Factor3 Effort''. The overall Cronbach's α was 0.77, and 0.82 for Factor1. The evidence of use/prescription, has a correlation with Use'' (p < 0.0001), willingness to prescribe (p < 0.0001) and self-medication (p < 0.0001). There is a correlation (r = 0.605, p < 0.0001) between HS recommendation and self-medication. There were differences in use, perception and attitudes among Personalized-Health-Care Units and Family-Health Units physicians in relation to Factor1: p = 0.007 and Factor2: p = 0.021, age (p = 0.001), years of Medical career (p = 0.002), HM use (p = 0.014) and information about alternatives (p = 0.03). Physicians who answered correctly to the question on silymarin had higher scores in factor1 than those who did not: 1.76 vs. 1.25 (p = 0.019).
Low adherence to HS and little use of HM/HP were confirmed, highlighting the need for specific knowledge in Phytotherapy and its regulatory framework. This knowledge will enable the evaluation of herb-drug interactions and HM/HP adverse effects by the physicians thus justifying the integration of programmatic contents about HS in Medical Education.
先前的研究表明，患者偏爱草药（HS），尽管这些研究也强调了医生对 HS 的使用及其推荐存在差异。
假设/目的：本研究旨在评估家庭医学方法中医生对患者使用 HS 的看法和态度。
观察性横断面探索性研究。
对国家卫生系统的医生进行问卷调查；在大里斯本地区发放了 113 份问卷。
共收到 80 份有效问卷。参与者的年龄在 29 至 64 岁之间，平均年龄 M ± SD：51.9 ± 10.0 岁，大多数为女性（71.4%）。其中，61.5%的人不知道传统草药药物（THMP）的法律认可，67.3%的人不知道 THMP 和已确立的药物之间的区别。医生对草药（HM）/草药产品（HP）的使用和知识之间的不一致（p=0.025）可能与缺乏基于 94.0%医生报告的特定培训的植物疗法知识感知有关。通过因子分析，得到了三个维度：因子 1，“使用”；因子 2，“自主”；因子 3，“努力”。整体 Cronbach's α 为 0.77，因子 1 为 0.82。证据表明，使用/处方（p<0.0001）、愿意开处方（p<0.0001）和自我用药（p<0.0001）与“使用”呈正相关。HS 推荐与自我用药之间存在相关性（r=0.605，p<0.0001）。个人保健单位和家庭保健单位的医生在因子 1（p=0.007）和因子 2（p=0.021）、年龄（p=0.001）、医学职业年限（p=0.002）、HM 使用（p=0.014）和替代信息（p=0.03）方面存在使用、感知和态度方面的差异。正确回答关于水飞蓟素问题的医生在因子 1 中的得分高于未正确回答的医生：1.76 对 1.25（p=0.019）。
确认对 HS 的低依从性和对 HM/HP 的使用较少，强调需要在植物疗法及其监管框架方面有特定的知识。这种知识将使医生能够评估草药-药物相互作用和 HM/HP 的不良反应，从而证明在医学教育中整合关于 HS 的计划内容是合理的。
