This phenomenon has stimulated considerable public health concern among physicians who are sometimes uncertain about the safety of herbs, especially when used concomitantly with allopathic drugs. There has been an unprecedented explosion in the popularity of herbal preparations during the last few decades, especially in developed countries. Consequently, many Western-trained physicians have little formal training and lack knowledge on the benefits and risks of herbal remedies. In the developed world the dramatic revolution in healthcare was facilitated by the discovery of pharmacologically active chemical entities (supported by evidence-based safety and efficacy testing) and this has shifted the emphasis away from traditional herbal medicine. ![]() More than 80% of the population in the developing world use traditional medicine, which includes herbal remedies, for the management of health. The integration of herbal medicine into the curriculum of medical schools, continuing education programs and the availability of reputable pharmacopoeias for referencing at public health institutions are useful instruments that can be used to close this gap and promote improved physician-patient communication. We recommend educational intervention to narrow the gap between acceptance and knowledge so that physicians would be adequately equipped to communicate with their patients on this modality. This interesting scenario of high acceptance levels and poor knowledge creates a situation that demands urgent intervention. Surprisingly, we demonstrated relatively high acceptance levels and use of herbs among physicians in Trinidad. The use of herbal remedies is relatively high in Trinidad, as throughout the world, and most patients self-medicate with or without the knowledge of their attending physician. Although 52 physicians (27.1%) recommended the use of herbs to their patients only 29 (15.1%) were able to identify at least one known herb-drug interaction. Seventy-eight physicians (40.6%) admitted having used herbs in the past, and 60 of these (76.9%) were satisfied with the outcome. Respondents had relatively high acceptance levels (mean = 5.69 ± 0.29 points or 40% of total possible score) and poor knowledge (mean = 7.77 ± 0.56 points or 15% of total possible score). Of 192 physicians interviewed, most (60.4%) believed that herbal remedies were beneficial to health. Acceptance and knowledge scores were analyzed using the ANOVA and Tukey's tests. ![]() The questionnaire utilized weighed questions to quantify acceptance (maximum score = 14 points) and knowledge (maximum score = 52 points). MethodsĪ cross-sectional survey was done using an interviewer-administered pilot tested de novo questionnaire at six public hospitals in Trinidad between May–July 2004. Most Western-trained physicians are ignorant of the risks and benefits of this healthcare modality and assessment of acceptance and knowledge would identify appropriate intervention strategies to improve physician-patient communication in this area. This raises important public health concerns, especially as it relates to safety issues including adverse effects and herb-drug interactions. The unprecedented global increase in the use of herbal remedies is set to continue apace well into the foreseeable future.
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