| Summary: | 碩士 === 中國醫藥學院 === 醫務管理研究所 === 91 === Despite the advances in Western medicine, more than one-third of the people seeking conventional medical treatment each year also are looking into complementary and alternative medicine remedies. Chinese traditional medicine (CTM) is an integral part of prevailing practice in Chinese communities. Most CTM treatments are provided in combination with orthodox medicine, requiring physicians and pharmacists to pay attention to adverse interactions between herbal medicine and Western medicine.
Herbal medications contain many active components, yet most patients believe these products are mild and safe, and they do not tell their physicians about taking these products. In addition, physicians seldom ask their patients about herbal medicines they may be taking, making the study of herb-drug interaction more difficult. This study investigates patient behavior toward taking medicine, in order to understand the characteristics of patients who follow both Western and herbal medicine practices.
A structured questionnaire was used to determine the relationships among personal characteristics, health practices, knowledge of practices, and behaviors related to taking medicine. Interviews were conducted with 2,176 general medicine outpatients from Western and Chinese traditional clinics at a medical school. A total of 1,994 (91.6%) of 2,176 participants completed the questionnaire.
Based on behavior related to taking medicine, we divided the population into three groups: Western medicine only, herbal medicine only, and both Western and herbal medicines. Among the subjects in the study, 1,450 (72.7%) reported taking both medicines, while 423 (21.2%) followed Western medical practices only and 121 (6.1%) took only herbal medicines. Polytomous Logistic Regression analysis was conducted to examine the differences among these three groups and determine the predictors for following both types of medical practices.
Our analysis showed that 85.7% of the population took their medicine according to the doctor’s prescriptions and 98.8% took medicine with water. The population following both Western and herbal medicine practices was more likely to be younger, use more health insurance resources, take some medicine to maintain health, and consider bodily constitution and drug adverse reactions when making decisions about visiting orthodox medicine or CTM practitioners.
Since drug information can be obtained from many sources, the patients who followed both type of medical practices paid more attention to health knowledge, asked advice from family and friends, and sought advice from a health care professional when they had a problem with a medication.
Results indicated that for every year increase in age, the likelihood of using Western medicine increased by 1.02 compared to those who accepted both medical practices. In addition, the more a patient knew about a medicine''s effects, the more likely that individual was to follow Western medicine practices. Patients with cardiovascular disease or diabetes tended to follow western medicine only.
The patients who took herbal medicines only paid close attention to the adverse reactions of drugs, made thoughtful decisions about visiting Western or CTM clinics, and were more likely to choose herbal medicines only as their knowledge of drug adverse reactions increased.
Approximately 70% population takes both Western and herbal medicines, leading us to recommend that physicians and pharmacists ask patients if they combined Western medicines with herbal remedies when an adverse drug reaction occurs. Probable cases should be reported to the Adverse Drug Reaction Center to allow systematic study of this situation. The news media can then inform the population about the adverse reactions or adverse herb-drug interactions that have been confirmed, so people can avoid dangerous products or combinations.
Key words: taking medicine behavior, combination of herbal-drug medicine, herbal-drug interaction.
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