Assessment of Concomitant Use of Herbal and Conventional Medicines among Diabetic Patients in Addis Ababa, Ethiopia

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Addis Ababa University


Introduction: Majority of population in developing countries including Ethiopia are dependent on traditional medicines. Patients who have chronic illness like diabetes mellitus were dissatisfied with conventional drugs are more likely to take simultaneously herbal remedies from traditional medicine (TM), with conventional treatment. However, such use could result in potential herb-drug interaction. Objective: To assess the prevalence of concomitant use of herbal and conventional anti diabetic medicines; and to identify the commonly used herbal medicines among patients with diabetes in public hospitals of Addis Ababa, Ethiopia. Method: A mixed approach of quantitative and qualitative designs was employed. A health facility based cross sectional study design was employed to determine the magnitude of concomitant use of herbal and conventional medicines among patients with diabetes in Addis Ababa. A qualitative study design with an in-depth interview data collection method was also employed to describe prescribers' history taking practice about TM during their encounter with the patients. Patients with diabetes from four public hospitals in Addis Ababa who were attending outpatient diabetic clinics were the study population for the quantitative study. All prescribers working in the diabetic clinic during an interview were considered as both the source and study population for the qualitative study. Data was collected from April 17 to August 30, 2016. Quantitative results from 791 questionnaires were entered in EPI-INFO version 3.5.1 and analyzed by SPSS Version 20 computer statistical software's. Simple descriptive statistics were used to describe variables and content analysis had been conducted manually for qualitative data. Result: From a total of 845 questionnaires, 791 were complete; making the response rate 93.6%. Out of 791 respondents, 409 (51.7%) used TM at least once in their life time and 357 (45.1%) used TM in the last six months prior to data collection. Majority 288 (80.7%) of respondents used herb/herbal products after starting the conventional anti diabetic drugs. Leaves of plants were used by most 187 (64.9%) of the patients and oral administration was the major route as cited by 281 (97.6%) of the respondents.. Moringa, thyme, fenugreek, black seed and garlic were among the frequently mentioned herbs used by diabetic patients. Sizable number of respondents 199 (69.1%) also perceived that herbal medicines they took were effective. vii None of the prescribers in the qualitative study gathered patients' herbal medicine use history in their history taking practice. They only would like to take any herbal medicine related information when they saw sign of liver toxicity and skin disease. Almost all key informant interviewees revealed that they had no adequate knowledge about drug-herb interactions. Conclusion: The study revealed that majority of respondents used herb/herbal products concomitantly with conventional antidiabetic drugs. Moringa, thyme, fenugreek, black seed and garlic were identified as the most commonly used herbs by patients with diabetes. This combined use of herbal medicines and conventional antidiabetic medicines could cause potentially serious herb-drug interactions. More studies with scientific methodology are required on dose, frequency, duration and modes of interaction to better healthcare of patients. Key words: Herb-drug interaction, Diabetes Mellitus, Herbal medicine, Chronic disease



Herb-drug interaction; Diabetes Mellitus; Herbal medicine; Chronic disease