The prevalence and predictors of herbal medicine use in surgical patients

BACKGROUND: Despite the rapid rise in herbal medicine consumption, explicitly eliciting and documenting herbal medicine usage among surgical patients is poor. STUDY DESIGN: A survey by means of a self-administered questionnaire was conducted among patients undergoing elective surgery inquiring into the self-health perceptions, herbal medicine use, and communication of such usage to surgical health-care staff. RESULTS: Sixty-five percent (n = 2,186) of all the patients undergoing elective surgery completed the survey during a 10-week period. Fifty-seven percent of respondents admitted to using herbal medicine at some point in their life, 38% in the past 2 years (eg, echinacea [48%], aloe vera [30%], ginseng [28%], garlic [27%], and ginkgo biloba [22%] were the most common). One in six respondents continued the use of herbal medicine during the month of surgery. Herbal medicine usage was significantly higher among patients undergoing a gynecologic procedure (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.29 to 2.18) and patients with a self-perception of good health (OR 1.32; 95% CI 1.04 to 1.69); it was lower among patients with a history of pulmonary symptoms (OR 0.77; 95% CI 0.62 to 0.94), African Americans (OR 0.69; 95% CI 0.51 to 0.95), in patients having a primary care physician (OR 0.71; 95% CI 0.52 to 0.98), in patients with a history of diabetes mellitus (OR 0.46; 95% CI 0.32 to 0.68), and in patients undergoing vascular surgery (OR 0.19; 95% CI 0.07 to 0.48). CONCLUSIONS: Herbal medicine use is common among surgical patients and is consistent with the substantial increase in the use of alternative medical therapies. Awareness of this rising herbal medicine usage and documentation of the use of herbal medicines by surgical health-care staff is important to prevent, recognize, and treat potential problems that may arise from herbal medications taken alone or in conjunction with conventional medications during the perioperative period. (C) 2004 by the American College of Surgeons.