Prevalence and potential interactions from concurrent use of prescription drugs, herbal medicinal products and dietary supplements among older adults: a cross sectional survey
Background - Polypharmacy is common among older adults, with increasing numbers also using prescription drugs with herbal medicinal products (HMPs) and dietary supplements. There is no reliable evidence from the UK on concurrent use of HMPs and dietary upplements with prescription drugs in older adults. Aim - To establish prevalence of concurrent prescription drugs, HMPs and dietary supplements among UK community dwelling older adults and identify potential interactions. Design and Setting - Cross sectional survey of older adults registered at two general practices in South East England. Methods - A questionnaire asking about prescription medications, HMPs and sociodemographic information posted to four hundred older adults ≥65 years, identified as taking one or more prescription drug. Results - Respondents = 155, response rate = 39%, prevalence of concurrent HMP and dietary supplements with prescriptions = 33%. Females more likely than males to be concurrent users (43.4% versus 22.5%; p = 0.009). Number of HMPs and dietary supplements ranged from 1 to 8, (mean = 3, median = 1; SD = 1.65). The majority of concurrent users (79.6%) used dietary supplements with prescription drugs. Most commonly used dietary supplements were cod liver oil, glucosamine, multivitamins and Vitamin D. Others (31.6%) used only HMPs with prescription drugs. HMPs were evening primrose oil, valerian, Nytol herbal© 56 (a combination of hops, gentian and passion flower). Sixteen participants (32.6%) were at risk of potential adverse drug interactions. Conclusion - General Practitioners should routinely ask questions regarding herbal and supplement use, to identify and manage older adults at potential risk of adverse-drug interactions. How this fits in • Older adults use herbal medicines and dietary supplements with prescription 66 drugs to manage chronic conditions and to maintain health. • The use of HMPs and dietary supplements with prescription drugs among older adults is under researched. • Concurrent use of HMPs and dietary supplements with warfarin, statins and anti-inflammatory drugs is common among UK older adults. • One in three concurrent user is at risk of a potential herb-drug or supplement drug interaction.
Published inBritish Journal of General Practice
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