Prevalence of Polyherbacy in Ambulatory Visits
to Traditional Chinese Medicine Clinics in Taiwan
Patients with a polyherbal
prescription are more likely to receive duplicate medications and thus suffer
from adverse drug reactions. We conducted a population-based retrospective
study to examine the items of Chinese herbal medicine (CHM) per prescription in
the ambulatory care of traditional Chinese medicine (TCM) in Taiwan. We
retrieved complete TCM ambulatory visit datasets for 2010 from the National
Health Insurance database in Taiwan. A total of 59,790 patients who received
313,482 CHM prescriptions were analyzed. Drug prescriptions containing more
than five drugs were classified as polyherbal prescriptions; 41.6% of patients
were given a polyherbal prescription. There were on average 5.2 ± 2.5 CHMs: 2.3
± 1.1 compound herbal formula items, and 3.0 ± 2.5 single Chinese herb items in
a single prescription. Approximately 4.6% of patients were prescribed 10 CHMs
or more. Men had a lower odds ratio (OR) among polyherbal prescriptions (OR =
0.96, 95% confidence interval [CI] 0.92-0.99), and middle-aged patients (35-49
years) had the highest frequency of polyherbal prescription (OR = 1.19, 95% CI
= 1.13-1.26). Patients with neoplasm, skin and subcutaneous tissue disease, or
genitourinary system disease were more likely to have a polyherbal
prescription; OR = 2.20 (1.81-2.67), 1.65 (1.50-1.80), and 1.52 (1.40-1.64),
respectively. Polyherbal prescription is widespread in TCM in Taiwan. Potential
herb interactions and iatrogenic risks associated with polyherbal prescriptions
should be monitored.
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