NATURAL HEALTH PRODUCT USE IN CANADA: ANALYSIS OF THE NATIONAL POPULATION HEALTH SURVEY
Main Article Content
Keywords
Natural health products, herbal, CAM, pharmacoepidemiology, NPHS
Abstract
Background
The use of natural health products (NHPs) in Western countries has increased dramatically over the past two decades. Although prevalence estimates have been published in the U.S. and elsewhere, little is known about the characteristics of persons who use NHPs.
Objectives
To measure the prevalence of NHP use among adults in Canada, identify the most commonly used agents, and determine the socioeconomic, demographic, and health-related correlates of use.
Methods
NHP use by adults was assessed using the 2000-2001 National Population Health Survey (NPHS), a biennial general health survey conducted by Statistics Canada. A total of 11,424 adults completed the survey in 2000-2001. NHPs were defined as botanical and naturally-derived non-botanical products, excluding essential vitamins and minerals. Prevalence of use estimates were calculated nationally, and by age, gender, socioeconomic status, disease states, and health care practices. Multivariate logistic regression modeling was used to simultaneously assess the correlations of these variables with NHP use.
Results
The prevalence of past 2-day NHP use in Canada was 9.3% in 2000-2001. Fifty-seven percent of users also reported taking a conventional medicine in the same period. Glucosamine, echinacea, and garlic were the most frequently used products. Women reported NHP use more frequently than men (11.5% vs. 7.1%). As compared to young adults, NHP use was about 50% higher in middle-aged and older Canadians. There were no associations with either income or education level. Several disease states were associated with a high prevalence of NHP use: respondents with fibromyalgia (23.3%), inflammatory bowel disease (17.4%), and urinary incontinence (16.8%) were most likely to be NHP users. However, in the multivariate analysis, age and the use of vitamins or minerals were most predictive of NHP use, while health status variables were of less importance.
Conclusions
NHP use is an important health phenomenon in Canada. Although respondents in poor health were more likely to use NHPs, a significant proportion of healthy Canadians also reported NHP use. The use of NHPs also cut across different socioeconomic groups. Concurrent use of conventional medications was common and suggests a need for health professionals to monitor for potential interactions.
References
0-1997. Journal of the American Medical Association 1998; 280(18):1569-1575.
2. Millar WJ. Use of alternative health care practitioners by Canadians. Canadian Journal of Public Health 1997; 88(3):154-158.
3. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population. Journal of the American Medical Association 2002; 287(3):337-344.
4. Troppmann L, Johns T, Gray-Donald K. Natural Health Product Use in Canada. Canadian Journal of Public Health 2002;93(6):426-430.
5. Harnack LJ, Rydell SA, Stang J. Prevalence of use of herbal products by adults in the Minneapolis/St. Paul, Minn. Metropolitan Area. Mayo Clinic Proceedings 2001; 76(7):688-694.
6. Radimer KL, Subar AF, Thompson FE Nonvitamin, nonmineral dietary supplements: Issues and findings from NHANES III. Journal of the American Dietetic Association 2000; 100:447-454.
7. Blanc PD, Trupin L, Earnest G, Katz PP, Yelin EH, Eisner MD. Alternative Therapies among adults with a reported diagnosis of asthma or
rhinosinusitis. Chest 2001; 120(5):1461-1467.
8. Rajendran PR, Thompson RE, Reich SG. The use of alternative therapies by patients with Parkinson’s disease. Neurology 2001; 57:790-794.
9. Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE. Complementary/ Alternative medicine use in a comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology 2000; 18(13):2505-2514.
10. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs. Drugs 2001;61(15):2163-2175.
11. Brazier N, Levine MAH. Drug-herb interaction among commonly used conventional medicines: A compendium for health care professionals.
American Journal of Therapeutics 2003; 10:163-169.
12. Hensrud DD, Engle DD, Scheitel SM. Underreporting of the use of dietary supplements and nonprescription medications among patients undergoing a periodic health examination. Mayo Clinic Proceedings 1999; 74(5):443-447.
13. Brazier N, Bedard M, Brazil K, Gaebel K, Levine M, Lohfeld L, MacLeod S. The use of natural health products (NHP) by Ontario seniors. Clinical Pharmacology and Therapeutics 2001;69(2):P14.
14. Catlin G, Will P. The National Population Health Survey: Highlights of initial developments. Health Rep 1992;4:313-319.
15. Tambay JL, Catlin G. Sample design of the National Population Health Survey. Health Rep 1995;7(1):1-11.
16. Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: John Wiley & Sons, Inc.,1989.
17. Furlong WJ, Feeny DH, Torrance GW, Barr RD. The Health Utilities Index (HUI) system for assessing health-related quality of life in clinical studies. Annals of Medicine 2001: 33(5):375-84.
18. Dergal JM, Gold JL, Laxer DA, Lee MSW, Binns MA, Lanctot KL, Freedman M, Rochon PA. Potential interactions between herbal medicines and conventional drug therapies used by older adults attending a memory clinic. Drugs and Aging 2002; 19(11):879-86.
19. Eliason BC, Kruger J, Mark D, Rasmann DN. Dietary supplement users: Demographics, product use, and medical system interaction. Journal of the American Board of Family Practice 1997; 10(4):265-271.
20. Astin JA. Why patients use alternative medicine. Journal of the American Medical Association 1998; 279(19):1548-1553.
21. Nestmann ER, harwood M, Martyres S. An innovative model for regulating supplement products: Natural health products in Canada. Toxicology 2006; 221:50-8.