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Herbal use is common among urban primary care patients and often is not disclosed to doctors

Use of herbal supplements remains popular in the United States. For instance, over one-third of patients visiting a network of primary care clinics in Houston, TX, used some type of herbal remedy in 2002 and 2003. However, herbal use varied widely among racial/ethnic minority groups, according to the study which was supported in part by the Agency for Healthcare Research and Quality (HS11187).

Half of Hispanics and half of Asians used herbs compared with 41 percent of whites and 22 percent of blacks. Also, patients were more likely to use herbs if they had an immigrant family history or other family members used herbs.

One-third of herbal users said they used herbs on a daily basis, and 60 percent said they had used them for longer than 3 years. Also, nearly half (46 percent) of herbal users reported taking herbal medicines and prescription medications at the same time. Yet, 43 percent of patients did not disclose their herbal use to their physicians or pharmacists. More whites (67 percent) disclosed their herbal use to their health care providers than blacks (45 percent), Hispanics, (31 percent), or Asians (31 percent).

This failure to disclose herbal use can cause problems, since certain herbs can interact negatively with prescription medications. Doctors need to know which herbs patients are taking to avoid adverse drug-herb interactions, explains Grace M. Kuo, Pharm.D., of Baylor College of Medicine, in Houston. The researchers surveyed 322 adults visiting six Houston primary care practices for routine, nonacute care about their use of herbs. The reasons given for herbal use included faster resolution of symptoms (47 percent), the desire to try alternative therapies (33 percent), and preference for personal methods of care (20 percent).

More details are in "Factors associated with herbal use among urban multiethnic primary care patients: A cross-sectional survey," by Dr. Kuo, Sarah T. Hawley, Ph.D., L. Todd Weiss, M.S.P.H., M.P.H., and others, in BMC Complementary and Alternative Medicine 4(18), published December 2004, online at

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