Physicians don't know much more about complementary and alternative medicine than their patients do, according to a new survey.
Most healthcare professionals who answered an online survey of Drug and Therapeutic Bulletin subscribers said their profession was just as poorly informed about herbal medicines (75.5%) as the general public (86.3%).
And almost half of respondents rated their own knowledge about herbal medicines as "quite" or "very" poor (36.2% and 10.4%, respectively).
Even more worrying, journal editor Ike Iheanacho, MBBS, said in a podcast released in conjunction with the survey, was that medical professionals exhibited a lack of interest in even asking whether patients were taking herbal compounds.
More than half of respondents said they never or only occasionally (8.6% and 46.6%, respectively) ask when reviewing patients' medications whether they are taking herbal medicines.
This was surprising, commented Linda Anderson, BPharm, PhD, principal pharmaceutical assessor at the British Medicines and Healthcare products Regulatory Agency.
Her agency's survey of the general population suggested that "most patients were quite willing to tell doctors they were taking herbal medicines and, in fact, expected their doctor to ask," she explained in the podcast.
Anderson's interpretation was that physicians don't ask because they don't know enough to respond.
Indeed, 89% of those surveyed said their knowledge of herbal medicines was "much poorer" than their knowledge of prescribed medicines.
However, 21.3% of respondents said that if they were faced with a patient taking an herbal medicine they were unfamiliar with, they wouldn't seek further information about it.
The primary reason cited for this was being unsure where to find such information (60%), followed by being unsure how to assess or use such information even if they were able to find it (42.9%).
This sets up a worrying conflict with patient expectations, Anderson noted.
"Our survey showed that patients thought doctors would be a good source of information," she said in the journal's podcast.
Notable, too, was that the largest proportion of medical professionals surveyed -- 50% -- said they would turn to general searches of the Internet, such as using Google, for reliable information on herbal medicines.
"I would suggest that that's a terrible source of information where herbal medicine is concerned," Michael McIntyre, chair of the European Herbal Practitioners Association, commented in the podcast.
"Unless you know what site you're on, you could get terrible information, wrong information," added McIntyre, who also serves as a member of the U.K. Department of Health Herbal Medicine Regulatory Working Group.
Patients would likely be horrified to know that physicians were relying on information on the Internet that wasn't qualified, Anderson agreed.
One reason for healthcare professionals' lack of information on herbal medicines may be that they feel it's a step backward, McIntyre said.
Doctors "don't want to get pulled back into the swamp," McIntyre suggested in the podcast. "There's the feeling that we got away from that because we found out what the active constituents are . . . this is science."
In the Drug and Therapeutic Bulletin survey, 75.3% of physicians thought herbal medicines were helpful in some circumstances, but an equally high proportion said that the general public has misplaced faith in these compounds (71.8%).
The survey garnered response from 164 individuals among a random sample of 1,157 journal subscribers -- primarily physicians and pharmacists -- representing a response rate of 14%. Among them, 87.8% practiced in Britain.
Disclosures
No information on conflicts of interest was provided.
Primary Source
Drug and Therapeutics Bulletin
Source Reference: "DTB survey on herbal medicines" Drug Ther Bull 2010.