Concurrent use of prescription drugs and herbal medicinal products in older adults: a systematic review protocol
Agbabiaka, T; Wider, B; Watson, LK; et al.Goodman, C
Date: 21 April 2016
Journal
Systematic Reviews
Publisher
BioMed Central
Publisher DOI
Abstract
Background: There has been a global increase in the use of herbal medicinal products (HMPs). About a quarter of
UK adults use HMPs, bought over the counter by self-prescription and often not disclosed to healthcare professionals.
Potential herb-drug interaction is a clinical concern, with older people at greater risk because of ...
Background: There has been a global increase in the use of herbal medicinal products (HMPs). About a quarter of
UK adults use HMPs, bought over the counter by self-prescription and often not disclosed to healthcare professionals.
Potential herb-drug interaction is a clinical concern, with older people at greater risk because of co-morbidities and
slower clearance of pharmacologically active compounds. While there is a good understanding of general herbal
medicine use by older people, less is known about the extent and implications of concurrent use with prescription
medicines. The aim of this systematic review is to assess the prevalence, patterns, safety issues and other factors
associated with concurrent prescription and herbal medicines use among older adults.
Methods/design: Systematic electronic searches of MEDLINE, PsychINFO, Excerpta Medica dataBASE (EMBASE),
Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database
(AMED), Web of Science and Cochrane from inception till present for studies reporting the concurrent use of
prescription medicines with HMPs in older adults (≥65 years). Lateral searching via related citation (PubMed) and
checking reference lists of identified studies will be performed. Two reviewers will independently screen studies, extract
data and appraise methodological quality using the Joanna Briggs Institute checklist for prevalence data and the
Critical Appraisal Skills Programme (CASP) checklist. Qualitative and quantitative studies from all settings will be
included. Non-empirical papers, in vitro experiments and animal studies will be excluded. Primary outcomes are
prevalence and patterns of concurrent use, number and types of prescription and HMPs and adverse reactions
reported. Secondary outcomes are disclosure of HMP use to healthcare professionals and cost of HMPs. A narrative
synthesis of included studies will be performed to summarise the evidence.
Discussion: This review will synthesise and critically appraise current knowledge on the concurrent use of drugs and
HMPs by older adults and thus provide a better understanding of the issue. It will also identify any gaps in knowledge.
By establishing safety issues associated with concurrent use, it will also inform strategies that can help practitioners to
identify and manage older people at potential risk of herb-drug interactions.
Systematic review registration: PROSPERO CRD42014009091
Institute of Health Research
Collections of Former Colleges
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