Advancing Caribbean herbs in the 21st century

The conference was the second in the series on "Advancing Caribbean herbs in the 21st Century". It was organised as the 7th workshop held since 1998 by the Caribbean Association of Researchers and Herbal Practitioners (CARAPA). It was held in conjunction with the 2nd Annual General Meeting and Display of Exhibits of the Caribbean Herbal Business Association (CHBA), with much support from the Inter-American Institute for Cooperation on Agriculture (IICA)

A gap between acceptance and knowledge of herbal remedies by physicians: the need for educational intervention.

BACKGROUND: The unprecedented global increase in the use of herbal remedies is set to continue apace well into the foreseeable future. This raises important public health concerns, especially as it relates to safety issues including adverse effects and herb-drug interactions. Most Western-trained physicians are ignorant of the risks and benefits of this healthcare modality and assessment of acceptance and knowledge would identify appropriate intervention strategies to improve physician-patient communication in this area. METHODS: A cross-sectional survey was done using an interviewer-administered pilot tested de novo questionnaire at six public hospitals in Trinidad between May-July 2004. The questionnaire utilized weighed questions to quantify acceptance (maximum score = 14 points) and knowledge (maximum score = 52 points). Acceptance and knowledge scores were analyzed using the ANOVA and Tukey's tests. RESULTS: Of 192 physicians interviewed, most (60.4%) believed that herbal remedies were beneficial to health. Respondents had relatively high acceptance levels (mean = 5.69 +/- 0.29 points or 40% of total possible score) and poor knowledge (mean = 7.77 +/- 0.56 points or 15% of total possible score). Seventy-eight physicians (40.6%) admitted having used herbs in the past, and 60 of these (76.9%) were satisfied with the outcome. Although 52 physicians (27.1%) recommended the use of herbs to their patients only 29 (15.1%) were able to identify at least one known herb-drug interaction. CONCLUSION: The use of herbal remedies is relatively high in Trinidad, as throughout the world, and most patients self-medicate with or without the knowledge of their attending physician. Surprisingly, we demonstrated relatively high acceptance levels and use of herbs among physicians in Trinidad. This interesting scenario of high acceptance levels and poor knowledge creates a situation that demands urgent intervention. We recommend educational intervention to narrow the gap between acceptance and knowledge so that physicians would be adequately equipped to communicate with their patients on this modality. The integration of herbal medicine into the curriculum of medical schools, continuing education programs and the availability of reputable pharmacopoeias for referencing at public health institutions are useful instruments that can be used to close this gap and promote improved physician-patient communication.

A gap between acceptance and knowledge of herbal remedies by physicians: the need for educational intervention

BACKGROUND: The unprecedented global increase in the use of herbal remedies is set to continue apace well into the foreseeable future. This raises important public health concerns, especially as it relates to safety issues including adverse effects and herb-drug interactions. METHODS: A cross-sectional survey was done using an interviewer-administered pilot tested de novo questionnaire at six public hospitals in Trinidad between May–July 2004. The questionnaire utilized weighed questions to quantify acceptance (maximum score = 14 points) and knowledge (maximum score = 52 points). Acceptance and knowledge scores were analyzed using the ANOVA and Tukey's tests. RESULTS: Of 192 physicians interviewed, most (60.4 per cent) believed that herbal remedies were beneficial to health. Respondents had relatively high acceptance levels (mean = 5.69 ñ 0.29 points or 40 per cent of total possible score) and poor knowledge (mean = 7.77 ñ 0.56 points or 15 per cent of total possible score). Seventy-eight physicians (40.6 per cent) admitted having used herbs in the past, and 60 of these (76.9 per cent) were satisfied with the outcome. Although 52 physicians (27.1 per cent) recommended the use of herbs to their patients only 29 (15.1 per cent) were able to identify at least one known herb-drug interaction. CONCLUSION: Surprisingly, we demonstrated relatively high acceptance levels and use of herbs among physicians in Trinidad. This interesting scenario of high acceptance levels and poor knowledge creates a situation that demands urgent intervention. The integration of herbal medicine into the curriculum of medical schools, continuing education programs and the availability of reputable pharmacopoeias for referencing at public health institutions are useful instruments that can be used to close this gap and promote improved physician-patient communication.

Herbal remedies today [abstract]

Over the last two decades, phytotherapy, or botanical medicine, and other "non-conventional" therapies have become increasingly prevalent in many countries around the world. Many actions involving WHO and other official agencies have been initiated concerning the regulatory situation, especially for herbal products, to provide reliable information and, further, to break down the barriers between western conventional medicine and complementary/alternative therapies. Alternative models of healthcare have been evolving quite rapidly, and research activity has been directed to the issues of quality, safety and efficacy of the traditional herbal remedies, modern phytomedicinals and the nutraceuticals. In this paper, a critical review has been undertaken of recent scientific and clinical studies which describe a variety of herbal medicinal preparations. An evaluation has been made of reports describing the knowledge, attitudes and practices of healthcare professionals towards herbal medicine. The findings have been translated into suggestions intended to encourage, and to enable, healthcare professionals to raise their awareness, and to improve their knowledge of, the established limitations and benefits of various formulations of herbal medicinal products in current use. (AU)

Screening of medicinal plants from Trinidad and Tobago for antimicrobial and insecticidal properties

Antibacterial activity in 51 extracts from 29 plant species currently used in traditional medicine in Trinidad and the neighbouring Caribbean islands was tested for by the agar dilution streak method using six bacteria: Escherichia coli, Pseudomonas aeruginosa. Salmonella tophimurium, Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis. The extracts from eight of the plants tested showed significant activity against one or more micro-organisms and the most susceptible bacterium was Staphylococcus aureus. In the bioassays for toxicity towards the Aedes aegypti mosquito the most effective plant extracts were from Justicia pectoralis, Manihot utilissima and Stachytarpheta jamaicensis.(AU)