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May 5, 2003


Uninformed Caregivers Treat Children With Herbal Therapies and Home Remedies, Emory Study Says

ATLANTA -- Nearly half of the caregivers surveyed in a large urban hospital reported giving their children herbal products or home remedies, even though they know little about potentially harmful side effects or adverse reactions with other medications, according to an Emory University study that will be published in the May issue of Pediatrics.

The researchers from the Emory University School of Medicine interviewed 142 families at a pediatric emergency department at an urban tertiary care children’s hospital between October 2001-December 2001. Using a questionnaire developed by the investigators, caregivers responded to a series of questions about herbal and alternative therapies given to their children (ranging in age from 3 weeks to 18 years old). For the purposes of this study, herbal products are defined as substances used as health treatments that are non-FDA approved and not considered prescription or over-the-counter medications.

"Many caregivers report using these products because they consider them natural, and therefore safer to use than traditional western medicine," says Steven Lanski, MD, assistant professor of pediatrics and emergency medicine, Emory University School of Medicine. "They fail to realize that herbal products do not require FDA approval prior to release in the marketplace and parents may incorrectly assume that the products are adequately regulated."

Forty-five percent of the caregivers interviewed reported using herbal or alternative remedies for their children. The most common therapies were aloe plant/juice (44%), echinacea (33%), and sweet oil (25%). The most common reasons for use of herbal therapies were colds, burns or cuts, immune stimulation and relaxation.

Seventy-seven percent of the caregivers either were uncertain about or did not believe there were any side effects from herbal products. Of those who believed side effects were possible, only 27% could name a potential side effect. Furthermore, 66% of the caregivers were unsure or thought that herbal products could not potentially interact with other medications. Only two of the responders who thought interactions could occur correctly identified a potential drug interaction.

Researchers also found that unusual products and an unexpected wide variety of products were reportedly given to this patient population. In one instance, turpentine was used to rub down a child who was thought to have ‘worms’ and another child was given a small amount of turpentine to drink for the same ailment. Use of pine needle tea and cow chip tea for colds was also reported, as well as the use of Echinacea to "boost" the immune system in a child with lupus who was taking steroids and an immunosuppresant.

Dr. Lanski notes that it is important that caregivers have knowledge about herbal medications and discuss risks and benefits with their doctor or pharmacist, including potentially dangerous interactions with over-the-counter and prescription medications.

Lanski and his team found that 61% percent of children on an herbal therapy were reportedly taking a prescription medication at the same time. The most dangerous potential herbal and prescription medication combination reported was the simultaneous use of ephedra and albuterol in an adolescent with asthma. That combination could result in a dangerously elevated heart rate.

Although 80% of people who used the therapies reported friends or relatives as their primary source of information, only 45% of those giving herbal products to children discussed the use with the child’s primary care provider.

The researchers wrote: "The lack of current regulatory control on these products highlights the heightened awareness consumers and medical personnel should have regarding the potential adverse reactions and medical interactions. Without prompting families, healthcare providers may no be adequately informed about the actual use of these products."

Others involved in the study include Michael Greenwald, MD, Harold K. Simon, MD, both pediatric researchers with the Emory University School of Medicine and Children’s Healthcare of Atlanta, and Amanda Perkins RN of the Children’s Healthcare of Atlanta nursing staff.

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