Herbal or traditional medicine consumption in a Thai worker population: pattern of use and therapeutic control in chronic diseases

Kanjanahattakij et al. BMC Complementary and Alternative Medicine https://doi.org/10.1186/s12906-019-2652-z RESEARCH ARTICLE (2019) 19:258 Open Access Herbal or traditional medicine consumption in a Thai worker population: pattern of use and therapeutic control in chronic diseases Napatt Kanjanahattakij1,2, Pakakrong Kwankhao3, Prin Vathesatogkit1, Nisakron Thongmung4, Yingampa Gleebbua5, Piyamitr Sritara1 and Chagriya Kitiyakara1* Abstract Background: Herbal and traditional medicines (HTM) are widely used in Asian countries. Specific data on prevalent of HTM usage and association with chronic diseases in the Thai population is currently lacking. We examined the prevalence and factors associated with HTM use in a Thai worker population. In addition, we explored the relationship between HTM use and therapeutic control of cardiovascular risk factors and documented the most common types of HTM used in various chronic diseases. Methods: Employees of EGAT (The Electric Generating Authority of Thailand) who had participated in a health examination were studied. Each participant documented their HTM consumption and self-reported chronic diseases in a questionnaire. Clinical disease and therapeutic control were also defined by concomitant laboratory tests. Results: Of a total of 6592 subjects, 32.6% were HTM-users. Age < 50 years, female gender, self-reported history of diabetes, liver disease, cancer, dyslipidemia, and alcohol use were independently associated with HTM use. HTM consumption increased in proportion to the numbers of self-reported chronic diseases. There were no differences in the therapeutic control of cardiovascular risk factors between HTM users and nonusers. Liver and kidney function were not different. The most commonly used HTM was turmeric. Conclusions: HTM consumption is common in community-based Thai subjects, with higher use among those with chronic diseases. Although there were no differences in control of cardiovascular risk factors between HTM users and non-users, many of the commonly used herbs have relevant biological activities for chronic disease prevention or treatment. Keywords: Asia, Cardiovascular, Diabetes, Hypertension, Herbs, Non-communicable diseases, Thai, Traditional medicine Asia & Oceania Background Rapid urbanization and globalization has led to a marked increase in non-communicable diseases (NCDs) around the world [1]. As the pathological processes linked to NCD may take years to develop, the use of preventive medicine to target risk factors during the pre-symptomatic period might prevent the development of cardiovascular disease (CVD) or other chronic diseases. * Correspondence: 1 Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand Full list of author information is available at the end of the article Continuous management of subclinical pathology requires very safe agents to be regularly taken for an individual’s lifetime. The use of herbal medicine either for primary prevention or as complementary and alternative medicine for CVD risk factors such as hypertension or diabetes and other NCD is thus of increasing interest to the public and the medical community [2]. The World Health Organization (WHO) estimated that 70–80% of populations from developing countries use herbal and traditional medicine (HTM) as the primary method for health care needs, and HTM use has also been extensively embraced in Western countries © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Kanjanahattakij et al. BMC Complementary and Alternative Medicine [3]. Despite the widespread use for centuries, HTM is often approached with skepticism by the medical community [4] and evidence-based studies of the efficacy and safety of HTM in the management of chronic diseases are still limited [2]. At present, few large population surveys have examined HTM use in conjunction with laboratory and clinical data. The relationship between HTM consumption and the level of therapeutic control of CVD risk factors in the general population is still relatively unknown. HTM may improve the control of CVD risk factors either through direct pharmacological effects and HTM users might be more proactive to health risk modifications. On the other hand, HTM has also been associated with worsening kidney function [5] or liver toxicity [6]. In 2011, Thailand was reclassified by the World Bank from a lower-middle income to a higher-middle-income country. Along with the economic transition, the prevalence of CVD and related risk factors have increased markedly [7]. Self-prescribed herbal medicine is common among patients attending healthcare facilities in Southeast Asia, [8, 9] but there is limited information on the relationship of HTM usage with chronic diseases in the Thai community at large. The main aims of this study were to examine the prevalence and factors associated with HTM use in a Thai worker population. In addition, we will explore the relationship between HTM use and therapeutic control of CVD risk factors, and also document the most common types of HTM used in various chronic diseases. Methods Study subjects The subjects were employees of EGAT (The Electric Generating Authority of Thailand), who had participated in a health survey to evaluate risk factors for cardiovascular and other chronic illnesses. The details of this cohort has been described in detail elsewhere [10]. This study is a part of the EGAT study’s cross-sectional survey from 2007 to 2009, in which 6796 employees or former employees of EGAT aged 25 to 76 agreed to participate. Every participant received a full medical history and physical examination by a trained medical personnel. A set of standardized, detailed questionnaires was also given to each participant to inquire about their demographic data and general health including questions about awareness of specific chronic diseases. (Additional file 1) In the questionnaire, the participants were asked if they used any HTM. Participants who responded “yes” were classified as a ‘HTM user’. Participants who responded “no” were classified as a ‘Non-user ‘. Participants who did not respond to this question were excluded from the study. HTM users were also asked to list the type of HTM they had used in the questionnaire. Blood samples were drawn after 12 h fast. This (2019) 19:258 Page 2 of 9 study was conducted in accordance with the Hel (...truncated)