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Factors Influencing Concomitant Use of Complementary and Alternative Medicines with Warfarin
Author(s) -
Hasan Shahzad S,
Feng Siow R,
Ahmadi Keivan,
Ahmad Kamarunnesa M,
Chong David WK,
Anwar Mudassir,
Badarudin Nurul Z
Publication year - 2010
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2010.tb00563.x
Subject(s) - medicine , warfarin , concomitant , adverse effect , socioeconomic status , adverse drug reaction , family history , drug , family medicine , pharmacology , environmental health , population , atrial fibrillation
Aim To investigate factors influencing complementary and alternative medicines (CAM) use among patients on warfarin. Method Cross‐sectional study of randomly selected patients at a hospital‐based anticoagulation clinic in Malaysia. A 38‐item validated data collection form was used to interview patients and investigate the reasons, perceived efficacy and adverse drug events experienced. Data were also collected on potential drug interactions and the international normalised ratio (INR). Results Of the 138 randomly selected patients, 76 (55%) reported using CAM – 46 (61%) used biologically based practices such as herbal products, vitamins and supplements. Monthly household income (p = 0.05, r s = 0.13) and family history of CAM use (p = 0.001, r s = 0.32) were significantly associated and positively correlated with CAM use. 19 patients reported adverse events with warfarin use while none reported adverse events with CAM use. 19 and 58 patients, respectively, were identified as being at risk of potential interactions between warfarin‐CAM and warfarin‐conventional medicines. No significant difference in the mean INR was found between CAM and non‐CAM users. Conclusion A large number of patients attending the anticoagulation clinic reported using CAM. Socioeconomic factors such as monthly household income, education level and family history of CAM use were significantly related with CAM use. Routine medication interviews should include questions about concomitant CAM use.