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PULMONARY AND ALLERGY

Herbals and Asthma: Usage Patterns Among a Border Population

Director and Clinical Associate Professor, University of Texas at El Paso/University of Texas (UTEP/UT)-Austin Cooperative Pharmacy Program, El Paso, TX; Assistant Dean, College of Pharmacy, University of Texas at Austin, Austin, TX

Harold W Hughes, MD

Assistant Professor, Division of Pulmonary and Critical Care Medicine, Internal Medicine Department, Texas Tech University Health Sciences Center at El Paso

Armando González Stuart, PhD

Research Coordinator, UTEP/UT-Austin Cooperative Pharmacy Program

Reprints: José O Rivera PharmD, UTEP/UT-Austin Cooperative, 1100 N. Stanton, Suite 301, El Paso, TX 79902-4153, fax 915/747-8521, jrivera{at}utep.edu

BACKGROUND: The use of herbal products (HP) is rising in the US. Higher rates of HP use have been documented in the US/Mexico border population, as well as increasing concerns about herbal-related adverse events.

OBJECTIVE: To evaluate the prevalence of HP use in adult asthmatic patients requiring hospitalization and the frequency of HP documentation in medical records.

METHODS: We conducted a retrospective chart review of admissions for asthma to determine the frequency of HP documentation. Additionally, during a 12-month period, a bilingual interviewer conducted prospective, semistructured interviews with patients with asthma exacerbations to record data on HPs used specifically for the treatment of asthma.

RESULTS: A total of 67 cases were chart-reviewed retrospectively; 60 patients were interviewed prospectively. We found no documentation of HP use by chart review, while prospective interviews showed that 42% of patients reported using HPs for the treatment of asthma. The most common HPs used were oregano 28%, chamomile 20%, garlic 16%, eucalyptus 12%, and lime 12%. Ten patients reported taking an HP that could potentially exacerbate their asthma and 18 patients reported using an HP that could interact with other medications or cause other types of adverse events.

CONCLUSIONS: An obvious lack of documentation for HP use was observed in the medical records reviewed. Because a number of HPs that are commonly used by residents along the border can interact with antiasthmatic agents and/or result in compromised asthma control, questions about HP use should be included in routine history taking.

Key Words: asthma, herbs, US/Mexico border

Published Online, December 19, 2003. www.theannals.com, DOI 10.1345/aph.1D319

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