Use of herbal medicinal products among children and adolescents in Germany
Tóm tắt
Germany is a country with a high use of herbal medicinal products. Population-based data on the use of herbal medicinal products among children are lacking. The aim of this study is to investigate the prevalence, patterns and determinants of herbal medicine use among children and adolescents in Germany. As data base served the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a representative population based survey conducted 2003–2006 by the Robert Koch Institute. 17,450 boys and girls aged 0–17 years provided information on drug use in the preceding seven days. Herbal medicinal products were defined according to the European and German drug laws. SPSS Complex Sample method was used to estimate prevalence rates and factors associated with herbal medicine use. The prevalence rate of herbal medicinal product use amounts to 5.8% (95% confidence interval 5.3-6.3%). Use of herbal medicine declines along with increasing age and shows no difference between boys and girls in younger age groups. Teenage girls are more likely to use herbal medicines than teenage boys. Two thirds of herbal medicines are used for the treatment of coughs and colds; nearly half of herbal medicines are prescribed by medical doctors. Determinants of herbal medicinal product use are younger age, residing in South Germany, having a poor health status, having no immigration background and coming from a higher social class family. Children’s and parents-related health behavior is not found to be associated with herbal medicine use after adjusting for social class. Use of herbal medicinal products among children and adolescents between the ages of 0 and 17 years in Germany is widely spread and shows relatively higher rates compared to international data. This study provides a reference on the use of herbal medicinal products for policy-makers, health professionals and parents. Further studies are needed to investigate the effectiveness and safety of specific herbal medicinal products, potential effects of long term use as well as possible interactions of herbal medicinal products with concomitantly used conventional medicines.
Tài liệu tham khảo
WHO: Traditional Medicine Strategy. 2002,http://whqlibdoc.who.int/hq/2002/WHO_EDM_TRM_2002.1.pdf, –2005,
Zuzak TJ, Boňková J, Careddu D, Garami M, Hadjipanayis A, Jazbec J, Merrick J, Miller J, Ozturk C, Persson IAL, Petrova G, Saz Peiró P, Schraub S, Simões-Wüst AP, Steinsbekk A, Stockert K, Stoimenova A, Styczynski J, Tzenova-Savova A, Ventegodt S, Vlieger AM, Längler A: Use of complementary and alternative medicine by children in Europe: published data and expert perspectives. Complement Ther Med. 2013, 21 (1): S34-S47.
Wu C-H, Wang C-C, Kennedy J: Changes in herb and dietary supplement use in the US adult population: a comparison of the 2002 and 2007 national health interview surveys. Clin Therapeut. 2011, 33 (11): 1749-1758.
De Smet PA: Herbal remedies. New Engl J Med. 2002, 347 (25): 2046-2056.
European drug law Art.1 No. 30; Directive 2001/83/EC of the European parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use, as amended
Arzneimittelgesetz in der Fassung der Bekanntmachung vom 12. Dezember 2005 (BGBl. I S. 3394), das durch Artikel 2a des Gesetzes vom 27. März 2014 (BGBl. I S. 261) geändert worden ist. 2005,http://www.gesetze-im-internet.de/bundesrecht/amg_1976/gesamt.pdf, (BGBl. I S. 3394), das durch Artikel 2a des Gesetzes vom 27. März 2014 (BGBl. I S. 261) geändert worden ist,
Vickers A, Zollman C: ABC of complementary medicine: herbal medicine. Bmj. 1999, 319 (7216): 1050-1053.
Cravotto G, Boffa L, Genzini L, Garella D: Phytotherapeutics: an evaluation of the potential of 1000 plants. J Clin Pharm Therapeut. 2010, 35 (1): 11-48.
Regulation (EC) No 1901/2006 of the European Parliament and of the Council of 12 December 2006 on medicinal products for paediatric use and amending Regulation (EEC) No 1768/92, Directive 2001/20/EC, Directive 2001/83/EC and Regulation (EC) No 726/2004. 1901,http://ec.europa.eu/health/files/eudralex/vol-1/reg_2006_1901/reg_2006_1901_en.pdf, /2006 of the European Parliament and of the Council of 12 December 2006 on medicinal products for paediatric use and amending Regulation (EEC) No 1768/92, Directive 2001/20/EC, Directive 2001/83/EC and Regulation (EC) No 726/2004,
Knopf H, Wolf I-K, Sarganas G, Zhuang W, Rascher W, Neubert A: Off-label medicine use in children and adolescents: results of a population-based study in Germany. BMC Publ Health. 2013, 13: 631-
Licata A, Macaluso FS, Craxì A: Herbal hepatotoxicity: a hidden epidemic. Int J Med Sci. 2013, 8 (1): 13-22.
Hawkes N: Herbal medicine might be responsible for high incidence of urinary tract cancer. Bmj. 2012, 344: e2644-
Izzo AA, Ernst E: Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs. 2009, 69 (13): 1777-1798.
Lim A, Cranswick N, South M: Adverse events associated with the use of complementary and alternative medicine in children. Arch Dis Child. 2011, 96 (3): 297-300.
Italia S, Batscheider A, Heinrich J, Wenig C, Bauer CP, Koletzko S, Lehmann I, Herbarth O, von Berg A, Berdel D, Hoffmann B, Schaaf B, Wolfenstetter SB: Utilization and costs of conventional and alternative pharmaceuticals in children: results from the German GINIplus and LISAplus birth cohort studies. Pharmacoepidemiol Drug Saf. 2012, 21 (10): 1102-1111.
Chen HY, Lin YH, Wu JC, Chen YC, Thien PF, Chen TJ, Yang SH, Chen JL, Lo SS: Characteristics of pediatric traditional Chinese medicine users in Taiwan: a nationwide cohort study. Pediatrics. 2012, 129 (6): e1485-1492.
Wong YW, Kim DG, Lee JY: Traditional oriental herbal medicine for children and adolescents with ADHD: a systematic review. Evid Based Complement Alternat Med. 2012, 2012: 520198-
Vlieger AM, Blink M, Tromp E, Benninga MA: Use of complementary and alternative medicine by pediatric patients with functional and organic gastrointestinal diseases: results from a multicenter survey. Pediatrics. 2008, 122 (2): e446-451.
Arykan D, Sivrikaya SK, Olgun N: Complementary alternative medicine use in children with type 1 diabetes mellitus in Erzurum, Turkey. J Clin Nurs. 2009, 18 (15): 2136-2144.
Humer M, Scheller G, Kapellen T, Gebauer C, Schmidt H, Kiess W: Use of herbal medicine in German children - prevalence, indications and motivation. Dtsch Med Wochenschr. 2010, 135 (19): 959-964.
Robinson N, Blair M, Lorenc A, Gully N, Fox P, Mitchell K: Complementary medicine use in multi-ethnic paediatric outpatients. Complement Ther Clin Pract. 2008, 14 (1): 17-24.
Lohse B, Stotts JL, Priebe JR: Survey of herbal use by Kansas and Wisconsin WIC participants reveals moderate, appropriate use and identifies herbal education needs. J Am Diet Assoc. 2006, 106 (2): 227-237.
Crowe S, Lyons B: Herbal medicine use by children presenting for ambulatory anesthesia and surgery. Paediatr Anaesth. 2004, 14 (11): 916-919.
Menniti-Ippolito F, Forcella E, Bologna E, Gargiulo L, Traversa G, Raschetti R: Use of unconventional medicine in children in Italy. Eur J Pediatr. 2002, 161 (12): 690-
Vernacchio L, Kelly JP, Kaufman DW, Mitchell AA: Medication Use among children <12 years of Age in the united states: results from the Slone survey. Pediatrics. 2009, 124 (2): 446-454.
CDC National Health Statistics Report #12: Complementary and Alternative Medicine Use Among Adults and Children: United States. 2007,http://www.cdc.gov/nchs/data/nhsr/nhsr012.pdf,
Gottschling S, Gronwald B, Schmitt S, Schmitt C, Längler A, Leidig E, Meyer S, Baan A, Shamdeen MG, Berrang J, Graf N: Use of complementary and alternative medicine in healthy children and children with chronic medical conditions in Germany. Complement Ther Med. 2013, 21 (1): S61-S69.
Weissenstein A, Straeter A, Villalon G, Luchter E, Bittmann S: High frequency of CAM use among children in Germany. J Altern Complement Med. 2012, 18 (8): 729-730.
Kurth BM, Kamtsiuris P, Holling H, Schlaud M, Dolle R, Ellert U, Kahl H, Knopf H, Lange M, Mensink GB, Neuhauser H, Rosario AS, Scheidt-Nave C, Schenk L, Schlack R, Stolzenberg H, Thamm M, Thierfelder W, Wolf U: The challenge of comprehensively mapping children's health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health. 2008, 8: 196-
Kamtsiuris P, Lange M, Schaffrath RA: Der Kinder- und Jugendgesundheitssurvey (KiGGS): Stichprobendesign, Response und Nonresponse-Analyse [The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): sample design, response and nonresponse analysis]. BundesgesundheitsblattGesundheitsforschungGesundheitsschutz. 2007, 50 (5–6): 547-556.
Knopf H: Medicine use in children and adolescents. Data collection and first results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. 2007, 50 (5–6): 863-870.
Gelbe Liste:http://www.gelbe-liste.de,
German Institute of Medical Documentation and Information (DIMDI): Drug Information System (AMIS).http://www.dimdi.de/static/en/amg/index.htm,
Rote Liste:http://www.rote-liste.de,
Schenk L, Ellert U, Neuhauser H: Kinder und Jugendliche mit Migrationshintergrund in Deutschland Methodische Aspekte im Kinder- und Jugendgesundheitssurvey (KiGGS) [Children and adolescents in Germany with a migration background. Methodical aspects in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. BundesgesundheitsblattGesundheitsforschungGesundheitsschutz. 2007, 50 (5–6): 590-599.
Bethell CD, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW: Identifying children with special health care needs: development and evaluation of a short screening instrument. Ambul Pediatr. 2002, 2 (1): 38-48.
Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnsen D, Korte W, Menner K, Müller G, Müller JM, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen HU, Zabransky S, Zellner K, Ziegler A, Hebebrand J: Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd. 2001, 149 (8): 807-818.
Mensink GB, Kleiser C, Richter A: Food consumption of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. 2007, 50 (5–6): 609-623.
Lampert T, Mensink G, Romahn N, Woll A: Körperlich-sportliche Aktivit„t von Kindern und Jugendlichen in Deutschland [Physical activity among children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2007, 50 (5): 634-642.
Lampert T, Kurth B-M: Socioeconomic Status and Health in Children and Adolescents – Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Dtsch Arztebl International. 2007, 104 (43): 2944-2949.
Lange C, Schenk L, Bergmann R: Verbreitung, Dauer und zeitlicher Trend des Stillens in Deutschland [Distribution, duration and temporal trend of breastfeeding in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2007, 50 (5): 624-633.
Everett LL, Birmingham PK, Williams GD, Brenn BR, Shapiro JH: Herbal and homeopathic medication use in pediatric surgical patients. Paediatr Anaesth. 2005, 15 (6): 455-460.
Menniti-Ippolito F, Gargiulo L, Bologna E, Forcella E, Raschetti R: Use of unconventional medicine in Italy: a nation-wide survey. Eur J Clin Pharmacol. 2002, 58 (1): 61-64.
Smith C, Eckert K: Prevalence of complementary and alternative medicine and use among children in South Australia. J Paediatr Child Health. 2006, 42 (9): 538-543.
Shih CC, Liao CC, Su YC, Yeh TF, Lin JG: The association between socioeconomic status and traditional chinese medicine use among children in Taiwan. BMC Health Serv Res. 2012, 12: 27-
Zuzak TJ, Zuzak-Siegrist I, Rist L, Staubli G, Simoes-Wust AP: Medicinal systems of complementary and alternative medicine: a cross-sectional survey at a pediatric emergency department. J Altern Complement Med. 2010, 16 (4): 473-479.
Du Y, Knopf H: Paediatric homoeopathy in Germany: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Pharmacoepidemiol Drug Saf. 2009, 18 (5): 370-379.
Heilpraktikergesetz: Gesetz über die berufsmäßige Ausübung der Heilkunde ohne Bestallung.http://www.gesetze-im-internet.de/heilprg/BJNR002510939.html,
Burghardt S: Beschäftigte im Gesundheitswesen in 1.000. Gliederungsmerkmale. Jahre, Deutschland: Alter, Geschlecht, Art der Beschäftigung, Berufe,http://www.gbe-bund.de/oowa921-install/servlet/oowa/aw92/dboowasys921.xwdevkit/xwd_init?gbe.isgbetol/xs_start_neu/&p_aid=3&p_aid=18881593&nummer=85&p_sprache=D&p_indsp=-&p_aid=74245431,
Statistisches Bundesamt, DESTASIS: Gesundheitspersonal.https://www.destatis.de/DE/Publikationen/Thematisch/Gesundheit/Gesundheitspersonal/PersonalPDF_2120731.pdf?__blob=publicationFile,
European Medicines Agencies: EMA/322570/2011 Rev. 3 Patient Health Protection. 2013
Birdee GS, Phillips RS, Davis RB, Gardiner P: Factors associated with pediatric use of complementary and alternative medicine. Pediatrics. 2010, 125 (2): 249-256.
Lanski SL, Greenwald M, Perkins A, Simon HK: Herbal therapy use in a pediatric emergency department population: expect the unexpected. Pediatrics. 2003, 111 (5 Pt 1): 981-985.
Lynch N, Berry D: Differences in perceived risks and benefits of herbal, over-the-counter conventional, and prescribed conventional, medicines, and the implications of this for the safe and effective use of herbal products. Complement Ther Med. 2007, 15 (2): 84-91.
Nahin RL, Byrd-Clark D, Stussman BJ, Kalyanaraman N: Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey. BMC Complement Altern Med. 2012, 12: 193-
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6882/14/218/prepub