MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Herb/drug interactions are important, much-neglected and potentially dangerous. We have covered this issue several times, e. g. here. Recently, a valuable new paper has been published on the subject in a respected journal. Here is the abstract:

AIM:

The aim of this review was to assess the severity of adverse drug reactions (ADRs) due to herb-drug interactions in patients taking herbs and prescribed medications based on published evidence.

METHOD:

Electronic databases of PubMed, the Cochrane Library, Medline and Scopus were searched for randomized or non-randomized clinical studies, case-control and case reports of herb-drug interactions (HDI). The data was extracted and the causal relationship of ADRs as consequences of HDI assessed using Horn’s drug interaction probability scale (DIPS) or Roussel Uclaf Causality Assessment Method (RUCAM) scoring systems. The mechanism of interaction was ascertained using Stockley’s herbal medicine interaction companion.

RESULTS:

Forty-nine case reports and two observational studies with 15 cases of ADRs were recorded. The majority of the patients were diagnosed with cardiovascular diseases (30.60%), cancer (22.45%) and renal transplants (16.32%) receiving mostly warfarin, alkylating agents and cyclosporine, respectively.

CONCLUSION:

HDI occurred in patients resulting in clinical ADRs with different severity. Patients may poorly respond to therapeutic agents or develop toxicity due to severe HDI which in either scenario may increase the cost of treatment and /or lead to or prolong patient hospitalisation. It is warranted to increase patient awareness of the potential interaction between herbs and prescribed medicines and their consequences to curb HDI as a potential health problem.

The journal must have published a press-release, because the findings were reported in several newspapers. THE DAILY TELEGRAPH picked up the story and reported it fairly well – at least this is what I thought when I started reading it. My opinion changed when, at the end of the article, I found this:

Emeritus Professor Edzard Ernst, Britain’s first professor of complementary medicine at Exeter University said that doctors should make it clear to patients that they could not be taking herbal remedies alongside drugs.

Prof Ernst said there was no good evidence that they work and that doctors were ‘contributing to disinformation’ by turning a blind eye to the practice.

WHAT????

I was taken aback!

I had not spoken to anyone at THE DAILY TELEGRAPH about this new publication.

What’s the harm?, you might ask.

Call me pedantic, but I think it is wrong to cite someone without interviewing him (or her).

Yet, I agree that the whole thing might be seen as a triviality, if the quote had been picked up correctly elsewhere. Sadly, that is not the case in this particular instance: the words that were put in my mouth are factually incorrect and I have never said or written anything remotely like them.

It is wrong to claim that there is no good evidence that they [herbal medicines] work (as discussed repeatedly on this blog and elsewhere, there are several herbal medicines that have been shown to work for defined conditions; St John’s Wort/depression is probably the best example). And consequently, it is nonsense to state that doctors were ‘contributing to disinformation’ by turning a blind eye to the practice.

When I first saw this article three days ago, I posted a comment asking the journalist to explain the situation. This would have been the opportunity to set things straight and correct the error to everybody’s satisfaction. Unfortunately, no reaction followed.

You might still think that this is a triviality. And perhaps you are right. But I nevertheless feel it is worrying that we seem to have gotten used to even ‘respected’ newspapers misrepresenting experts and facts. If this happens in the realm of medicine, who tells us that it is not also happening in politics etc?

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