Prevalence of and factors associated with herbal remedy use in the United States

The use of herbal remedies (HR) as complementary and alternative medicines (CAM) appears to be popular despite the limited evidence of their safety and efficacy. The overall purposes of this investigation were to (1) investigate the relationship between regular use of HR and self-reported health status, (2) evaluate this relationship when the HR use was concomitant with pharmaceutical use, and (3) describe consumer beliefs, behaviors, and characteristics related to HR use. A national random-digit dialed telephone survey of 1,500 adult English- and Spanish-speaking Americans was conducted. The survey yielded a response rate of 40.4%. The prevalences of HR use and HR-pharmaceutical concomitant use were 17.1% and 7.9%, respectively. Multivariate modeling indicated that HR use was not associated with health status but was independently associated with race/ethnicity ("other" compared with White adjusted OR = 0.38, 95% CI 0.16-0.85), educational attainment (greater than high school diploma/GED compared with a high school diploma/GED or less adjusted OR = 2.05, 95% CI 1.47-2.87), and urbanicity (Metropolitan Statistical Area- [MSA]-4 compared with MSA-5 adjusted OR = 2.14, 95% CI 1.05-4.34). Among HR users, HR-pharmaceutical concomitant use was independently associated with health status (MCS-12 score adjusted OR = 0.95, 95% CI 0.92-0.99; PCS-12 score adjusted OR = 0.96, 95% CI 0.93-0.99), race/ethnicity (non-White compared with White adjusted OR = 0.26, 95% CI 0.11-0.62), and age (adjusted OR = 1.02, 95% CI 1.01-1.04). Over 45% of HR users reported that they were motivated to use HR for health maintenance. In contrast, HR non-users reported most commonly that the motive to not use HR was because they did not have any health problems that required their use (43.6%). Adult Americans were estimated to have spent between 7.9 and 15.7 billion per year out-of-pocket on HR. Respondents agreed that the government should become more involved in regulating HR safety and efficacy (p < 0.005). In conclusion, this investigation provided evidence that HR and HR-pharmaceutical concomitant use were prevalent across a variety of sociodemographic groups. Furthermore, the evidence indicated that consumers were willing to spend sizeable amounts out-of-pocket for largely unproven preventive agents/therapies, suggesting that the demand for these products would continue