Applying evidence-based-medicine when prescribing herbal products

Introduction. This review is written for practitioners wishing to apply the evidence-based medicine model when prescribing herbal products for use in their clinical practise. The paucity of well-conducted clinical trials is only one of the challenges faced by practitioners. There is also natural variability of herbs and a lack of standardisation for naming and processing herbs that has resulted in wide variations between herbal products containing the same plant, including batch to batch variations. Three steps are therefore recommended: select quality products; evaluate the evidence and apply the best available evidence in clinical practise. Conclusion. High quality herbal products with product-specific evidence are recommended in preference to other unproven products. Traditional knowledge about the use of herbs should be given greater weighting than poor quality studies, especially if the study is investigating a novel use for an herbal product