KNOWLEDGE OF SAFETY AND HERB-DRUG INTERACTIONS AMONGST HIV+ INDIVIDUALS: A FOCUS GROUP STUDY

Main Article Content

Blair Leonard Leonard
Bill Merryweather
Aileen Lim Lim
Edward Mills

Keywords

HIV, complementary medicine, herb-drug interactions

Abstract

Objective


To determine how HIV+ individuals access safety and knowledge of drug interactions related to complementary and alternative medicine (CAM).


 Methods


We conducted two separate focus group sessions with HIV+ users of complementary therapies. A total of 8 men participated at an urban health centre. Focus group sessions were audio taped and transcribed verbatim. Analysis was conducted independently and in duplicate, using thematic analysis.


 Results


All focus group participants described their use of CAM as very important for their health maintenance, giving them a feeling of empowerment in their health care. Potential side effects and safety issues were indicated as major concerns for treatment decisions, but the participant’s knowledge of safety issues involved in CAM care for HIV+ patients was limited. The sources used by the participants to gather information regarding safety and interactions with medications were varied but included: their CAM providers, their physicians, books, resources from AIDS Service Organizations, the internet and health food stores. Participants acknowledged that appraising the quality of such information is difficult.


 Conclusions


The participants in this study had a strong trust in CAM and used a wide variety of sources to gather information on CAM safety, though their knowledge base was poor.  As the use of CAM grows, further research on how to disseminate reliable information on safety and efficacy to this potentially vulnerable population is required.

Abstract 138 | PDF Downloads 89

References

1. Fairfield KM, Eisenberg DM, Davis RB, Libman H, Phillips RS. Patterns of use, expenditures, and perceived efficacy of complementary and alternative therapies in HIV-infected patients. Arch Intern Med 1998; 158:2257-64.
2. Furler MD, Einarson TR, Walmsley S, Millson M, Bendayan R. Use of complementary and alternative medicine by HIV-infected outpatients
in Ontario, Canada. AIDS Patient Care STDS 2003; 17:155-68.
3. Wynia MK, Eisenberg DM, Wilson IB. Physician- patient communication about complementary and alternative medical therapies: a survey of physicians caring for patients with human immunodeficiency virus infection. J Altern Complement Med 1999; 5:447-56.
4. Foote-Ardah CE. The meaning of complementary and alternative medicine practices among people with HIV in the United States: strategies for managing everyday life. Sociol Health Illn 2003; 25:481-500.
5. London AS, Foote-Ardah CE, Fleishman JA, Shapiro MF. Use of alternative therapists among people in care for HIV in the United States. Am J
Public Health 2003; 93:980-7.
6. Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John's wort. Lancet 2000; 355:547-8.
7. Piscitelli SC, Burstein AH, Welden N, Gallicano KD, Falloon J. The effect of garlic supplements on the pharmacokinetics of saquinavir. Clin Infect Dis 2002; 34:234-8.
8. Slain D, Amsden JR, Khakoo RA. Effect of high- dose Vitamin C on the steady state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. 43rd ICAAC, Sept; 2003:Abstract A 1610.
9. de Maat MM, Hoetelmans RM, Math t RA, et al. Drug interaction between St John's wort and nevirapine. Aids 2001; 15:420-1.
10. Huber JT, Gullion JS. Complementary and alternative medicine as represented in the HIV/AIDS body of knowledge: a bibliometric analysis. Med Ref Serv Q 2003; 22:23-32.
11. Kitzinger J. Introducing focus groups. BMJ 1995; 311:299-302.
12. Morgan DL, Kreuger RA. Successful Focus Groups: Advancing the state of the Art. Sage 1993; CA, USA.
13. Kreuger RA. Focus Groups: A practical guide for applied research, 2nd edn. Sage 1997; London, UK.
14. Mills E, Singh R, Kawasaki M, et al. Examination of Health Food Store Practices: Advice Presented to the HIV Community. Can J Pub Health 2003; 5:363-366.
15. Ernst E. Harmless herbs? A review of the recent literature. Am J Med 1998; 104:170-8.
16. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs 2001; 61:2163-75.
17. Sandhu RS, Prescilla RP, Simonelli TM, Edwards DJ. Influence of goldenseal root on the pharmacokinetics of indinavir. J Clin Pharmacol
2003; 43:1283-8.
18. Piscitelli SC, Formentini E, Burstein AH, Alfaro R, Jagannatha S, Falloon J. Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers. Pharmacotherapy 2002; 22:551-6.
19. Gallicano K, Foster B, Choudhri S. Effect of short- term administration of garlic supplements on single-dose ritonavir pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2003; 55:199-202.
20. Mills EJ, Wilson K, Foster BC, et al. Determining if ingestion of Silybum Marianum (Milk Thistle) influences the metabolism of indinavir in healthy
subjects: a randomized controlled phase I study. Unpublished 2004.
21. DiCenzo R, Shelton M, Jordan K, et al Coadministration of milk thistle and indinavir in healthy subjects. Pharmacotherapy 2003; 23:866-70