Concurrent use of prescription drugs and herbal medicinal products in older adults: a systematic review protocolReport as inadecuate

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Systematic Reviews

, 5:65

First Online: 21 April 2016Received: 05 January 2016Accepted: 13 April 2016DOI: 10.1186-s13643-016-0244-2

Cite this article as: Agbabiaka, T., Wider, B., Watson, L.K. et al. Syst Rev 2016 5: 65. doi:10.1186-s13643-016-0244-2


BackgroundThere has been a global increase in the use of herbal medicinal products HMPs. About a quarter of UK adults use HMPs, bought over the counter by self-prescription and often not disclosed to healthcare professionals. Potential herb-drug interaction is a clinical concern, with older people at greater risk because of co-morbidities and slower clearance of pharmacologically active compounds. While there is a good understanding of general herbal medicine use by older people, less is known about the extent and implications of concurrent use with prescription medicines. The aim of this systematic review is to assess the prevalence, patterns, safety issues and other factors associated with concurrent prescription and herbal medicines use among older adults.

Methods-designSystematic electronic searches of MEDLINE, PsychINFO, Excerpta Medica dataBASE EMBASE, Cumulative Index to Nursing and Allied Health Literature CINAHL, Allied and Complementary Medicine Database AMED, Web of Science and Cochrane from inception till present for studies reporting the concurrent use of prescription medicines with HMPs in older adults ≥65 years. Lateral searching via related citation PubMed and checking reference lists of identified studies will be performed. Two reviewers will independently screen studies, extract data and appraise methodological quality using the Joanna Briggs Institute checklist for prevalence data and the Critical Appraisal Skills Programme CASP checklist. Qualitative and quantitative studies from all settings will be included. Non-empirical papers, in vitro experiments and animal studies will be excluded. Primary outcomes are prevalence and patterns of concurrent use, number and types of prescription and HMPs and adverse reactions reported. Secondary outcomes are disclosure of HMP use to healthcare professionals and cost of HMPs. A narrative synthesis of included studies will be performed to summarise the evidence.

DiscussionThis review will synthesise and critically appraise current knowledge on the concurrent use of drugs and HMPs by older adults and thus provide a better understanding of the issue. It will also identify any gaps in knowledge. By establishing safety issues associated with concurrent use, it will also inform strategies that can help practitioners to identify and manage older people at potential risk of herb-drug interactions.

Systematic review registrationPROSPERO CRD42014009091

KeywordsConcurrent use Herbal medicinal product Prescription drug Prevalence Herb-drug interaction Adverse reaction Safety Elderly AbbreviationsADRadverse drug reaction

AMEDAllied and Complementary Medicine Database

BWBarbara Wider

CASPCritical Appraisal Skills Programme

CGClaire Goodman

CINAHLCumulative Index to Nursing and Allied Health Literature

EMBASEExcerpta Medica dataBASE

HMPherbal medicinal product

MeSHmedical subject heading

PRISMA-PPreferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols

PROSPEROInternational Prospective Register of Systematic Reviews

TATaofikat Agbabiaka

Electronic supplementary materialThe online version of this article doi:10.1186-s13643-016-0244-2 contains supplementary material, which is available to authorized users.

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Author: Taofikat Agbabiaka - Barbara Wider - Leala Kay Watson - Claire Goodman


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