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Physician knowledge of herbal toxicities and adverse herb–drug interactions

Suchard, Jeffrey R.a; Suchard, Marc A.b; Steinfeldt, Jennifer L.a

European Journal of Emergency Medicine: August 2004 - Volume 11 - Issue 4 - p 193-197
doi: 10.1097/01.mej.0000134721.72356.f7

Objective: To determine how knowledgeable physicians are regarding the toxic effects and drug interactions of herbal remedies.

Methods: An anonymous voluntary demographic survey and 16-question, multiple-choice quiz was distributed at educational meetings of emergency medicine and internal medicine physicians. The primary outcome measures were to determine whether significant associations existed between quiz scores and the amount of clinical experience, or between quiz scores and self-assessed familiarity with the topic of herbal toxicities and adverse herb–drug interactions.

Results: A total of 142 surveys and quizzes were completed by 59 attending physicians, 57 resident physicians, and 26 medical students. The mean subject score on the quiz was only slightly higher than would have occurred from random guessing. Neither the amount of the subjects' clinical experience, nor their self-assessed familiarity with herbal toxicities and drug interactions correlated significantly with the score on the quiz.

Conclusion: The physicians and medical students surveyed had little training in herbal toxicities and drug interactions. They generally rated their familiarity with these topics as ‘poor’, and their scores on the quiz bore out this assessment as correct. Educational efforts might improve physician knowledge of the adverse effects of herbal remedies.

aDepartment of Emergency Medicine, University of California Irvine Medical Center, Orange, CA, USA

bDepartment of Biomathematics, David Geffen School of Medicine at the University of California Los Angeles, CA, USA

Correspondence and reprint requests to Jeffrey R. Suchard, MD, Department of Emergency Medicine, University of California Irvine Medical Center, 101 The City Drive, Route 128, Orange, CA 92868, USA.

Tel: +1 714 456 5239; fax: +1 714 456 5390;


© 2004 Lippincott Williams & Wilkins, Inc.