Positive Health Online

Abstract

WAGNER and colleagues, Department of Family Medicine, Medical College of Georgia, Augusta 30912-3500 USA. pwagner@mail.mcg.edu. write that the number of visits to practitioners of alternative medicine in the US is estimated at 425 million, more than the number of visits to allopathic primary care physicians in1990. Patients use of St Johns Wort (SJW) has followed this trend. The authors investigated the reasons whereby people choose to treat themselves with SJW rather than seeking help from a conventional health care provider.

Background

Methodology

The authors used open-ended interviews of 22 current users of SJW (21 women, mean age of 45 years). The interviews were transcribed, with descriptive quotes extracted for analysis.

Results

Users reported moderate effectiveness and few side effects of SJW . 4 dominant decision-making themes were consistently found: 1) Personal health care values: patients had a history of alternative medicine use and a belief in the need for personal control of their health; 2) Mood: all SJW users reported a depressed mood with occasional irritability, cognitive difficulties, social isolation and hormonal mood changes; 3) Perceptions of seriousness of disease and risks of treatment: SJW users reported the self-diagnosis of "minor" depression, high risks of prescription drugs, and a perception of safety with herbal remedies; and 4) Accessibility issues: subjects had barriers to and lack of knowledge of traditional health care providers, but awareness of the ease of use and popularity of SJW. Some SJW users (6 of 22) did not inform their primary care providers that they were taking the herb.

Conclusion

Users of SJW reported depression, ease of access to alternative, history of exposure to and belief in the safety of herbal remedies, and saw little benefit to providing information regarding SJW to primary care physicians.

References

Wagner PJ et al. Taking the edge off: why patients choose St Johns Wort. The Journal of Family Practice 48(8): 615-9. Aug 1999.

Comment

It would appear from the tone of the above research update, that the authors point of view is that patients should always see their primary care physician, who presumably know better than the individual concerned. I do not advocate people shunning medical care for their health problems; however, I find the attitude in the above update somewhat patronising. Surely taking a fairly safe herbal remedy such as St Johns Wort, which has a long history of use, is superior to being prescribed powerful anti-depressants or worse, with potentially very serious side effects!