gms | German Medical Science

Background: Although not reimbursed by German statutory health insurances, herbal medicines are frequently self-medicated by patients who actively take care of their health [1], [2]. Herbal medicines are mostly applied therapeutically rather than proactively [3]. Nevertheless, little is known about the use of herbal medicines in specific indications. The aim of this study was to identify personal and health-related factors that have an impact on application in mental symptom load.

Materials and Methods: A subset of data concerning mental symptom load was extracted from the database PhytoVIS and statistically analysed. PhytoVIS was established in the context of a scientific project on the pharmaco-epidemiology and effectiveness of herbal medicines in Germany. Data was collected in medical practices and pharmacies by interviewing patients with a structured questionnaire. Application frequency was differentiated into “daily” and “as needed” and application reasons into “acute complaints”, “chronic disease”, and “preventive measure”.

Chi²-Tests were computed to analyse dependency of application frequency and reasons with age group, gender, mental symptom load indication, severity level, number of disease symptoms, and used herbal preparation.

Results: Data of 2,208 adults were analysed. The majority of patients preferred to take herbal medicines on a daily basis (68.8%) instead of applying them “as needed”. Interestingly, herbal medicines are predominantly used for “acute complaints” (52.8%), followed by “chronic disease” (37.7%), and “preventive measure” (9.5%). Application frequency was significantly associated with age group, indication, severity level, and herbal preparation used. This also applies to the reasons for application; in addition, number of disease symptoms was identified as a significant factor.

Among those patients who applied herbal medicines “as needed”, patients aged 18-30 yrs. had the highest frequency compared to all other age groups (38.8%). Indications with depressive or cognitive symptom load appeared to have the lowest frequency in use “as needed” relative to anxiety symptoms, increased motor excitation, and sleep disorders. This is also reflected in the use of Ginkgo and St. John’s wort preparations that are preferably applied daily (95.7% and 88.0%, respectively).

While herbal medicines are generally used for acute mental symptoms, a different picture was found regarding age groups and indications. Patients older than 65 yrs. use herbal medicines predominantly for the treatment of a chronic disease. For indications with cognitive symptoms, the reasons for intake are mostly “chronic disease” and “preventive measure” with similarly high rates. This is also true for Ginkgo preparations.

Conclusion: Patients taking herbal medicines usually do so regularly on a daily basis. However, young adults do not seem to adhere to a strict intake regimen. Since the same age group reports lower clinical benefits [4], there is a need for education on how herbal medicines are most effective. For indications with cognitive symptoms and Gingko preparations, irregular and preventive use was observed most-frequently.