Use of Ethno-Medicinal Herbs (EMH) among diabetic patients in western Nepal: A cross-sectional study in Dang valley

Abstract

Background: Diabetes is one of the major public health challenges as it causes premature death and disability-adjusted life-years (DALYs) loss worldwide. Due to the lack of financial protection and high catastrophic cost more than half of the diabetic patients in Nepal are not in access towards western medicine and they heavily rely on ethno medicinal herbs. However, the proportion of diabetic patients who use ethno medicinal herbs has not been still documented. Therefore, this study is aimed to investigate factors influencing use of ethno medicinal herbs among diabetic patients in Nepal. Moreover, the prevalence, pattern, characteristics of ethno medicinal herbs users are also study to discover patient’s needs. Method: A descriptive cross-sectional study was used among (331) diabetic patients, who attended in outpatient clinic of Rapti Sub Regional Hospital, Dang, Nepal. Data was collected by face to face interview with structured questionnaires, containing (41) items after getting informed consent from each patients. Descriptive statistics was used to describe characteristics of study sample. Univariate analysis by chi-squire test was used to make comparison between ethno medicinal herbs user and non-users. The p-value equal to or less than 0.05 was considered as significant. Results: From a total of 331patients who responded, 223(67%) reported the use of ethno medicinal herbs for management of diabetes. Significant factors associated with ethno medicinal herbs use were, gender (p=0.01), educations (p=0.01), employments (p<0.05), smoking (p<0.001), physical exercise habit (p<0.001) and number of meal per day (p=0.01). The most commonly used herbs were fenugreek, Gudmar, cinamon and black plum tree. Family and friends are the main source of information. Nearly 59% of diabetic patient failed to inform their doctors about the use of herbs and the main reason given for this were fear of negative response by physician (20.9%) and physician did not ask (46%). Conclusion: The prevalence of use of ethno medicinal herbs concurrently with conventional medicine among diabetic patients is high but disclosure with modern health care provider is low. Therefore, both patients and doctor should be educated about the potential risk of herb drug interactions and adverse effects. Health services should be provided from same umbrella through integrated approach for welfare of the patents.