The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67768

Kirby P. Lee, PharmD¹, Cathi E. Dennehy, PharmD¹, Candy Tsourounis, PharmD¹, and Lisa A. Bero, PhD². (1) Department of Clinical Pharmacy, UCSF School of Pharmacy, 521 Parnassus Avenue, Room C-152, Box 0622, San Francisco, CA 94143, 415-476-1181, klee7493@itsa.ucsf.edu, (2) Institute for Health Policy Studies, Department of Clinical Pharmacy, and Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, Box 1390, Library, San Francisco, CA 94143

About 16% of the adult US population take herbal supplements concurrently with prescription medications. Moreover, 72 million Americans search the internet for health information, often encountering commercial websites marketing herbal supplements. We systematically surveyed websites selling herbal mono-preparations of echinacea, kava, ephedra, and ginseng. Data on echinacea (n=91 websites) found that 58% made unsubstantiated claims, of which 77% stated one or more outrageous claims as defined by the FDA. The majority failed to describe potential adverse effects (88%), disease interactions or contraindications (54%), and herb-drug interactions (91%). Although 30% cited primary or anecdotal references, citations were often misinterpreted and lacked sufficient scientific support of claims made. Only 62% recommended consultation with a physician. According to DSHEA regulations, 64% identified the product as a dietary supplement, yet 93% made structure/function claims with only 76% stating the FDA disclaimer. Nearly half (45%) suggested using echinacea as a drug (e.g. to diagnose, treat, cure or prevent disease). Approximately 80% originated in the USA and 77% employed marketing appeals. All websites provided contact information, but fewer offered a money back guarantee (60%). These results indicate that commercial websites marketing echinacea supplements frequently report incomplete, inaccurate, and misleading information that could potentially lead to harm. Furthermore, a significant number of websites are in violation of DSHEA regulations. Consumers may often be misinformed or have misconceptions about herbal supplements. Considering the rise in concomitant use of herbal supplements and prescription medications, health care providers should discuss the appropriate use of herbal supplements with their patients. Website evaluation of the remaining herbs is currently being conducted.

Learning Objectives:

At the end of this session, participants will be able to:
• Identify characteristics of high quality consumer websites providing health information.
• Recognize and provide examples of unsubstantiated and outrageous claims of four popular herbal supplements.
• Describe DSHEA regulation requirements.

Keywords: Herbal Medicine, Health Information

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.