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Canadian Journal of Public Health

, Volume 104, Issue 3, pp e222–e228 | Cite as

Polypharmacy Meets Polyherbacy: Pharmaceutical, Over-the-counter, and Natural Health Product Use Among Canadian Adults

  • Kristine VotovaEmail author
  • Régis Blais
  • Margaret J. Penning
  • Malcolm K. Maclure
Quantitative Research

Abstract

Objectives

Natural health products (NHP) are increasingly being used to supplement prescription medications (PM) and over-the-counter (OTC) products. The objective of this study was to examine patterns of overall health product use and how these patterns are associated with social and health factors.

Methods

We used direct health measures data from the Canada Health Measures Survey (CHMS) Cycle 1.0 (2007/2009) to examine recent product use among adults aged 18–79 years (n=3,721). Latent class analyses were used to detect use (propensity) and intensity of use among users of all three product types. Associations between social and health covariates and product patterns were examined using linear and multinomial logit regression procedures.

Results

Three latent classes of health product use were identified. The largest (43%) was characterized by a high probability of PM and NHP but not OTC use. Class two (37%), in contrast, had a low probability of using any of the three health products. Class three (20%) had a high probability of PM and OTC but not NHP use. Age, gender, immigrant status, household size, co-morbidity, perceived health status, and having a regular doctor were associated with these patterns of use. Analyses of intensity of product use among users revealed seven distinct classes; these were differentiated by age, household size, co-morbidity and weight (BMI status).

Conclusion

If defining polypharmacy or polyherbacy is based simply on number of health products used, then for Canadians under age 80 neither practice appeared to be widespread. More work needs to be done to define the “poly” in polypharmacy and polyherbacy. This will inform the conversation on appropriate product use, particularly given that about one half of Canadians used medications and NHPs concurrently.

Key Words

Polypharmacy over-the-counter drugs dietary supplements nonprescription drugs 

Résumé

Objectifs

Les produits de santé naturels (PSN) sont de plus en plus utilisés comme suppléments aux médicaments d’ordonnance (MO) et aux produits en vente libre (VL). L’objectif de cette étude était d’examiner les patrons d’usage de l’ensemble des produits de santé et comment ces patrons sont associés à des facteurs sociaux et sanitaires.

Méthodes

Nous avons utilisé les données du cycle 1.0 (2007-2009) de l’Enquête canadienne sur les mesures de la santé (ECMS) afin d’examiner l’usage récent de produits chez les adultes âgés de 18 à 79 ans (n=3721). Des analyses de classes latentes ont été utilisées pour détecter l’usage (propension) et l’intensité de l’usage chez les utilisateurs des trois types de produits. Les associations entre les covariables sociales et sanitaires et les patrons d’usage des produits ont été examinées à l’aide d’analyses de régression logistique linéaire et multinomiale.

RéSULTATS

Trois classes latentes d’usage des produits de santé ont été identifiées. La plus grande classe (43 %) était caractérisée par une forte probabilité d’usage de MO et de PSN mais pas de VL. Par contre, la 2e classe (37 %) avait une faible probabilité d’utiliser l’un ou l’autre des trois produits de santé. La 3e classe (20 %) avait une forte probabilité d’utiliser les MO et les VL mais pas les PSN. L’âge, le genre, le statut d’immigrant, la taille du ménage, la comorbidité, l’état de santé perçue, et le fait d’avoir un médecin régulier étaient associés avec ces patrons d’usage. L’analyse de l’intensité d’usage des produits chez les utilisateurs a permis d’identifier sept classes distinctes; celles-ci variaient selon l’âge, la taille du ménage, la comorbidité et le poids (indice de masse corporelle).

Conclusion

Si la définition de la polypharmacie et de la polyherbacie est basée seulement sur le nombre de produits consommés, alors aucune des deux pratiques ne semble répandue chez les Canadiens de moins de 80 ans. Plus de travaux sont nécessaires pour définir la « poly » dans la polypharmacie et la polyherbacie. Ceci alimentera la discussion sur l’usage approprié des produits, surtout qu’environ la moitié des Canadiens consomment des médicaments et des PSN en même temps.

Mots Clés

polypharmacie médicaments en vente libre suppléments diététiques médicaments sans ordonnance 

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Copyright information

© The Canadian Public Health Association 2013

Authors and Affiliations

  • Kristine Votova
    • 1
    Email author
  • Régis Blais
    • 2
  • Margaret J. Penning
    • 3
  • Malcolm K. Maclure
    • 1
  1. 1.Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  2. 2.Département d’administration de la santéUniversité de Montréal (DASUM)MontréalCanada
  3. 3.Department of Sociology, Faculty of Social SciencesUniversity of VictoriaVictoriaCanada

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