Herb-drug interactions: Perception and revelations of nurses in primary healthcare clinics, South Africa

Purpose: This study aims to explore and describe the perceptions and revelations of primary healthcare nurses regarding the use of herbal medicine and herb-drug interactions. Background: Research has shown that a large percentage of the South African population uses herbal medicine (HM) alongside conventional medicine. In light of this, primary healthcare (PHC) nurses should educate and advise patients about potential herb-drug interaction (HDI). Methods: An exploratory, qualitative study was conducted in primary healthcare clinics in Gauteng, Free State, and Mpumalanga provinces in South Africa. Eight PHC nurses were recruited for face-to-face, digitally recorded interviews. Data was transcribed and coded using content analysis. Results: The study identified five main themes emanating from the interviews: nurses' perception and personal use of herbal medicine; nurses' knowledge of herbal medicine and herb-drug interaction; enquiring about the use of herbal medicine use; nurses’ behaviour, and patient disclosure on herbal medicine use. The sub-themes were nurses pursuing knowledge of herbal medicine, the advice given to patients, and the discouragement of herbal medicine use. Conclusions: This study revealed that a broader depth of knowledge regarding the use of herbal medicine could enable primary healthcare nurses to communicate better with their patients about the risks and benefits of such use. Taking into account that a large portion of the South African population uses herbal medicine, the nursing profession should consider introducing an education intervention to assist nurses in their response to patients’ questions regarding the use of herbal medicine. This study recommends that a history case-taking form should be utilized as a standardized approach to address the use of herbal medicine among patients. This is currently not mandatory in the South African primary healthcare system.