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Concurrent Use of Prescription Drugs and Herbal Medicinal Products in Older Adults: A Systematic Review
Open accessAbstract
BACKGROUND: The use of herbal medicinal products (HMPs) is common among older adults; however, little is known about concurrent use with prescription drugs, as well as potential interactions associated with such combinations. OBJECTIVE: The aim of this systematic review was to identify and evaluate the literature on concurrent prescription and HMP use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. METHODS: Systematic searches were conducted in the MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane databases from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults ≥ 65 years of age. Quality was assessed using the Joanna Briggs Institute checklists. And the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) three-stage approach to mixed method research was used to synthesise data. RESULTS: Twenty-two studies were included. A definition of HMPs or what was considered an HMP was frequently missing. Prevalence of concurrent use by older adults varied widely between 5.3 and 88.3%. Prescription medicines most combined with HMPs were antihypertensive drugs, β-blockers, diuretics, antihyperlipidemic agents, anticoagulants, analgesics, antihistamines, antidiabetics, antidepressants and statins. The HMPs most frequently used were Ginkgo biloba, garlic, ginseng, St John's wort, Echinacea, saw palmetto, evening primrose oil and ginger. Potential risks of bleeding due to the use of Ginkgo biloba, garlic or ginseng with aspirin or warfarin was the most reported herb-drug interaction. Some data suggest being female, and having a lower household income and less than a high-school education were associated with concurrent use. CONCLUSION: The prevalence of concurrent prescription drugs and HMP use among older adults is substantial and potential interactions have been reported. Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals in appropriately identifying and managing patients at risk. Systematic Review Registration Number: PROSPERO 2014:CRD42014009091.
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“Concurrent, often undisclosed use with prescription drugs is common in older adults, yet berberine is far from inert.”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [5]
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“Population studies report that between 5% and over 80% of older adults combine supplements with prescription drugs, and a substantial proportion carry at least one potential interaction [3,4,5,6,7].”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [5]
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Metadata
- Authors
- Agbabiaka, T. B., Wider, B., Watson, L. K., & Goodman, C.
- Affiliations
- University of Hertfordshire (GB)
- University of Exeter (GB)
- Corresponding author
- Agbabiaka, Taofikat B.
- Venue
- Drugs & Aging
- Published
- 2017-12
- Volume
- 34
- Issue
- 12
- Pages
- 891-905
- ISSN
- 1170-229X (ISSN-L)
- 1179-1969
- PMC
- PMC5730633
- OpenAlex
- W2773883339
- Cited by
- 141
- References
- 63
- Citations by year
- 2026: 20 · 2025: 18 · 2024: 8 · 2023: 19 · 2022: 16 · 2021: 22 · 2020: 10 · 2019: 17 · 2018: 9 · 2017: 2
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Drugs & Aging (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion)
- Figshare (submittedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by-nc)
- University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion, cc-by-nc)
- Funders
- National Institute for Health and Care Research (NF-SI-0515-10103)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Phytochemistry Medicinal Plant Applications
- Keywords
- herbal medicinal products, prescription drugs, polypharmacy, older adults, herb-drug interactions, anticoagulants, Ginkgo biloba, garlic, ginseng, Hypericum perforatum, saw palmetto, bleeding risk, warfarin, aspirin, socioeconomic factors
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Female, Humans, Male, Phytotherapy, Plant Preparations, Herb-Drug Interactions, Prescription Drugs
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