Study of Natural Products Adverse Reactions (SONAR) in Adults with Mental Health Conditions: A Cross-Sectional Study
Introduction Mental illness is a leading cause of non-fatal disease burden worldwide. Natural health products (NHPs) are sought by patients with mental health conditions as a safer and more ‘natural’ option than conventional pharmacotherapy; however, the possible adverse events (AE) and interactions...
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| Veröffentlicht in: | Drug safety 2021-09, Vol.44 (9), p.999-1006 |
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| creator | Zorzela, Liliane Khamba, Baljit Sparks, Emma Necyk, Candace Urichuk, Liana Katzman, Martin A. Koczerginski, David Chue, Pierre Barnes, Joanne Vohra, Sunita |
| description | Introduction
Mental illness is a leading cause of non-fatal disease burden worldwide. Natural health products (NHPs) are sought by patients with mental health conditions as a safer and more ‘natural’ option than conventional pharmacotherapy; however, the possible adverse events (AE) and interactions between NHPs and prescription medicines are not fully known.
Objectives
The aim of this study was to determine (i) the prevalence of adult patients with mental health conditions taking prescription medications only, NHPs only, NHPs and prescription medications concurrently, or neither, (ii) which prescription medications and NHPs are most commonly used, (iii) AEs (serious and non-serious) experienced in the last 30 days for each product use group.
Methods
Mental health clinics in Alberta and Ontario, Canada, were included in an active surveillance study investigating NHP–drug interactions. On their first clinic visit, adult mental health patients were provided with a form inquiring about prescription drug use, NHP use, and any undesirable health events experienced in the last month. Healthcare professionals were also asked to report AEs.
Results
A total of 3079 patients were screened at 11 mental health clinics in Alberta and Ontario. In total, 620 AEs were reported in 447 patients (14.9%). The majority of adverse events were seen in patients using both NHPs and prescription medicines (58.8%), followed by patients taking only prescription medicines (37.1%), NHPs only (3.4%) and neither (0.67%). Combining NHPs and prescription medications increases the likelihood of experiencing AEs (OR 2.1;
p
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| doi_str_mv | 10.1007/s40264-021-01092-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2565209948</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2565209948</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-70e60afc9e8bcc78da4f9121080e719c00be9249677b2d195a14820496680e683</originalsourceid><addsrcrecordid>eNp9kE9PAjEQxRujEUS_gAfTxIseqtNut7v1RoiKCYIBPTdlt6tLYBfbroRvb_mj3jxNZub33kweQucUbihAcus4MMEJMEqAgmRkdYDalCaSUMnZIWoDpZzEkooWOnFuBgApE-kxakU8YiwVURv5iW_yNa4LPNS-sXqOX2ydN5l3uJt_GesMHhud-bKuHL6ajIbd8TUuq7Bs5oFZlf4DP5vKB2Hf6HnoenWVl1v-Dndxz9bOkYnZOgRoe-4UHRV67szZvnbQ28P9a69PBqPHp153QLIoiT1JwAjQRSZNOs2yJM01LyRlFFIwCZUZwNRIxqVIkinLqYw15SmDMBCBEGnUQZc736WtPxvjvJrVjQ1vOMViETOQkm8otqOyza_WFGppy4W2a0VBbYJWu6BVCFptg1arILrYWzfThcl_JT_JBiDaAS6sqndj_27_Y_sNsACH5g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2565209948</pqid></control><display><type>article</type><title>Study of Natural Products Adverse Reactions (SONAR) in Adults with Mental Health Conditions: A Cross-Sectional Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zorzela, Liliane ; Khamba, Baljit ; Sparks, Emma ; Necyk, Candace ; Urichuk, Liana ; Katzman, Martin A. ; Koczerginski, David ; Chue, Pierre ; Barnes, Joanne ; Vohra, Sunita</creator><creatorcontrib>Zorzela, Liliane ; Khamba, Baljit ; Sparks, Emma ; Necyk, Candace ; Urichuk, Liana ; Katzman, Martin A. ; Koczerginski, David ; Chue, Pierre ; Barnes, Joanne ; Vohra, Sunita</creatorcontrib><description>Introduction
Mental illness is a leading cause of non-fatal disease burden worldwide. Natural health products (NHPs) are sought by patients with mental health conditions as a safer and more ‘natural’ option than conventional pharmacotherapy; however, the possible adverse events (AE) and interactions between NHPs and prescription medicines are not fully known.
Objectives
The aim of this study was to determine (i) the prevalence of adult patients with mental health conditions taking prescription medications only, NHPs only, NHPs and prescription medications concurrently, or neither, (ii) which prescription medications and NHPs are most commonly used, (iii) AEs (serious and non-serious) experienced in the last 30 days for each product use group.
Methods
Mental health clinics in Alberta and Ontario, Canada, were included in an active surveillance study investigating NHP–drug interactions. On their first clinic visit, adult mental health patients were provided with a form inquiring about prescription drug use, NHP use, and any undesirable health events experienced in the last month. Healthcare professionals were also asked to report AEs.
Results
A total of 3079 patients were screened at 11 mental health clinics in Alberta and Ontario. In total, 620 AEs were reported in 447 patients (14.9%). The majority of adverse events were seen in patients using both NHPs and prescription medicines (58.8%), followed by patients taking only prescription medicines (37.1%), NHPs only (3.4%) and neither (0.67%). Combining NHPs and prescription medications increases the likelihood of experiencing AEs (OR 2.1;
p
< 0.001; 95% CI 1.7–2.6).
Conclusions
Adult patients with mental health conditions who are taking both prescription medications and NHPs are more likely to report an adverse event than patients taking prescription drugs or NHPs alone. Polypharmacy increases the likelihood of an adverse event. Active surveillance is feasible and could contribute to enhanced pharmacovigilance.</description><identifier>ISSN: 0114-5916</identifier><identifier>EISSN: 1179-1942</identifier><identifier>DOI: 10.1007/s40264-021-01092-w</identifier><identifier>PMID: 34322863</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Amino acids ; Anxiety ; Biological Products - adverse effects ; Clinics ; Cross-Sectional Studies ; Dietary minerals ; Dietary supplements ; Drug Interactions ; Drug Safety and Pharmacovigilance ; Drug therapy ; Fatty acids ; Herbal medicine ; Hospitalization ; Humans ; Medicine ; Medicine & Public Health ; Mental disorders ; Mental Health ; Mental health care ; Natural products ; Ontario - epidemiology ; Original Research Article ; Patients ; Pharmacology ; Pharmacology/Toxicology ; Pharmacovigilance ; Polypharmacy ; Prescription drugs ; Prescription Drugs - adverse effects ; Probiotics ; Surveillance</subject><ispartof>Drug safety, 2021-09, Vol.44 (9), p.999-1006</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><rights>Copyright Springer Nature B.V. Sep 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-70e60afc9e8bcc78da4f9121080e719c00be9249677b2d195a14820496680e683</citedby><cites>FETCH-LOGICAL-c375t-70e60afc9e8bcc78da4f9121080e719c00be9249677b2d195a14820496680e683</cites><orcidid>0000-0002-6210-7933</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40264-021-01092-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40264-021-01092-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34322863$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zorzela, Liliane</creatorcontrib><creatorcontrib>Khamba, Baljit</creatorcontrib><creatorcontrib>Sparks, Emma</creatorcontrib><creatorcontrib>Necyk, Candace</creatorcontrib><creatorcontrib>Urichuk, Liana</creatorcontrib><creatorcontrib>Katzman, Martin A.</creatorcontrib><creatorcontrib>Koczerginski, David</creatorcontrib><creatorcontrib>Chue, Pierre</creatorcontrib><creatorcontrib>Barnes, Joanne</creatorcontrib><creatorcontrib>Vohra, Sunita</creatorcontrib><title>Study of Natural Products Adverse Reactions (SONAR) in Adults with Mental Health Conditions: A Cross-Sectional Study</title><title>Drug safety</title><addtitle>Drug Saf</addtitle><addtitle>Drug Saf</addtitle><description>Introduction
Mental illness is a leading cause of non-fatal disease burden worldwide. Natural health products (NHPs) are sought by patients with mental health conditions as a safer and more ‘natural’ option than conventional pharmacotherapy; however, the possible adverse events (AE) and interactions between NHPs and prescription medicines are not fully known.
Objectives
The aim of this study was to determine (i) the prevalence of adult patients with mental health conditions taking prescription medications only, NHPs only, NHPs and prescription medications concurrently, or neither, (ii) which prescription medications and NHPs are most commonly used, (iii) AEs (serious and non-serious) experienced in the last 30 days for each product use group.
Methods
Mental health clinics in Alberta and Ontario, Canada, were included in an active surveillance study investigating NHP–drug interactions. On their first clinic visit, adult mental health patients were provided with a form inquiring about prescription drug use, NHP use, and any undesirable health events experienced in the last month. Healthcare professionals were also asked to report AEs.
Results
A total of 3079 patients were screened at 11 mental health clinics in Alberta and Ontario. In total, 620 AEs were reported in 447 patients (14.9%). The majority of adverse events were seen in patients using both NHPs and prescription medicines (58.8%), followed by patients taking only prescription medicines (37.1%), NHPs only (3.4%) and neither (0.67%). Combining NHPs and prescription medications increases the likelihood of experiencing AEs (OR 2.1;
p
< 0.001; 95% CI 1.7–2.6).
Conclusions
Adult patients with mental health conditions who are taking both prescription medications and NHPs are more likely to report an adverse event than patients taking prescription drugs or NHPs alone. Polypharmacy increases the likelihood of an adverse event. Active surveillance is feasible and could contribute to enhanced pharmacovigilance.</description><subject>Adult</subject><subject>Amino acids</subject><subject>Anxiety</subject><subject>Biological Products - adverse effects</subject><subject>Clinics</subject><subject>Cross-Sectional Studies</subject><subject>Dietary minerals</subject><subject>Dietary supplements</subject><subject>Drug Interactions</subject><subject>Drug Safety and Pharmacovigilance</subject><subject>Drug therapy</subject><subject>Fatty acids</subject><subject>Herbal medicine</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental disorders</subject><subject>Mental Health</subject><subject>Mental health care</subject><subject>Natural products</subject><subject>Ontario - epidemiology</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pharmacology</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacovigilance</subject><subject>Polypharmacy</subject><subject>Prescription drugs</subject><subject>Prescription Drugs - adverse effects</subject><subject>Probiotics</subject><subject>Surveillance</subject><issn>0114-5916</issn><issn>1179-1942</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE9PAjEQxRujEUS_gAfTxIseqtNut7v1RoiKCYIBPTdlt6tLYBfbroRvb_mj3jxNZub33kweQucUbihAcus4MMEJMEqAgmRkdYDalCaSUMnZIWoDpZzEkooWOnFuBgApE-kxakU8YiwVURv5iW_yNa4LPNS-sXqOX2ydN5l3uJt_GesMHhud-bKuHL6ajIbd8TUuq7Bs5oFZlf4DP5vKB2Hf6HnoenWVl1v-Dndxz9bOkYnZOgRoe-4UHRV67szZvnbQ28P9a69PBqPHp153QLIoiT1JwAjQRSZNOs2yJM01LyRlFFIwCZUZwNRIxqVIkinLqYw15SmDMBCBEGnUQZc736WtPxvjvJrVjQ1vOMViETOQkm8otqOyza_WFGppy4W2a0VBbYJWu6BVCFptg1arILrYWzfThcl_JT_JBiDaAS6sqndj_27_Y_sNsACH5g</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Zorzela, Liliane</creator><creator>Khamba, Baljit</creator><creator>Sparks, Emma</creator><creator>Necyk, Candace</creator><creator>Urichuk, Liana</creator><creator>Katzman, Martin A.</creator><creator>Koczerginski, David</creator><creator>Chue, Pierre</creator><creator>Barnes, Joanne</creator><creator>Vohra, Sunita</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0002-6210-7933</orcidid></search><sort><creationdate>20210901</creationdate><title>Study of Natural Products Adverse Reactions (SONAR) in Adults with Mental Health Conditions: A Cross-Sectional Study</title><author>Zorzela, Liliane ; Khamba, Baljit ; Sparks, Emma ; Necyk, Candace ; Urichuk, Liana ; Katzman, Martin A. ; Koczerginski, David ; Chue, Pierre ; Barnes, Joanne ; Vohra, Sunita</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-70e60afc9e8bcc78da4f9121080e719c00be9249677b2d195a14820496680e683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Amino acids</topic><topic>Anxiety</topic><topic>Biological Products - adverse effects</topic><topic>Clinics</topic><topic>Cross-Sectional Studies</topic><topic>Dietary minerals</topic><topic>Dietary supplements</topic><topic>Drug Interactions</topic><topic>Drug Safety and Pharmacovigilance</topic><topic>Drug therapy</topic><topic>Fatty acids</topic><topic>Herbal medicine</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental disorders</topic><topic>Mental Health</topic><topic>Mental health care</topic><topic>Natural products</topic><topic>Ontario - epidemiology</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pharmacology</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacovigilance</topic><topic>Polypharmacy</topic><topic>Prescription drugs</topic><topic>Prescription Drugs - adverse effects</topic><topic>Probiotics</topic><topic>Surveillance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zorzela, Liliane</creatorcontrib><creatorcontrib>Khamba, Baljit</creatorcontrib><creatorcontrib>Sparks, Emma</creatorcontrib><creatorcontrib>Necyk, Candace</creatorcontrib><creatorcontrib>Urichuk, Liana</creatorcontrib><creatorcontrib>Katzman, Martin A.</creatorcontrib><creatorcontrib>Koczerginski, David</creatorcontrib><creatorcontrib>Chue, Pierre</creatorcontrib><creatorcontrib>Barnes, Joanne</creatorcontrib><creatorcontrib>Vohra, Sunita</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Drug safety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zorzela, Liliane</au><au>Khamba, Baljit</au><au>Sparks, Emma</au><au>Necyk, Candace</au><au>Urichuk, Liana</au><au>Katzman, Martin A.</au><au>Koczerginski, David</au><au>Chue, Pierre</au><au>Barnes, Joanne</au><au>Vohra, Sunita</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Study of Natural Products Adverse Reactions (SONAR) in Adults with Mental Health Conditions: A Cross-Sectional Study</atitle><jtitle>Drug safety</jtitle><stitle>Drug Saf</stitle><addtitle>Drug Saf</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>44</volume><issue>9</issue><spage>999</spage><epage>1006</epage><pages>999-1006</pages><issn>0114-5916</issn><eissn>1179-1942</eissn><abstract>Introduction
Mental illness is a leading cause of non-fatal disease burden worldwide. Natural health products (NHPs) are sought by patients with mental health conditions as a safer and more ‘natural’ option than conventional pharmacotherapy; however, the possible adverse events (AE) and interactions between NHPs and prescription medicines are not fully known.
Objectives
The aim of this study was to determine (i) the prevalence of adult patients with mental health conditions taking prescription medications only, NHPs only, NHPs and prescription medications concurrently, or neither, (ii) which prescription medications and NHPs are most commonly used, (iii) AEs (serious and non-serious) experienced in the last 30 days for each product use group.
Methods
Mental health clinics in Alberta and Ontario, Canada, were included in an active surveillance study investigating NHP–drug interactions. On their first clinic visit, adult mental health patients were provided with a form inquiring about prescription drug use, NHP use, and any undesirable health events experienced in the last month. Healthcare professionals were also asked to report AEs.
Results
A total of 3079 patients were screened at 11 mental health clinics in Alberta and Ontario. In total, 620 AEs were reported in 447 patients (14.9%). The majority of adverse events were seen in patients using both NHPs and prescription medicines (58.8%), followed by patients taking only prescription medicines (37.1%), NHPs only (3.4%) and neither (0.67%). Combining NHPs and prescription medications increases the likelihood of experiencing AEs (OR 2.1;
p
< 0.001; 95% CI 1.7–2.6).
Conclusions
Adult patients with mental health conditions who are taking both prescription medications and NHPs are more likely to report an adverse event than patients taking prescription drugs or NHPs alone. Polypharmacy increases the likelihood of an adverse event. Active surveillance is feasible and could contribute to enhanced pharmacovigilance.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34322863</pmid><doi>10.1007/s40264-021-01092-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6210-7933</orcidid></addata></record> |
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| ispartof | Drug safety, 2021-09, Vol.44 (9), p.999-1006 |
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| subjects | Adult Amino acids Anxiety Biological Products - adverse effects Clinics Cross-Sectional Studies Dietary minerals Dietary supplements Drug Interactions Drug Safety and Pharmacovigilance Drug therapy Fatty acids Herbal medicine Hospitalization Humans Medicine Medicine & Public Health Mental disorders Mental Health Mental health care Natural products Ontario - epidemiology Original Research Article Patients Pharmacology Pharmacology/Toxicology Pharmacovigilance Polypharmacy Prescription drugs Prescription Drugs - adverse effects Probiotics Surveillance |
| title | Study of Natural Products Adverse Reactions (SONAR) in Adults with Mental Health Conditions: A Cross-Sectional Study |
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