The use of herbal medicine for hypertension in rural and urban Thailand: a cross sectional study

Introduction: Using herbal medicine to treat hypertension is common in Thailand. However, there is variation in the use of herbs between rural and urban areas. This study aims to observe the prevalence of herb use, describe herb users' behaviours, and describe anti-hypertensive drug compliance among the users. Methods: A cross-sectional survey among hypertensive patients visiting primary care services in Tak (rural) and Chiang Mai (urban) provinces was conducted between March and April 2019. Patients were assessed by using questionnaires that gathered information about patient demographic data, history of hypertension, herb use behaviours, and the concurrent use of standard treatment. Results: In total, 400 participants were included in this study-200 from rural and 200 from urban areas. Sixty-two percent were female. The prevalence of herb use was 13.0% in urban areas and 17.5% in the rural areas. Rural participants reported a significantly longer duration of herb use (P < 0.01), and a significantly higher proportion of using unapproved herbal products (91% vs 54%, P < 0.001). Participants mostly use herbs along with standard treatment (86.9%); nevertheless, poor drug compliance was similar in both areas, with rural participants more frequently taking their medications at the wrong time (P = 0.03). Conclusion: There was a trend of higher use of unapproved herbals in rural participants. Drug compliance among herb users was poor. It is recommended that a comprehensive assessment of herb use is conducted during care for hypertensive patients in this and similar contexts.