Concurrent use of corticosteroids with licorice-containing TCM preparations in Taiwan: a national health insurance database study.

摘要

OBJECTIVES: This study used a nationwide population-based dataset from the 1997-2003 National Health Insurance claims to explore the prevalence, frequency, and relative risk of concurrent use of systemic corticosteroids with licorice-containing Traditional Chinese Medicine (TCM) preparations that might possibly result in drug-herb interactions. DESIGN: This study was based on the complete datasets of Western medicine and TCM outpatient reimbursement claims from 1997 to 2003 contained in the National Health Insurance Research Database of Taiwan. According to the date and duration of prescriptions, the patients who concurrently used systemic corticosteroids with licorice-containing TCM preparations were derived for statistical analysis. SETTING: This study was set in Taiwan. OUTCOME MEASURES: Descriptive statistics were used to analyze the demographics of patients who used corticosteroids with licorice-containing TCM preparations concurrently, including age, gender, and the frequency and percentage of major diseases in International Classification of Diseases, 9th version, Clinical Modification (ICD-9-CM) categories. The relative risk of potential corticosteroid-herb interaction was also analyzed with respect to different characteristics of the patients (age, sexuality etc.). RESULTS: The prevalence of concurrent use of systemic corticosteroids with licorice-containing TCM preparations through prescriptions from different Chinese medicine and Western medicine physicians was 1.495%. Among the major disease categories, ICD-9-CM codes 280-289 had the highest prevalence rate of 3.803%. CONCLUSIONS: Potential risk of corticosteroid-licorice interactions may happen, even through formal medical services. In the future, such educational propagations should be reinforced. Furthermore, an alert device that includes well-recognized drug-herb interactions should be built into every hospital's computer system to remind physicians to be cautious on drug safety.