Prevalence, associated factors, and safety implications of prehospital herbal medicine use in Southwestern, Ethiopia

Herbal medicine has historically played an important role in healthcare in Ethiopia. However, its use in prehospital settings, where individuals self-administer herbal remedies before seeking formal healthcare, is not well understood. There is limited evidence of its prevalence, factors associated with its use, and potential safety implications. Therefore, this study aimed to assess the prevalence of prehospital herbal medicine use, identify determinants, and explore potential safety risks among patients admitted to Jimma Medical Center (JMC) in Southwestern Ethiopia. A hospital-based cross-sectional study was conducted among 217 patients admitted to the medical wards of Jimma Medical Center (JMC) between June and September 2021. Data were collected using a pretested, structured questionnaire. And a literature review was conducted to evaluate the potential toxicity and herb-drug interactions associated with the herbal medicines used by the patients. The data were analyzed using SPSS version 21. Descriptive statistics were used to summarize the findings, while bivariate and multivariate logistic regression analyses were employed to identify factors associated with pre-hospital herbal medicine use. A P-value < 0.05 was considered statistically significant. The prevalence of prehospital herbal medicine use was 34%. Most patients (78.7%) did not inform healthcare providers about their herbal use. Additionally, prehospital herbal medicine usage is influenced by age (AOR = 0.281, 95% CI: 0.115-0.683), secondary educational level (AOR = 2.7, 95% CI: 1.101-6.485), and lack of insurance coverage (AOR = 2.1, 95% CI: 1.083-4.004). This indicates that demographic, socioeconomic, and cultural factors jointly influence prehospital herbal medicine use. The study also found that Ocimum gratissimum, Ruta chalepensis, Croton macrostachyus, Zingiber officinale, Eucalyptus globulus, Echinops kebericho, and Carica papaya were the most utilized herbal medicines in the studied area. Furthermore, the literature review revealed potential herb-drug interactions and toxicity risks, especially with Zingiber officinale, Carica papaya, Eucalyptus globulus, and Ruta chalepensis. Prehospital use of herbal medicines was relatively high and often undisclosed to healthcare providers, raising safety concerns due to potential toxicities and herb-drug interactions. Age, education, and insurance status significantly influenced herbal medicine use. These findings emphasize the need for healthcare providers to proactively inquire about herbal medicine use during patient assessments, as well as for community awareness programs promoting the safe use of herbal remedies.