Taking the edge off: why patients choose St. John's Wort
Wagner, P.J.; Jester, D.; LeClair, B.; Taylor, A.T.; Woodward, L.; Lambert, J.
Journal of Family Practice 48(8): 615-619
1999
ISSN/ISBN: 0094-3509 PMID: 10496640 Document Number: 507543
The number of visits to alternative medicine practitioners in the USA is estimated at 425 million, which is more than the number of visits to allopathic primary care physicians in 1990. Patients' use of St. John's Wort (SJW; Hypericum perforatum) has followed this sweeping trend. The purpose of this study was to examine the reasons why people choose to self-medicate with SJW instead of seeking care from a conventional health care provider. Open-ended interviews with key questions were used to elicit information. Twenty-two current users of SJW (21 women; 20 white; mean age=45 years) in a Southern city participated. All interviews were transcribed, and descriptive participant quotes were extracted by a research assistant. Quotes were reviewed for each key question for similarities and contextual themes. Four dominant decision-making themes were consistently noted. These were: (1) personal health care values: subjects had a history of alternative medicine use and a belief in the need for personal control of health; (2) mood: all SJW users reported a depressed mood and occasionally irritability, cognitive difficulties, social isolation, and hormonal mood changes; (3) perceptions of seriousness of disease and risks of treatment: SJW users reported the self-diagnosis of "minor" depression, high risks of prescription drugs, and a perception of safety with herbal remedies; and (4) accessibility issues: subjects had barriers to and lack of knowledge of traditional health care providers and awareness of the ease of use and popularity of SJW. Also of note was the fact that some SJW users did not inform their primary care providers that they were taking the herb (6 of 22). Users reported moderate effectiveness and few side effects of SJW.