Concurrent use of herbal and prescribed medicine by patients in primary health care clinics, South Africa.

BACKGROUND: The use of herbal medicine (HM) as a self-management practice for treating various diseases has gained popularity worldwide. Consumers co-administer herbal products with conventional medicine without the knowledge of possible herb-drug interaction (HDI). AIM: This study aimed to assess patients' perception and use of HM and their knowledge of HDI. SETTING: Participants attending primary health care (PHC) clinics in three provinces (Gauteng, Mpumalanga and Free State), South Africa, were recruited. METHODS: Focus group discussions comprising a total of thirty (N = 30) participants were conducted using a semi-structured interview guide. Discussions were audio-recorded and then transcribed verbatim. Data were analysed using thematic content analysis. RESULTS: Reasons for using HM, sources of information on HM, co-administration of HM and prescribed medicine, disclosure of the use of HM, PHC nurses' attitudes and not having time to engage were frequently discussed. Respondents' lack of knowledge and perceptions about HDI and their dissatisfaction with prescribed medicine because of experienced side effects were also discussed. CONCLUSION: Because of the lack of discussions and non-disclosure about HM in PHC clinics, patients are at risk of experiencing HDIs. Primary health care providers should regularly enquire about HM use on every patient, to identify and prevent HDIs. The lack of knowledge about HDIs by patients further compromises the safety of HM.Contribution: The results highlighted the lack of knowledge of HDI by patients thus assisting the healthcare stakeholders in South Africa to implement measures to educate patients attending PHC clinics.

Experiences of neurofeedback therapists in treating attention-deficit hyperactivity disorder.

Background: Neurofeedback is a neurostimulatory biofeedback behavioural therapy that regulates brain wave levels for optimal cognitive functioning. It has shown promising results for the treatment of attention-deficit hyperactivity disorder (ADHD). Aim: To explore and describe the experiences of neurofeedback therapists (NTs) using neurofeedback to treat children and adults with ADHD and their experience of its role and value in treating this condition. Setting: Interviews were conducted in participants' private consultation rooms in Gauteng, South Africa. Methods: In this qualitative study using a descriptive phenomenological approach, six registered NTs with experience of treating ADHD were interviewed. Participants were asked: 'Tell me about your experiences of neurofeedback with ADHD patients in your practice.' Responses were audio-recorded, transcribed and underwent thematic analysis. Results: Participants experienced neurofeedback as an effective treatment for ADHD and other coexisting conditions, such as anxiety and insomnia. Participants felt that the neurofeedback process facilitates a beneficial therapeutic relationship and integrates well with other treatment methods. Challenges faced in practice included certain underlying comorbidities, home environment, poor patient compliance and NTs' level of expertise, which impact treatment outcomes. Conclusion: Neurofeedback therapists expressed an overall positive perception of the value of neurofeedback to reduce ADHD symptom severity and improve quality of life, particularly when used as part of a multimodal approach. Participants identified a need for further education and awareness regarding the use of neurofeedback for ADHD. Contribution: This study has contributed to our understanding of the role of neurofeedback in treating ADHD in the South African setting.

Physiotherapy and a Homeopathic Complex for Chronic Low-back Pain Due to Osteoarthritis: A Randomized, Controlled Pilot Study.

CONTEXT: Osteoarthritis (OA) is a common cause of chronic low-back pain (CLBP) and can be managed with drug therapy and physiotherapy. Homeopathic remedies may assist managing OA; however, research that supports their effectiveness is limited. OBJECTIVES: The study aimed to investigate the efficacy of a homeopathic complex in combination with physiotherapy in treating CLBP due to OA. DESIGN: The study was a 6-wk, randomized, double-blind, placebo-controlled pilot. SETTING: The study took place in a private physiotherapy practice in Gauteng, South Africa. PARTICIPANTS: The participants were 30 males and females, aged 45-75 y, who were receiving physiotherapy treatment for OA of the lumbar spine from a therapist in private practice. INTERVENTIONS: The intervention and control groups both received standard physiotherapy treatment-massage, thermal therapy, and joint mobilization-every 2 wk. In addition, the treatment group received a homeopathic complex-6cH each of Arnica montana, Bryonia alba, Causticum, Kalmia latifolia, Rhus toxicodendron, and Calcarea fluorica. The control group a received a placebo. OUTCOME MEASURES: The primary measure was a visual analogue scale (VAS) for pain. Secondary outcome measures included the Oswestry Disability Index (ODI), an evaluation of each patient's range of motion (ROM) of the lumbar spine, and a determination of each patient's need for pain medication. RESULTS: Intergroup analysis revealed that the treatment group significantly outperformed the control group with regard to pain, daily functioning, and ROM. No difference existed between the groups, however, in the need for conventional pain medication. CONCLUSIONS: The study was too small to be conclusive, but results suggest the homeopathic complex, together with physiotherapy, can significantly improve symptoms associated with CLBP due to OA.