Portuguese Healthcare Practitioners Lack Specific Herb-Drug Interaction Knowledge
A new study reveals that despite recognising clinical relevance, 90.6% of Portuguese healthcare professionals lack specific knowledge regarding herb-drug interactions, leading to inconsistent patient questioning and potential safety risks.
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New research from the University of Coimbra, Portugal, highlights significant knowledge deficits among Portuguese healthcare practitioners (HPs) regarding herb-drug interactions (HDIs). An online survey of 311 HPs revealed that 90.6% acknowledge the clinical relevance of HDIs, yet specific interaction knowledge is limited. Only 57.6% routinely inquire about patients' food supplement or herbal product use, suggesting a significant gap in proactive safety assessment.
The study, published in Nutrients, found wide variations in specific HDI knowledge, with correct response rates ranging from 21.8% to 72.5% across different interactions. Low-scoring areas included interactions between chamomile and hormonal therapies, and liquorice and antihypertensive medicines. This inconsistency points to a systemic educational shortfall, exacerbated by a high non-disclosure rate (40–70%) from patients who either believe supplements are inherently safe or are not prompted to share this information.
Furthermore, the research underscores a critical lack of understanding regarding the impact of quality defects, such as contamination or adulteration, on exposure profiles and interaction risks. Undeclared pharmacologically active substances can generate unexpected drug-drug interactions, a concern particularly relevant given the high proportion (approximately 88%) of EU citizens who have used a supplement at least once, according to a 2022 Foods Supplements Europe survey. This situation is compounded by an aging population, where polypharmacy makes patients more susceptible to adverse interactions.
The authors advocate for enhanced training, improved access to reliable information, and systematic screening for natural product use in clinical practice. They also call for future research into HPs' recognition of product quality as an interaction determinant and continued analytical surveillance of product identity and purity.
What this means for Portugal
Portuguese supplement manufacturers and brand owners must anticipate increased pressure for clear product safety data and consumer education. The identified HP knowledge gap necessitates enhanced product information, potentially including detailed interaction warnings on packaging or through digital channels, to mitigate liability. Regulatory bodies like Infarmed may introduce stricter guidelines for demonstrating product purity and confirming absence of adulterants, impacting formulation and quality control processes. Brand owners should consider investing in HP education programmes to build trust and market share, as improved HP-patient dialogue could drive informed purchasing decisions. This scenario presents an opportunity for brands that proactively address safety concerns and provide robust, research-backed formulations to differentiate themselves.
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