Grant: Partnerships for Health System Improvement (PHSI)

Nearly 73% Canadians use natural health products (NHPs) such as herbal medicines, vitamins and essential fatty acids etc, often assuming natural means safe. Studies show that patients who use NHPs and prescription medications concurrently are putting themselves at increased risk for adverse events that negatively affect quality of life, cost of care (more office and hospital visits, prolonged therapy), as well as potentially life-threatening events. Commonly used NHPs such as ginseng, echinacea, St. Johns wort, black cohosh, garlic, gingko, cranberry and soy may interact with medications, leading to increased adverse effects. We suggest that mental health patients experience more clinically relevant NHP-drug interactions since they are a vulnerable population at high risk for co-morbidities and also indulge in polypharmacy. We propose to implement our active surveillance program to identify serious NHP AE in mental health clinics and to partner with scientists to investigate their mechanism of action. We will ask patients coming to our participating clinics for concurrent NHP and prescription medication use, and presence/absence of adverse events by a simple questionnaire. Patients experiencing a serious, severe, or unexpected adverse reaction will be invited to participate in a telephone interview conducted by our study team and if appropriate, requested to send product samples via courier; to our participating labs for analysis. Our research team has expertise in NHP AE active surveillance, laboratory expertise to evaluate mechanism(s) of action, and the collaboration of participating clinics, including clinical expertise to adjudicate suspected adverse events. Findings from our innovative active surveillance will be relevant to policy-makers such as Health Canada, and other partnering organizations. It provides sharing of data between researchers, clinician scientists, and care providers as well as end user mental health network organization.