INTRODUCTION TO HERBAL MEDICINE: Herbal Jeopardy

1. INTRODUCTION TO HERBAL MEDICINE:Herbal Jeopardy Kathi J Kemper, MD,MPH Caryl J. Guth Chair for Holistic & Integrative Medicine Wake Forest University School of Medicine Cora Breuner, MD, MPH Associate Professor Pediatrics University of Washington School of Medicine

2. AAP NCE Faculty Disclosure Information In the past 12 months, neither Dr. Cora Breuner nor Dr. Kathi Kemper have had a significant financial interest or other relationship with any Speakers Bureau, manufacturer(s) or provider(s) of any service(s) that will be discussed in our presentation. This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA

3. Objectives: By the end of this session, participants will be able to: • Describe which supplements are used most often by US children • Describe the risks and benefits of commonly used herbs and dietary supplements (HDS) • Identify and use reliable internet resources for information on herbs and DS

4. What it is NOT • Comprehensive overview of complementary medicine • Comprehensive overview of herbs and supplements More references on herbs, see review articles in Contemporary Pediatrics; AAP PIR; NIH NCCAM; See also WFUSM on-line classes: https://northwestahec.wfubmc.edu/learn/herbs_ce/index.cfm

5. What it IS • Fun introduction to herbs • Interest you in learning more • Provide resources • Potential enrollment in CME in more depth • https://northwestahec.wfubmc.edu/learn/herbs_ce/index.cfm

6. Who uses herbs and supplements? Do YOU use herbs or other dietary supplements regularly, ie. 4 or more days a week? Are you the only one?

7. It depends on how you define a supplement! FDA definition includes herbs; vitamins; minerals; amino acids; and other substances; or their constituents

8. Mayo Clinic 1999 Survey • Surveyed 200 adults getting check-ups • 31% reported using DS on written self-report • 61% reported using DS during structured interview • It depends on how you ask!!!! Hensrud, DD, et al. Mayo Clin Proc, 1999;74: 443-47

9. How many adults use supplements? • 10 – 19% of American Adults use herbs • 50% - 70% of American adults use multivitamins, calcium, Vitamin C, B vitamins, Vitamin E, iron, fish oil, etc. • 85% of professionals enrolled in our on-line course on herbs and supplements: multivits, vitamin C, B vitamins, fish oil, green tea, • Use is highest among women, middle and older ages; chronic health conditions; teenagers

10. How many kids receive supplements for colds? • 6 pediatric practices in Puget Sound (Dr. Jim Taylor, 1998) • 595 parents responded to anonymous survey • Treated kids’ previous colds with • Vitamin C: 47% • Echinacea: 34%

11. How many kids with chronic illnesses use HDS? • ADHD: 39% - 55% • Asthma: 15% - 30% • Cancer: 15% - 50% • Depression: >20% • IBD: 19% - > 50%

12. How many teenagers use HDS? • 2002 survey of 1200+ teens on-line • Lifetime CAM use: 79% CAM • Past month CAM: 48.5% CAM • Lifetime DS: 46.2% • Past month DS: 29.1% • Concurrently use DS and Rx: 9.3% • Higher use in older kids, those who smoke, drink and take drugs Wilson KM, et al. J Adolesc Med, 2006 Yussman SM, et al. J Adolesc Med, 2006

13. https://northwestahec.wfubmc.edu/learn/herbs_ce/index.cfm

16. JEOPARDY RULES • Two teams: RED and BLUE • We need three volunteers for each team • Score keeper: One volunteer • Judge: One volunteer to help decide which team answered first • Categories from top, down • Must wait until question has been read to answer it! You do not have to wait for all the answers to be read. • Lose points for wrong answers!