Consideration of interactions and side effects of herbal medicines in German S3 guidelines of the Association of the Scientific Medical Societies (AWMF)

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Journal Article
Forschende Komplementarmedizin, 2016, 23 (3), pp. 154 - 164
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© 2016 S. Karger GmbH, Freiburg. Herbal remedies have a long history in the medical care of the German-speaking regions but they are rarely taken into account in the development of medical guidelines. In a prestudy, our working group analyzed as to how far herbal remedies were taken into consideration in the current interdisciplinary evidence- and consensus-based S3 medical guidelines established by the Association of the Scientific Medical Societies (AWMF) in Germany. The aim of this study was to analyze to what extent possible side effects and interactions of herbal remedies are mentioned in the S3 medical guidelines. In January 2015, 134 S3 guidelines were counted and analyzed. 27.6[%] (n = 37) of them show 194 statements summarized under the term 'phytotherapy'. References to side effects and interactions can be found in 28.4[%] of the statements (n = 55); 13.9[%] (n = 27) of these references are backed by the literature. 14 of the statements deal with nutritional supplements, 11 are statements about phytotherapy in general, and 7 summarize at least 2 medical plants in 1 statement. Hence, only 23 statements pay attention to side effects and interactions of individual medical plants; 14 of these are backed by the literature. These results do not correspond to the standards required by the AWMF, which is due to imprecise terms as well as to the insufficiently systematic approach in the search for scientific evidence for the safety of medical plants. Here, the Association for Phytotherapy may achieve an important contribution to quality improvement.
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