Main findings

In this primary care study, the majority of participants reported regular use of home remedies, mainly for preventive purposes, self-care and as an alternative to conventional medicine. Only one-third of patients considered that it was the GP’s role to spontaneously inform them about home remedies, while another third considered that it was the GP’s role to inform them, but merely upon specific request. The last third of patients declared that it was not the GP’s role to provide information about home remedies.

Comparison with existing literature

In accordance with existing literature, use of non-pharmacological treatments is highly prevalent among primary care patients [1, 4, 6, 7, 13, 21, 22]. In a German study conducted in 2013 in a primary care setting, Parisius et al. found that NPHRs were widely known and used by about 80% of participants [1]. Our results were consistent with the German study population, and similarly, NPHRs were essentially used for prevention, self-care and as an alternative to conventional medicine (i.e. for common minor health problems in primary care as stated by Finley et al. and Wändell et al.) [22, 24, 25].

Several studies underlined the association between female gender and NPHR use [1, 3, 4]. According to our results, there seemed to be an association between NPHR use and female gender, but this association did not reach statistical significance. Sebo’s study investigating GPs’ perspectives on NPHRs also showed an association between female gender and the prescription of NPHRs [6], suggesting that GPs employment of such remedies for their patients may reflect their private use. This is in line with the traditional conception that the knowledge of home remedies came from the grandmother and was passed on by the female descendants [4]. At that time when the conservative family model was even more pronounced, women took on the “care-giving role” by looking after and caring for the whole family [4, 6]. However, our findings suggest that female gender is associated with the view that it is not the GP’s role to address NPHR use. This might be due to their greater responsibility for their health, since women are more likely to be actively involved in healthcare decisions than men [4, 6].

As previously shown in other studies [1, 6, 7], there was little discussion about NPHRs between patients and GPs (N = 65; 33.5%). Contrary to other studies in which patients reported that they would like to be informed by their GP about NPHRs [1, 6, 7], two-thirds of participants in our study did not endorse this view. Surprisingly, only one-third of NPHR users considered that the GP’s role was to spontaneously inform them about NPHRs.

Limitations

The canton of Geneva is a predominantly urban region. GPs participating in our study are not necessarily representative of all GPs practicing in Switzerland, as only 22.1% of the approached GPs agreed to participate, potentially representing a bias. However, the demographic profile of our patients is in line with the expected profile for our region. As all participants were recruited in the primary care context, our study does not necessarily reflect patients’ views in other healthcare contexts that may offer more common sources of information about home remedies.

In addition, comparisons with the few studies that have been published in this field are difficult, as there is no unanimous definition of home remedies. However, since this study is part of a research project on the use of NPHRs in primary care and paediatrics, currently performed by the University Institute for Primary Care of the Faculty of Medicine of Geneva, the same working definition was used for all studies. Consequently, comparison was easier with these studies, namely with Sebo’s study [6].

As to keep recall bias low, participants were asked about their NPHR use within the last 12 months. Recall bias should not be a problem per se since our project aimed at assessing only NPHRs used on a regular basis, and thus memory should not be impaired in this regard. During data collection it became apparent, however, that many patients were not always aware of their NPHR use, either because these were so naturally integrated into their habits or simply because they had not given thoughts to such use. Therefore, it might be assumed that the prevalence of NPHR use was somewhat underestimated in our study. The investigators refrained from further exploring this salience because it was considered a level of detail that could dilute the message of this study.

Implications for research and practice

NPHR use is highly prevalent among primary care patients in Western countries, but only poorly integrated into the doctor-patient discourse. The idea that GPs should inform their patients more about NPHRs is being ubiquitously propagated [1, 6,7,8]. Our study sheds new light on this conclusion: according to two-thirds of NPHR users in our study, GPs are not expected to spontaneously inform them about NPHRs. These remedies are basically used for common minor health problems in primary care [22, 24, 25]. It therefore seems relevant for GPs to advise their patients only if there is a need, without systematically exploring the use of NPHRs of each patient.

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