Navigating complementary and alternative medicine use, medication adherence, and herb–drug interaction risks among gout patients: a multicenter cross-sectional study in indonesia

OBJECTIVES: The use of complementary and alternative medicine (CAM) is increasing worldwide, specifically among gout patients, due to the perceived safety, low cost, and accessibility, but data on the usage remain limited. Therefore, this study aimed to assess the prevalence of CAM use, the predictors associated with CAM use, the impact on medication adherence, and the potential herb-drug interactions among gout patients. METHODS: This cross-sectional study was conducted from June to November 2024 across all 47 community health centers in Makassar City, Indonesia. The entire respondents were patients aged 18 years and older diagnosed with gout. Eligible respondents were recruited through direct questionnaire distribution, collecting data on socio-demographics, CAM and conventional medicine use, CAM perceptions, and medication adherence, while potential herb-drug interactions were assessed using the UpToDate database. RESULTS: Among the 430 respondents, 52.8 % reported using CAM, with herbal medicine being the most frequently used option. CAM use was significantly associated with prior experience (p<0.001) and influence from family or friends (p<0.001). A significant association was also found between CAM use and medication adherence (p<0.001), with a higher proportion of non-CAM users exhibiting high adherence (76.8 vs. 7.9 %) and a higher proportion of CAM users demonstrating poor adherence (8.4 vs. 0.5 %). Four potential herb-drug interactions were identified, namely ginger-aspirin (n=2), ginger-glibenclamide (n=1), honey-warfarin (n=1), and garlic-aspirin (n=1), suggesting a need for clinical monitoring. CONCLUSIONS: The frequent use of CAM among gout patients highlights the crucial role of healthcare practitioners in educating patients about safety, efficacy, and potential interactions. It also underscores the need for strategies to address medication non-adherence associated with CAM use and to monitor herb-drug interactions in clinical settings.