The Journal of Family Practice

Taking the Edge Off: Why Patients Choose St. John's Wort
Peggy J. Wagner, PhD; David Jester, MD; Bruce LeClair, MD; A. Thomas Taylor, PharmD; Lisa Woodward, RN; and Jerry Lambert, MD

 

Known to the public as St. John's Wort, Hypericum perforatum has gained popularity as an over-the-counter herbal antidepressant. The authors of this study report the reasons why patients choose to self-medicate with St. John's Wort rather than seek more conventional care from their physicians.

Background: The purpose of our study was to examine the reasons people choose to selfmedicate with St.John's Wort (SJW) instead of seeking care from a conventional health care provider.

Methods: Open-ended interviews with key questions to elicit information. Twenty-two current users of SJW (21 women, 20 white;mean age =45years) in a Southern City participated.

Results: Four dominant decision-making schemes were consistently noted.                                           1. Personal Healthcare Values: subjects had a hx of alternative medicine use and a belief in the need for personal control of health. 2. Mood: all SJW users reported a depressed mood and occasional irritability, cognitive difficulties, social isolation and hormonal mood changes. 3. Perception of seriousness of Disease and Risk of Treatment:SJW users reported the self-diagnosis of minor depression, high risk of prescription drugs, and a perception of safety with with herbal remedies; and 4.Accessibility Issues: subjects had barrier to and lack of knowledge of traditional health care providers and awareness of the ease of use and popularity of SJW. Also of note was the fact that some SJW users did not inform their primary care providers that they were taking the herb (6 of 22). Users reported moderate effectiveness and few side effects of SJW.

Conclusions:

SJW users reported depression, ease of access to alternative medicines, and a history of exposure to and belief in the safety of herbal remedies. Users saw little benefit to providing information about SJW to primary care physicians.

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