Practice of traditional Chinese herbal medicine shops in central London

Abstract

The popularity of traditional Chinese herbal medicine (TCHM) in the UK raises questions about the safety of practice of TCHM retail outlets/ shops. This pilot study involving twelve TCHM outlets included interviews with six employees to understand some aspects of TCHM practices in London and to assess the feasibility of undertaking this type of work. Overall, eight shops displayed names of medical uses/conditions at their premises. There were 274 occurrences of 137 different terms for uses/conditions displayed; after classification by British National Formulary 49 chapters, the most frequent therapeutic categories to which displayed uses/conditions belonged were Central Nervous System (n = 53/274; 19.3%), Obstetrics, Gynaecology and Urinary-tract Disorders (14.2%) and Skin (13.5%). Most staff interviewed believed TCHM was more effective for chronic problems, and inappropriate for acute conditions. Interviewees considered TCHM safer than western medicines. Interviewees used several strategies to ensure safe and effective practice of TCHM, e.g. giving medical advice to customers. Adverse effects (AEs) occurring during TCHM treatments were considered part of the normal response (e.g. diarrhoea is ‘‘expected’’ with treatments for ‘‘clearing heat’’). Staff’s actions to reported AEs included asking customers to stop taking medicines and consulting colleagues. There are areas where interviewees described behaviours or expressed opinions suggesting a lack of awareness of current safety issues; communication of information on herbal safety between the UK competent authority for regulating medicines and TCHM shops appears to be inadequate.