Friday, July 24, 2015

Many Hospital Patients Not Asked About Supplements

Most hospitalized Americans aren’t asked if they take dietary supplements, such as multivitamins, a new study suggests. Photo by ClipArtLord

“If clinicians are unaware of possible drug-[dietary supplement] reactions, they may unknowingly provide a treatment plan or prescribe medications that could have an adverse reaction or interactions with the dietary supplement,” said study author Dr. Paula Gardiner.

She is assistant director of Boston Medical Center;s program for integrative medicine and health care disparities.

“Dietary supplements also affect physiological processes in the body and could have an impact on medical procedures like surgery, chemotherapy, blood work and many other treatments or procedures,” she added in a medical center news release.

Nearly 18% percent of American adults (more than 40 million) take dietary supplements, according to the 2012 National Health Interview Survey.

The most commonly used dietary supplements are vitamins and minerals, the U.S. Centers for Disease Control and Prevention reports.  But other supplements may include herbs, amino acids or other substances, the study authors pointed out.

The study, published recently in the journal Patient Education and Counseling, looked at 558 hospital patients, more than half of whom (60%) used dietary supplements.

Of those 333 patients, only 36% had use of supplements documented at admission to the hospital.  Only 18% told a health care provider about their dietary supplements use, and only one in five were asked about dietary supplement use by a health care provider, the study found.

The ideal scenario is to be asked at admission about dietary supplement use, to disclose use of the products, and have their use documented in medical records.  But all three criteria were met for only 6% of the supplement users, the researchers found.

“Research has shown patients  either don’t know that physicians need the information or there’s a fear of being judged by a clinician,” Gardiner said.

Doctors need to establish a formalized approach to documentation to help prevent adverse reactions from dietary supplement-prescription medication interactions, Gardiner concluded.

My Take:
The medical response to dietary supplementation is non-sensical.  They claim that supplements are useless on one hand and dangerous on the other.  Regardless, this study indicates hospitals are negligent in meeting the minimum standards for record keeping.  That is the real danger.

The “ideal scenario” described above is nothing more than standard record keeping.  My entrance case history form asks the patient to list any and all supplements, just as it asks for any and all drugs, past surgeries, accidents, and a medical history.  I review this information with them and then record it all in my notes.  Often the verbal history elicits information the patient failed to record.  I also ask them why they take each of the supplements.  The answers are enlightening, and often amusing.

The Bottom Line:
Please give your physicians a list of dietary supplements and medications that will become a permanent part of your medical records.  Don't worry about being judged, maybe you will actually provide some education.

Source: June 24, 2015 National Institutes of Health

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