A Cross-sectional Study of Provider and Patient Characteristics Associated with Outpatient Disclosures of Dietary Supplement Use

Overview

Journal Patient Educ Couns

Publisher Elsevier

Specialties Health Services
Nursing

Date 2015 Apr 14

PMID 25865413

Citations 14

Authors

Derjung M Tarn

Arun Karlamangla

Ian D Coulter

Debora A Paterniti

Lyndee Knox

Peter S Khang

Ka-Kit Hui

Neil S Wenger

Affiliations

Soon will be listed here.

Abstract

Objective: Explore patterns in patients' disclosures of supplement use and identify provider and patient characteristics associated with disclosures.

Methods: Cross-sectional study of 61 outpatient primary care, integrative medicine, and complementary medicine providers, and 603 of their patients. Primary outcomes were supplement disclosures (based on audio recorded office visits, post-visit patient surveys and medical record abstractions for the day of the visits).

Results: Seventy-nine percent of 603 patients reported on a post-visit survey that they took a total of 2107 dietary supplements. Of those taking supplements, 232 patients (48.6%) discussed at least one supplement with their provider on the day of their office visit. However, patients disclosed only 714 (33.9%) of the 2107 supplements they were taking. Patients more frequently disclosed supplement use when they saw providers who attributed greater importance to asking about supplements. Patient characteristics such as patient activation, number of medical conditions, and use of prescription medications were not associated with disclosure of supplement use.

Conclusions: Provider rating of the importance of asking about supplements is a major factor prompting patients' disclosures of supplement use.

Practice Implications: Provider-targeted interventions to encourage provider awareness about potential supplement-drug interactions are needed to increase disclosures about dietary supplement use.

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References

. NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention. NIH Consens State Sci Statements. 2007; 23(2):1-30. View

Huang H, Caballero B, Chang S, Alberg A, Semba R, Schneyer C . The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference. Ann Intern Med. 2006; 145(5):372-85. DOI: 10.7326/0003-4819-145-5-200609050-00135. View

Bjelakovic G, Nikolova D, Gluud C . Antioxidant supplements to prevent mortality. JAMA. 2013; 310(11):1178-9. DOI: 10.1001/jama.2013.277028. View

De Smet P . Herbal remedies. N Engl J Med. 2002; 347(25):2046-56. DOI: 10.1056/NEJMra020398. View

Qato D, Alexander G, Conti R, Johnson M, Schumm P, Lindau S . Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008; 300(24):2867-78. PMC: 2702513. DOI: 10.1001/jama.2008.892. View

EISENBERG D, Davis R, Ettner S, Appel S, Wilkey S, Van Rompay M . Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998; 280(18):1569-75. DOI: 10.1001/jama.280.18.1569. View

Robinson A, McGrail M . Disclosure of CAM use to medical practitioners: a review of qualitative and quantitative studies. Complement Ther Med. 2004; 12(2-3):90-8. DOI: 10.1016/j.ctim.2004.09.006. View

Peng C, Glassman P, Trilli L, Hayes-Hunter J, Good C . Incidence and severity of potential drug-dietary supplement interactions in primary care patients: an exploratory study of 2 outpatient practices. Arch Intern Med. 2004; 164(6):630-6. DOI: 10.1001/archinte.164.6.630. View

Mehta D, Gardiner P, Phillips R, McCarthy E . Herbal and dietary supplement disclosure to health care providers by individuals with chronic conditions. J Altern Complement Med. 2008; 14(10):1263-9. PMC: 2787410. DOI: 10.1089/acm.2008.0290. View

10.

Zou G . A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004; 159(7):702-6. DOI: 10.1093/aje/kwh090. View

11.

de Groot V, Beckerman H, Lankhorst G, Bouter L . How to measure comorbidity. a critical review of available methods. J Clin Epidemiol. 2003; 56(3):221-9. DOI: 10.1016/s0895-4356(02)00585-1. View

12.

Kennedy J, Wang C, Wu C . Patient Disclosure about Herb and Supplement Use among Adults in the US. Evid Based Complement Alternat Med. 2008; 5(4):451-6. PMC: 2586312. DOI: 10.1093/ecam/nem045. View

13.

Villegas J, Barabe D, Stein R, Lazar E . Adverse effects of herbal treatment of cardiovascular disease: what the physician must know. Heart Dis. 2002; 3(3):169-75. DOI: 10.1097/00132580-200105000-00007. View

14.

Miller L . Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998; 158(20):2200-11. DOI: 10.1001/archinte.158.20.2200. View

15.

Wittkowsky A . Dietary supplements, herbs and oral anticoagulants: the nature of the evidence. J Thromb Thrombolysis. 2007; 25(1):72-7. DOI: 10.1007/s11239-007-0110-0. View

16.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

17.

Gardiner P, Graham R, Legedza A, Eisenberg D, Phillips R . Factors associated with dietary supplement use among prescription medication users. Arch Intern Med. 2006; 166(18):1968-74. DOI: 10.1001/archinte.166.18.1968. View

18.

Kemper K, Amata-Kynvi A, Dvorkin L, Whelan J, Woolf A, Samuels R . Herbs and other dietary supplements: healthcare professionals' knowledge, attitudes, and practices. Altern Ther Health Med. 2003; 9(3):42-9. View

19.

Cupp M . Herbal remedies: adverse effects and drug interactions. Am Fam Physician. 1999; 59(5):1239-45. View

20.

Corbin Winslow L, Shapiro H . Physicians want education about complementary and alternative medicine to enhance communication with their patients. Arch Intern Med. 2002; 162(10):1176-81. DOI: 10.1001/archinte.162.10.1176. View