Asking patients the right questions about herbal and dietary supplements: Cross cultural perspectives

Ben‐Arye, Eran; Halabi, Inbal; Attias, Samuel; Goldstein, Lee H.; Schiff, Elad

doi:10.1016/j.ctim.2014.01.005

Cited by 22 publications

(12 citation statements)

References 35 publications

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“…This requires an awareness and understanding of the terms and concepts, whether scientific (e.g., Ephedra foeminea Forssk ) or cultural (Alanda). An accurate botanical classification of the products in question should follow, with quantification of the active components through accepted scientific methods (e.g., high performance liquid chromatography, HPLC) and assurance of quality (e.g., good manufacturing practice, GMP), in order to rule out any contamination by toxic substances or conventional medications 27 .…”

Section: Discussionmentioning

confidence: 99%

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Ben‐Arye

Mahajna

Aly

et al. 2016

J Cancer Res Clin Oncol

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Context and objectives The unmonitored use of herbal medicinal remedies by patients with cancer presents a significant challenge to oncology healthcare professionals. We describe an increasingly popular herbal "wonder drug", Ephedra foemina (Alanda in Arabic), whose use has spread from the Palestinian patient population throughout the Middle East. We conducted a multi-centered and multidisciplinary collaborative research effort in order to understand the potential benefits and harms of this popular herbal remedy. Methods We conducted an in-depth search of the medical literature, both traditional and modern, for any mention of the clinical use of Alanda for the treatment of cancer. We then tested the remedy, first for toxic ephedra alkaloid components and then for anti-cancer effects, as well as effects on the cytotoxic activity of chemotherapy agents (cisplatin, carboplatin) on breast cancer cell cultures. Results We found no mention in the literature, both conventional and traditional, on the use of Alanda for the treatment of cancer. Laboratory testing did not find any toxic components (i.e., ephedra alkaloids) in the preparation. However, in vitro exposure to Alanda led to a reduced cytotoxic effect of chemotherapy on breast cancer cell cultures. Conclusions The use of an integrative ethno-botanical, laboratory and clinical research-based approach can be extremely helpful when providing non-judgmental and evidence-based guidance to patients with cancer, especially on the use of traditional herbal medicine. The effectiveness and safety of these products need to be examined by integrative physicians (IPs) who are dually-trained in both complementary medicine and supportive cancer care.

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Section: Discussionmentioning

confidence: 99%

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Ben‐Arye

Mahajna

Aly

et al. 2016

J Cancer Res Clin Oncol

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“…Clinicians with culturally sensitive language can improve DS history taking. [8] Inpatient socio-demographic and clinical factors associated with the presence of medical chart documentation of DS has not been determined. If clinicians are unaware of possible adverse reactions or if they do not document information about use in the medical chart, they may unknowingly provide a treatment plan or prescribe medications that have potential adverse reactions or interactions with DS.…”

Section: Introductionmentioning

confidence: 99%

Medical reconciliation of dietary supplements: Don’t ask, don’t tell

Gardiner

Sadikova

Filippelli

et al. 2015

Patient Education and Counseling

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Objective To explore inpatient reconciliation of dietary supplement (DS) use and determine characteristics associated with DS documentation. Methods We analyzed DS use among 558 inpatients recruited from the Re-Engineered Discharge clinical trial to identify: 1) if patients self-reported DS and 2) if DS use was documented at admission. We examined socio-demographics for association with documentation using chi squares and t-tests. Logistic regression was performed to assess adjusted associations with DS documentation. Results Sixty percent reported DS use (n=333). Among users, 36% had admission DS documentation, 20% were asked about use at admission, 18% reported disclosing use to a provider, and 48% reported they would continue to use DS. Overall, 6% of participants were asked, disclosed, and had documentation of DS. Logistic regression revealed increased age associated with lower odds of DS documentation. Identifying as Hispanic or African American reduces DS documentation odds compared to those identifying as white. Conclusions There is lack of consistent DS medical reconciliation in the inpatient setting. While more than half of patients used DS prior to hospitalization, most were not asked about use on admission. Practice Implications This study adds to literature on medical reconciliation which requires that providers inquire and document patient DS use.

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“…The use of keywords that address sociocultural diversities can facilitate careful history taking about DHS use. Moreover, promoting access to outpatient medical files and encouraging physicians and herbal practitioners to report on the use of supplements can help hospitals collect accurate information about DHS use.…”

Section: Discussionmentioning

confidence: 99%

“…The study, part of an overarching study on various aspects of DHS use among hospitalized patients, was reviewed and approved by the Institutional Ethics Committee of Bnai‐Zion Medical Centre in accordance with the Helsinki Declaration. The research database was used for diverse research goals, and some data overlapped between the different studies . Figure shows the flowchart of the present research methodology.…”

Section: Methodsmentioning

confidence: 99%

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Adverse events associated with interactions with dietary and herbal supplements among inpatients

Levy

Attias

Ben‐Arye

et al. 2016

Brit J Clinical Pharma

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AIMSDietary and herbal supplements (DHS) are commonly used among inpatients and may cause interactions with drugs or other DHS. This study explored whether adverse events were actually associated with such interactions and examined specific characteristics among inpatient DHS users prone to such adverse events. METHODSThis was a cross-sectional study of 947 patients hospitalized in 12 departments of a tertiary academic medical centre in Haifa, Israel. It evaluated the rate of DHS use among inpatients, the potential for interactions, and actual adverse events during hospitalization associated with DHS use. It also assessed whether DHS consumption was documented in patients' medical files. Statistical analysis was used to delineate DHS users at risk for adverse events associated with interactions with conventional drugs or other DHS. RESULTSIn 17 (3.7%) of the 458 DHS users, an adverse event may have been caused by DHS-drug-DHS interactions. According to the Drug Interaction Probability Scale, 14 interactions 'probably' caused the adverse events, and 11 'possibly' caused them. Interactions occurred more frequently in older patients (P = 0.025, 95% CI: 2.26-19.7), patients born outside Israel (P = 0.025, 95% CI: 0.03-0.42), those with ophthalmologic (P = 0.032, 95% CI: 0.02-0.37) or gastrointestinal (P = 0.008, 95% CI: 0.05-0.46) comorbidities, and those using higher numbers of DHS (P < 0.0001, 95% CI: 0.52-2.48) or drugs (P = 0.027, 95% CI: 0.23-3.77). CONCLUSIONSApproximately one in 55 hospitalizations in this study may have been caused by adverse events associated with DHS-drug-DHS interactions. To minimize the actual occurrence of adverse events, medical staff education regarding DHS should be improved. British Journal of Clinical PharmacologyBr J Clin Pharmacol (2017) 83 836-845 836

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Asking patients the right questions about herbal and dietary supplements: Cross cultural perspectives

Cited by 22 publications

References 35 publications

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Medical reconciliation of dietary supplements: Don’t ask, don’t tell

Adverse events associated with interactions with dietary and herbal supplements among inpatients

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