Dietary Supplements

Cellini, Matthew; Attipoe, Selasi; Seales, Paul; Gray, Robert J.; Ward, Andrew; Stephens, Mark B.; Deuster, Patricia A.

doi:10.1249/mss.0b013e318269904f

Cited by 45 publications

(17 citation statements)

References 32 publications

(38 reference statements)

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“…This lack of knowledge also results in under-reporting of CAM-related adverse events. In fact, almost three in four physicians do not know how or where to report medication-related adverse events (33). MedWatch (http://www.fda.gov/Safety/MedWatch/HowToReport/default.htm) is one tool clinicians can use to report adverse events to the FDA (34).…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury

Hillman

Gottfried

Whitsett

et al. 2016

American Journal of Gastroenterology

104

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OBJECTIVES The increasing use of complementary and alternative medicines (CAMs) has been associated with a rising incidence of CAM-induced drug-induced liver injury (DILI). The aim of this study was to examine the clinical features and outcomes among patients with acute liver failure (ALF) and acute liver injury (ALI) enrolled in the Acute Liver Failure Study Group database, comparing CAM-induced with prescription medicine (PM)-induced DILI. METHODS A total of 2,626 hospitalized patients with ALF/ALI of any etiology were prospectively enrolled between 1998 and 2015 from 32 academic transplant centers. Only those with CAM or PM-induced ALI/ALF were selected for analysis. RESULTS A total of 253 (9.6%) subjects were found to have idiosyncratic DILI, of which 41 (16.3%) were from CAM and 210 (83.7%) were due to PM. The fraction of DILI-ALF/ALI cases due to CAM increased from 1998–2007 to 2007–2015 (12.4 vs. 21.1%, P=0.047). There was no difference in the type of liver injury—hepatocellular, cholestatic, or mixed—between groups as determined by R score (P=0.26). PM-induced DILI showed higher serum alkaline phosphatase levels compared with the CAM group (median IU/L, 171 vs. 125, P=0.003). The CAM population had fewer comorbid conditions (1.0 vs. 2.0, P<0.005), higher transplantation rates (56 vs. 32%, P<0.005), and a lower ALF-specific 21-day transplant-free survival (17 vs. 34%, P=0.044). CONCLUSIONS CAM-induced DILI is at least as severe in presentation as that observed due to PM with higher rates of transplantation and lower transplant-free survival in those who progress to ALF. This study highlights the increasing incidence of CAM-induced liver injury and emphasizes the importance of early referral and evaluation for liver transplantation when CAM-induced liver injury is suspected.

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Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury

Hillman

Gottfried

Whitsett

et al. 2016

American Journal of Gastroenterology

104

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“…Therefore, it is important to increase the number of adverse event reports from physicians and pharmacists. However, some physicians and pharmacists have inadequate knowledge about dietary supplements and do not know how or where to report adverse events [28, 29]. Furthermore, 28.0% of physicians and 35.1% of pharmacists were using dietary supplements themselves, while 20.6% of physicians and 35.1% of pharmacists had previously used dietary supplements in this present survey.…”

Section: Discussionmentioning

confidence: 81%

Behaviors of consumers, physicians and pharmacists in response to adverse events associated with dietary supplement use

Chiba

Sato

Kobayashi

et al. 2017

Nutr J

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BackgroundThe prevalence of dietary supplements has increased in Japan, and, as a consequence, the adverse events associated with dietary supplement use have become more prominent. Severe adverse events must be reported to the Japanese government via public health centers. However, the number of cases reported to the Japanese government is limited. To clarify this discrepancy, we conducted an internet questionnaire, and surveyed how consumers, physicians and pharmacists acted when they or their patients developed adverse events due to dietary supplement use.MethodsThis study was completed by 2732 consumers, 515 physicians, and 515 pharmacist via internet surveillance on November 2015.ResultsAlthough 8.8% of consumers developed adverse events including diarrhea, constipation, stomachache, headache, and nausea and vomiting, most of them did not report their adverse events to public health centers. However, some consumers went to hospitals because of adverse events. We also surveyed how physicians and pharmacists acted when their patients developed adverse events due to dietary supplement use. Most physicians and pharmacists did not report these cases to public health centers because they were unable to definitively prove the cause-and-effect relationship of these adverse events. Furthermore, some physicians and pharmacists did not know how or where to report these adverse events.ConclusionsWe clarified the reasons for the limited number of reports of adverse events to the Japanese government in this survey. It is important to encourage not only consumers, but also physicians and pharmacists to report adverse events to public health centers. In addition, an analyzing tool of cause-and-effect relationships might be helpful for physicians and pharmacists.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-017-0239-4) contains supplementary material, which is available to authorized users.

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“…[25] Without the knowledge that a patient is taking a DS, providers may be unable to write an inpatient order for the patient to use a DS home supply, discharge a patient home with a reconciled medication list, and appropriate counsel patients on stopping or restarting a DS. [26, 27]…”

Section: Discussionmentioning

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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Dietary Supplements

Cited by 45 publications

References 32 publications

Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury

Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury

Behaviors of consumers, physicians and pharmacists in response to adverse events associated with dietary supplement use

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

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