Patient Disclosure about Herb and Supplement Use among Adults in the US

Abstract

Analyses of 2002 National Health Interview supplement on complementary and alternative medicine (NHI%AM) indicate that approximately 38 million adults in the US (18.9% of the population) used natural herbs or supplements in the preceding 12 months, but only one-third told their physician about this use. The objectives of this study are: (i) to determine subpopulation rates of patient–physician communication about herbal product and natural supplement use and (ii) to identify the relative influence of patient factors and interaction factors associated with patient-physician communication about herb and supplement use. Logistic secondary analysis was done by using the complementary and alternative medicine supplement of the 2002 National Health Interview Survey. Subjects were a random stratified sample of US adults who used herbs in the past 12 months (n = 5 196) and self-reported rates of disclosure to physicians about herb and supplement use. Results show that disclosure rates were significantly lower for males, younger adults, racial and ethnic minorities and less intensive users of medical care. Across subpopulations, disclosure was the exception rather than the norm. Given the potential risks of delayed or inappropriate treatment and adverse drug reactions and interactions, physicians should be aware of herb and supplement use and counsel patients on the potential risks and benefits of these treatments.

Introduction to Complementary, Alternative, and Traditional Therapies

“…10 Despite the use of CAM by health care workers, nearly two-thirds of the users have reported not discussing their use of CAM with their physicians. 5,11 More recent studies 12 have indicated variable change in those disclosure rates; for instance, in cross-sectional surveys of pregnant women, disclosure rates of CAM use increased from less than 1% in 2006 to 50% in 2013. Disclosure rates in the United Kingdom are 20% to 40%.…”

Effects of Long-Term Use of Flavonoids on the Absorption and Tissue Distribution of Orally Administered Doses of Trace Elements in Rats

“…The concomitant intake of "supra-nutritional" flavonoid doses together with conventional drugs may lead to flavonoid-drug interactions [8]. Approximately 38 million adults in the US (18.9% of the population) use herbal products that contain flavonoids or other natural supplements, but only one third tell their physician about this use [9]. This lack of information, combined with the fact that natural products are usually a mixture of many active ingredients, increases the likelihood of harm.…”

Provider and Patient Expectations for Dietary Supplement Discussions

“…Given these concordant views, it is surprising that the majority of patients do not disclose their supplement use to their providers. [35][36][37][38] Both parties are to blame-providers frequently do not ask about patients' supplement use, 35,39 and patients may not think to let their providers know. 40 Although providers may have inadequate information or suboptimal training regarding supplements, 41,42 in their interviews they much more frequently cited the importance of discussing certain topics than did patients.…”