Communication Failure about Supplement Use between Patients and Physicians?

A new study by the Boston Medical Center suggests that patients who use dietary supplements may not be telling their physicians about their supplement use.

More than half of Americans may take dietary supplements regularly, but the majority of those supplement users might not be telling their physicians about their supplement use.

A new study of 558 inpatient records by the Boston Medical Center (Boston) revealed that only 6% of patients were asked by their physicians about dietary supplement use, disclosed that use to a physician, and had their dietary supplement (DS) use documented. In some cases, this lack of communication between physicians and their patients about supplement use can present a health hazard.

“If clinicians are unaware of possible drug-DS reactions, they may unknowingly provide a treatment plan or prescribe medications that could have an adverse reaction or interactions with the dietary supplement,” says Paula Gardiner, MD, lead author of the study and assistant director for the Program for Integrative Medicine and Health Care Disparities. She added that supplement use can also affect medical procedures such as surgery, chemotherapy, blood work, and others.

The study included 558 patients aged 18 and older who came from a “cohort of low-income, racially-diverse prescription medication users,” according to the study. All of the participants were treated at Boston Medical Center, with patient records collected from October 2008 to October 2010.

60% of the participants included in the analysis reported using dietary supplements. Among those supplement users, 36% had documentation of dietary supplement use in the medical chart, 20% were asked about supplement use by a provider, and 18% reported telling a provider about their supplement use. Overall, only 6% of participants were asked, disclosed, and had documentation of dietary supplement use.

“Research has shown that some of the reasons patients do not disclose dietary supplement use is because they either don’t know that physicians need the information, or sometimes there’s a fear of being judged by a clinician,” says Gardiner.

The study also suggested that documentation of medical supplement use “decreases with increasing patient age, and is lower among those who self-identify as Hispanic or a race other than Caucasian.”

In a press release, Gardiner highlighted the need for medical schools to educate tomorrow’s physicians “about the importance of DS dialogue with patients of all ages and cultural backgrounds.”

“Physicians need to establish a formalized approach to DS documentation to help prevent adverse reactions from dietary supplement-prescription medication interactions and ultimately to improve outcomes," says Gardiner.

Gardiner P et al. “Medical reconciliation of dietary supplements: don’t ask, don’t tell.” Patient Education and Counseling, vol. 94, no. 4 (April 2015): 512-517

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