Nutraceutical Drug Use Often Ignored by Clinicians

Use of nutraceuticals, OTCs appears high; cardiology providers rarely ask about them
By Beth Gilbert
HealthDay Reporter

WEDNESDAY, July 7 (HealthDay News) -- Although the use of nutraceuticals and nonprescription over-the-counter (OTC) drugs may be high among patients, cardiovascular clinicians may largely ignore the use of these agents among their patients, according to research published in the July 6 issue of the Annals of Internal Medicine.

In a prospective, single-blind, observational study of attending cardiology specialists (10 providers; 40 patient encounters) and cardiologists-in-training (11 providers; 38 patient encounters), Patricia Uber, of the University of Maryland School of Medicine in Baltimore, and colleagues evaluated the accuracy of cardiovascular clinicians' efforts in determining patient use of nutraceuticals and OTC drugs. The researchers also measured clinicians' attitudes toward assessing the use of these agents. A clinical pharmacist observed cardiovascular clinician and patient interactions and then questioned patients after clinicians left the room.

The pharmacist identified 54 patients who were using 86 nutraceuticals and 45 OTC drugs. However, cardiovascular clinicians identified use of nutraceuticals and OTC drugs during only seven patient encounters. In addition, the pharmacist observed attending cardiology specialists querying patients about nutraceutical and nonprescription OTC drug use during 2 percent of patient encounters, and cardiologists-in-training querying patients about the use of these agents during 16.3 percent of patient encounters. Yet, cardiovascular clinicians estimated they questioned patients about nutraceutical and nonprescription OTC drug use during 47.1 percent of patient encounters (57 percent for attending cardiology specialists and 38.2 percent for cardiologists-in-training). Just five providers overall asked at least one patient about use of these agents.

"It is possible that providers neglect evaluation of these agents because they consider them innocuous; lump them with dietary measures and lifestyle interventions; or consider them to be 'natural' and, therefore, safe and effective," the authors write.

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