Dietary Supplements: Knowledge and Adverse Event Reporting Practices of Department of Defense Health Care Providers

Abstract

Introduction The purpose of the study was to assess the knowledge of dietary supplements (DS) and adverse event (AE) reporting practices of the Department of Defense health care providers. AEs related to use of DS are not uncommon. However, it is estimated that less than 2% of AEs are reported. This is problematic given the Food and Drug Administration relies on AE reports to identify and ultimately remove unsafe products from the market. Inadequate reporting of AE puts all DS users at risk. Materials and Methods Cross-sectional design was used. Electronic surveys were sent to the Department of Defense health care professionals (HCPs) and Emergency Medicine (EM) physicians asking questions about practices regarding DS and AE knowledge and reporting behaviors. The surveys were open for 5 months. During this period of time, HCPs received three email reminders following the initial email to enhance participation. The computer package IBM SPSS version 25 software (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 21.0, Armonk, New York) was used for statistical analysis. Frequency distributions of the responses were analyzed. Results Of the 1,700 surveyed, 270 HCPs and 68 EM physicians completed the surveys. At least 39% of HCPs reported never receiving formal DS training. Seventy-two percent of HCPs reported asking their patients about the use of DS. However, when asked if they knew where to report an AE, only 40% of HCPs knew where to report an AE and only 38% knew how to report an AE. Of the EM physicians, only 38% asked their patients about DS. However, a majority (78%) reported that they had encountered an AE. EM physicians also reported they lacked knowledge regarding where (87%) and how (87%) to report AE. Conclusions It is clear that physician and nonphysician HCPs would benefit from additional training about DS and how and where to report suspected AE. Providing regular training on risks, common AE, and how and where to report an AE would help fill the knowledge gap in the ever-changing DS industry. Addressing these issues and coming up with a solution to integrating AE reporting into clinical care could improve health care practices and increase AE reporting to the Food and Drug Administration, which would have a beneficial impact on patient care, public safety, and mission readiness.

Impact of Nutrition Education on Knowledge and Beliefs about Dietary supplements/Herbal foods: A pre - post intervention study

“…Similarly, 88.9% of the dietitians believed the positive relationship between adequate-balanced nutrition and the course of COVID-19 in a study (32). Studies reported that health professionals had low to moderate knowledge about DS/HF, and they may need additional education on DS/HF use (28, 31,33,34). Our study showed that the total knowledge scores of health professionals were 3.85 ± 1.60 and increased to 5.51 ± 1.45 signi cantly after education (p = 0.000).…”

“…Although DS/HF are widely recommended during COVID-19 pandemic, studies showed that health professionals may not be adequately informed about their use (28)(29)(30). Therefore, it is vital to provide additional training or information to health professionals on DS/HF use (31). Studies about health professionals' knowledge on DS/HF during the COVID-19 pandemic are limited however, one study reported that 94.5% of the dietitians used DS, and 46.1% used HF for the prevention of COVID-19 (32).…”

Challenges in Reporting Adverse Events From Dietary Supplements

“…Published reports indicate that 60% to 81% of HCPs have encountered an AE in association with a DS. [20][21][22] Despite observing such events, most HCPs report lacking the knowledge as to where and how to report such AE. [20][21][22] Interestingly, many do report the observed AE (10%-41%), but to various sources, including the hospital database, other specialists, Poison Control Center, and the like.…”

“…[20][21][22] Despite observing such events, most HCPs report lacking the knowledge as to where and how to report such AE. [20][21][22] Interestingly, many do report the observed AE (10%-41%), but to various sources, including the hospital database, other specialists, Poison Control Center, and the like. The FDA's Safety Reporting Portal is intended to streamline the process of reporting product safety issues to the FDA and the National Institutes of Health.…”

“…However, when data from the various studies are combined, estimates for reporting AEs to FDA's Safety Reporting Portal range from 0% to 15%. [20][21][22][23] Most of the AEs submitted to the FDA are not voluntary, but rather related to the postmarket surveillance requirement for manufacturers to report all serious AEs to the agency within 15 business days of receipt. 24 Also, if one wanted to review a FDA case record, a request must be filed under the Freedom of Information Act.…”