Disclosure of complementary medicine use to medical providers: a systematic review and meta-analysis

Foley, Hope; Steel, Amie; Cramer, Holger; Wardle, Jon; Adams, Jon

doi:10.1038/s41598-018-38279-8

Cited by 143 publications

(147 citation statements)

References 118 publications

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“…The rates of patients' disclosure of dietary supplements or other complementary or alternative medicine use to health professionals vary. A meta-analysis showed that the disclosure rate of complementary medicine was 33% [31]. In the present study, less than one-third of mothers of concomitant users had consulted with health professionals about their children's dietary supplement use.…”

Section: Discussionmentioning

confidence: 49%

Concomitant Use of Dietary Supplements and Medicines Among Preschool and School-Aged Children in Japan

et al. 2019

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Dietary supplement use is widespread amongst the general population including in children and adolescents. The ingredients in dietary supplements can interact with medicines when patients take them concomitantly. However, the prevalence of the concomitant use of dietary supplements and medicines in Japan among children remains unclear. To clarify this issue, a nationwide internet survey was administered to 55,038 mothers (25 to 60 years old) of preschool- or school-aged children in Japan. Among them, 7.6% currently provide dietary supplements and 3.2% concomitantly provide dietary supplements and prescription or over-the-counter medicines to their children. The prevalence of concomitant use increased with the children’s grade. Among 1057 mothers with 1154 children who were concomitantly using dietary supplements and medicines, 69.1% provided dietary supplements without physician consultation because they considered dietary supplements as only foods and therefore safe. Although the purpose of the use and types of dietary supplement differed between boys and girls, the most popular product was probiotics in both boys and girls. Among concomitant users, 8.3% of mothers gave dietary supplements for treatment of diseases and 4.9% mothers recognized the adverse events of dietary supplements in their child. The findings of this study suggest that mothers’ knowledge about the risk of using dietary supplement with medicines is insufficient. Parental education about the safety of dietary supplements and potential risk of drug–supplement interaction is needed.

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Section: Discussionmentioning

confidence: 49%

Concomitant Use of Dietary Supplements and Medicines Among Preschool and School-Aged Children in Japan

et al. 2019

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“…Whether this observation of increasing disclosure is due to the location of the OCC within an academic center, to differences in population of the 2 surveys, or to changes over time cannot be determined by this study. In addition to in national surveys, disclosure patterns have also been reported in studies at primary care centers 6,7 and in specific patient populations, 8 such as low-income diabetes patients, 9 and women with HIV, 10 with varying rates of disclosure reported. Since our study at an integrative medical center differed from prior studies examining national, local, or targeted patient populations, our findings are difficult to compare directly.…”

Section: Discussionmentioning

confidence: 95%

Patient Disclosure of Complementary and Integrative Health Approaches in an Academic Health Center

Connor

Buring

Eisenberg

et al. 2020

Glob Adv Health Med

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Background: Effective patient-doctor communication about complementary and integrative health (CIH) is crucial to coordinate multimodal treatment for complex conditions. While rates of patient disclosure of CIH use to physicians have increased in the United States over the last 30 years, many patients still do not disclose these facts. Integrating CIH approaches within academic medical centers may enhance the communication, but this has not been explicitly studied. Objective: To examine rates of patient disclosure of CIH to physicians and reasons for nondisclosure. Methods: We surveyed 1177 patients at an academic center's CIH clinic regarding their CIH use and disclosure of CIH use to their physician. Results: Of the 1067 who responded to the disclosure questions, 80.1% had discussed their CIH use with their physician, while 19.9% did not. Of those who did not disclose, lack of physician inquiry was reported by 58% as the principal reason. Discussion: Within an academic center, there is still a need to improve communication about CIH use. Possible strategies might include continued education of both patients and physicians about CIH and communication skills and integration of CIH disclosure into routine patient health questionnaires.

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“…Findings reveal several factors promoting disclosure that have not been previously identified in the literature. Previous research suggests that a provider's "communication style [30]" (i.e. receptive/non-judg- on patient recall.…”

Section: Discussionmentioning

confidence: 99%

“…Because of such risks, the Food and Drug Administration (FDA) recommends that patients consult with a healthcare professional before using supplements [25]. However, most patients take dietary supplements on their own, and infrequently disclose their use to healthcare providers [7,[26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Categorization Of Supplementsmentioning

confidence: 99%

“…Conventional physicians' queries about supplement use are associated with disclosure [27]. And patients are more likely to disclose Complementary and Alternative Medicine (CAM) use, including dietary supplements, if a professional recommended the supplement [42], if it was used to treat a medical condition [42], or if patients believed the provider was knowledgeable or open-minded about CAM [26,30,38]. Disclosure may also be motivated by the belief that disclosure is important for safety or to help others with the same condition [30].…”

Section: Categorization Of Supplementsmentioning

confidence: 99%

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Factors Related to Disclosure and Nondisclosure of Dietary Supplements in Primary Care, Integrative Medicine, and Naturopathic Medicine

Guzman¹,

Paterniti²,

Liu³

et al. 2019

J Fam Med Dis Prev

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Background: Patients infrequently disclose use of dietary supplements to providers. Little is known about factors that motivate patients to disclose supplement use. The study aimed to identify reported factors motivating patients' disclosure and nondisclosure of dietary supplement use and explore differences based on type of supplement and provider practice. Methods: Mixed methods study combining qualitative content analysis of semi-structured interviews with statistical analyses to assess differences in identified factors by provider practice type and supplement type. Seventy-eight English-speaking patients who reported taking 466 dietary supplements in the previous 30 days were recruited from primary care and Complementary and Alternative Medicine (CAM), and Integrative Medicine (IM) offices in Southern California. Results: We identified nine themes related to disclosure and nine related to nondisclosure of dietary supplement use. Major themes were features of the office visit, circumstances in patient health and medical care, and provider/patient characteristics. The most commonly raised theme promoting disclosure of supplement use was provider inquiry. Patients associate disclosure with having concerns about a supplement but also with annual physical exams and some routine topics of discussion, including self-care, lab results, and new medication prescriptions. Themes related to nondisclosure included lack of provider inquiry, features of the office visit, such as supplements being unrelated to the visit purpose, and patients' convictions that supplements are safe or not important to discuss. Themes did not vary by supplement type. Primary care patients were more likely than CAM/IM patients to attribute nondisclosure to convictions that supplements were beneficial, not worth mentioning, or equivalent to food (p ≤ 0.001). Conclusions: When providers fail to ask directly about dietary supplement use, disclosure is often an impromptu decision that is driven by the content of provider-patient interactions. Ensuring disclosure of dietary supplement use to prevent potential drug-supplement interactions or adverse health outcomes likely requires consistent, proactive provider queries about supplement use.

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Disclosure of complementary medicine use to medical providers: a systematic review and meta-analysis

Cited by 143 publications

References 118 publications

Concomitant Use of Dietary Supplements and Medicines Among Preschool and School-Aged Children in Japan

Concomitant Use of Dietary Supplements and Medicines Among Preschool and School-Aged Children in Japan

Patient Disclosure of Complementary and Integrative Health Approaches in an Academic Health Center

Factors Related to Disclosure and Nondisclosure of Dietary Supplements in Primary Care, Integrative Medicine, and Naturopathic Medicine

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