Medication and Dietary Supplement Interactions among a Low-Income, Hospitalized Patient Population Who Take Cardiac Medications

Abstract

Purpose. To identify characteristics associated with the use of potentially harmful combinations of dietary supplements (DS) and cardiac prescription medications in an urban, underserved, inpatient population. Methods. Cardiac prescription medication users were identified to assess the prevalence and risk factors of potentially harmful dietary supplement-prescription medication interactions (PHDS-PMI). We examined sociodemographic and clinical characteristics for crude (χ 2 or t-tests) and adjusted multivariable logistic regression associations with the outcome. Results. Among 558 patients, there were 121 who also used a DS. Of the 110 participants having a PHDS-PMI, 25% were asked about their DS use at admission, 75% had documentation of DS in their chart, and 21% reported the intention to continue DS use after discharge. A multivariable logistic regression model noted that for every additional medication or DS taken the odds of having a PHDS-PMI increase and that those with a high school education are significantly less likely to have a PHDS-PMI than those with a college education. Conclusion. Inpatients at an urban safety net hospital taking a combination of cardiac prescription medications and DS are at a high risk of harmful supplement-drug interactions. Providers must ask about DS use and should consider the potential for interactions when having patient discussions about cardiac medications and DS.

The Use of Nutritional Supplement in Romanian Patients – Attitudes and Beliefs

“…Nutritional supplements for sleep can determine the sudden discontinuation of treatment with benzodiazepines, for example, which can cause a rebound effect and withdrawal. The increased risks on adverse events when combining the prescribed drugs with medicinal products are also mentioned in previous studies that emphasize the dietary supplement interactions with medication for cardiovascular diseases or psychiatric, anticoagulant medication, because of their content in garlic, gingko, ginseng [6,11,12,16,19]. Achieving nutritional supplements from online shops or even supermarkets can lead to unjustified use of these products because there is no healthcare specialist to consult in these places and more over the untrusted source of purchasing can result in contaminated products with microorganisms or undeclared substances as presented before in similar studies [1,4,7,18,22,23].…”

“…There were taken into account variables such as age, gender, income level, education level. Thus, the patients were assessed using the items below: (1) The definition of food supplement; (2) The primary source of information to be taken into account when purchasing such a product; (3) The main reasons for buying nutritional supplements; (4) The observed differences in health status after using a nutritional supplement; (5) The assessment of health status after using the nutritional supplement is done by evaluating specific clinical parameters, such as laboratory tests; (6) The importance of medical advice when buying food supplements; (7) The influence of the price of a food supplement; (8) How many food supplements do they use; (9) What are the main categories of nutritional supplements that they use; (10) Where do they purchase these products; (11) Their knowledge about the legislative framework of nutritional supplements.…”

Beyond Nutrition Recommendations: What Healthcare Professionals Should Know about Dietary Supplements to Best Serve Their Patients

“…With the majority of adults taking some form of dietary supplements and many concomitantly taking prescription medications [15], healthcare providers should be conscientious of adverse effects [16] [17] [18] and interactions that may occur between dietary supplements and prescription drugs [19] [20]. The risk of adverse events and interactions increases with comorbidities and increasing number of prescription drugs [21]. Unfortunately, most patients do not voluntarily disclose dietary supplement use.…”

Adverse events associated with interactions with dietary and herbal supplements among inpatients

“…The interaction potentially decreases the cyclosporine blood level, with increased risk of transplant rejection . Some of these DHS–drug interactions have been studied in sub‐populations of outpatients, inpatients or people with specific comorbidities .…”