Use of Herbal Remedies by Hispanic Patients: Do They Inform Their Physician?

Howell, Laura; Kochhar, Komal; Saywell, Robert M.; Zollinger, Terrell W.; Koehler, Julie; Mandzuk, Christina; Sutton, Brittany; Sevilla-Martir, Javier; Allen, Deborah I.

doi:10.3122/jabfm.19.6.566

Cited by 90 publications

(76 citation statements)

References 31 publications

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“…There has been little investigation of patientclinician communication about TM/CAM in ethnic minority populations. 10,19,[27][28][29][30] Although TM/CAM use is common in ethnic minority primary care populations, [31][32][33][34][35][36][37][38][39][40][41] research conducted on disclosure and discussion of TM/CAM with primary care clinicians shows it is limited at best. 6,37,38 Nondisclosure is found to be more common among minority groups, including Hispanics and Native Americans, as well as among indigent patients.…”

Section: Discussionmentioning

confidence: 99%

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Shelley¹,

Sussman²,

Williams³

et al. 2009

The Annals of Family Medicine

204

156

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PURPOSE Although high rates of traditional medicine and complementary and alternative medicine (TM/CAM) use have been well documented, there has been less attention to the factors infl uencing communication between patients and their primary care clinicians about TM/CAM. Such communication can be important in anticipating possible drug-herb interactions and in assuring agreement about therapeutic plans. METHODSWe used sequential, multistage, qualitative methods, including focus groups, in-depth interviews, and a video vignette, to explore communication about TM/CAM between patients and their primary care clinicians. The study was conducted in RIOS Net (Research Involved in Outpatient Settings Network), a Southwestern US practice-based research network, situated largely in Hispanic and American Indian communities where TM/CAM is an important part of self-care. RESULTSOne hundred fourteen patients, 41 clinic staff members, and 19 primary care clinicians in 8 clinic sites participated. The degree and nature of TM/ CAM communication is based on certain conditions in the clinical encounter. We categorized these fi ndings into 3 themes: acceptance/nonjudgment, initiation of communication, and safety/effi cacy. Perceived clinician receptivity to and initiation of discussion about TM/CAM strongly infl uenced patients' decisions to communicate; perceived clinician expertise in TM/CAM was less important. Clinicians' comfort with patients' self-care approaches and their level of concern about lack of scientifi c evidence of effectiveness and safety of TM/CAM infl uenced their communication about TM/CAM with patients. CONCLUSIONS Specifi c communication barriers limit patient-clinician communication about TM/CAM. Clinicians who wish to communicate more effectively with their patients about these topics and better integrate the types of care their patients use can change the communication dynamic with simple strategies designed to overcome these barriers. INTRODUCTIONT he use of traditional, complementary, and alternative medicine is widespread, 1-4 although most users of traditional medicine and complementary and alternative medicine (TM/CAM) 2 also use allopathic care. 3 There are numerous studies, however, documenting a lack of communication in the conventional care setting between patients and their primary care clinicians about patients' use of TM/CAM. [5][6][7] Patient-centered communication is an evolving construct unifi ed by a set of core values defi ned by Epstein et al as a set of strategies (or a "way of being") designed to enhance a sense of partnership in the patient-clinician 8 Applied to TM/CAM use, patient-centered communication can be important because it may (1) result in closer agreement between the clinician and patient about treatment plans, (2) reduce misunderstandings between patients and clinicians, (3) uncover potential herb-drug interactions, (4) strengthen the quality of the patient-clinician relationship, and (5) provide an opportunity to discuss specifi c TM/CAM modalities with high-qu...

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Section: Discussionmentioning

confidence: 99%

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Shelley¹,

Sussman²,

Williams³

et al. 2009

The Annals of Family Medicine

204

156

View full text Add to dashboard Cite

show abstract

“…[8][9][10][11] A more integrated and inclusive approach to healing that provides a wider range of treatment choices may improve patient satisfaction, decrease costs (by avoiding expensive…”

Section: N the Report Complementary And Alternative Medicine In Thementioning

confidence: 99%

Patient and Clinician Openness to Including a Broader Range of Healing Options in Primary Care

Hsu

Cherkin

Hoffmeyer

et al. 2011

The Annals of Family Medicine

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PURPOSE We studied the openness of patients and clinicians to introducing a broader range of healing options into primary care.METHODS Focus groups were conducted with primary care patients (4 groups) and clinicians (3 groups) from an integrated medical care system in 2008. Transcripts of discussions were analyzed using an immersion/crystallization approach. RESULTSBoth patients (n = 44) and clinicians (n = 32) were open to including a wider variety of healing options in primary care. Patients desired some evidence of effectiveness, although there was wide variation in the type of evidence required. Many patients believed that the clinician's personal and practice experience was an important form of evidence. Patients wanted to share in the decision to refer and the choice of options. Clinicians were most concerned with safety of specifi c treatments, including some of the herbs and dietary supplements. They also believed they lacked adequate information about the nature, benefi ts, and risks of many alternatives, and they were not aware of local practitioners and resources to whom they could confi dently refer their patients. Both patients and clinicians were concerned that services recommended be covered by insurance or be affordable to patients. CONCLUSIONSIntegrating additional healing options into primary care may be feasible and desirable, as well as help meet the needs of patients with conditions that have not been responsive to standard medical treatments.

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“…Los aspectos de eficacia y especialmente de seguridad de estos productos en las personas mayores son un tema pendiente de investigación, por consiguiente es sumamente importante la vigilancia y observaciones de los pocos datos que tienen al respecto en la actualidad. Existe un grado importante de desinformación sobre los riesgos de la medicina herbaria (13) .…”

Section: Paso 2 Hacer Una Lista De Medicina Herbaria Del Pacienteunclassified

Uso seguro de los medicamentos en adultos mayores: una lista de chequeo

Oscanoa

2014

Rev Peru Med Exp Salud Publica

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Use of Herbal Remedies by Hispanic Patients: Do They Inform Their Physician?

Cited by 90 publications

References 31 publications

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

'They Don't Ask Me So I Don't Tell Them': Patient-Clinician Communication About Traditional, Complementary, and Alternative Medicine

Patient and Clinician Openness to Including a Broader Range of Healing Options in Primary Care

Uso seguro de los medicamentos en adultos mayores: una lista de chequeo

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