Brown Bag Consults Reveal Undisclosed Supplement Use

Complementary and alternative medicine use isn't uncommon among seniors, but it can predispose them to polypharmacy.

Complementary and alternative medicine use isn’t uncommon among seniors, but it can predispose them to polypharmacy.

Through brown bag consults, pharmacists may be able to help identify seniors who use complementary and alternative treatments and recognize potential medication problems.

Patients may be unlikely to disclose their dietary supplement use, often because health care providers forget to ask or are uninterested. They may also think that their prescribers disapprove of this alternative therapy or believer it is irrelevant to their treatment.

Recently, pharmacists were included in a study published in the Journal of Geriatric Oncology that assessed complementary and alternative medicine use via brown bag consults among elderly ambulatory cancer patients.

The study authors examined 248 patients who received a comprehensive geriatric oncology assessment at 2 large senior adult oncology centers between January 2011 and June 2013.

The patients brought all of their medications to a session with a pharmacist to discuss medication possession and/or self-administration, indication, and adverse effects.

Herbal medications, minerals, and other dietary supplements were considered complementary and alternative medicines in the study.

The researchers found that complementary and alternative medicine use was associated with polypharmacy, age-related macular degeneration, and urinary complaints.

The study authors posited that adding pharmacists to the health care team reduced per-patient costs $230 and also curbed morbidity (eg, hospital admissions).

The researchers also found that more than 26% of enrolled patients used complementary or alternative medicine. Unlike a previous study that reported this prevalence at 46%, the current research excluded fish oil and multivitamins from its definition of complementary and alternative medication.

Patients 80 years and older were most likely to use complementary and alternative medicine—a finding that led the study authors to suggest the inclusion of more older patients into future similar studies.

Among these older patients, the authors also compared their results with a previous study that reported a complementary and alternative medicine prevalence of 12.5%. However, the current study enrolled a greater number of patients higher on the age spectrum, possibly explaining this difference.