Making Time to Ask About Dietary Supplements

Dietary supplementation with vitamins, minerals, and other substances is widespread, and medical talk shows like The Doctors and Dr. Oz sometimes promote such supplement use.

Professional organizations often remind their members to document supplements and screen for food or drug interactions or side effects. Furthermore, the Joint Commission wants health care professionals to treat supplements just like they would prescription medication. Nevertheless, providers don’t always make note of supplement use.

Now, researchers have attempted to quantify how often health care professionals ask about supplements, and more importantly, how often they don’t. The investigators analyzed dietary supplement use among 558 patients recruited from the Re-Engineered Discharge clinical trial to determine the subjects’ self-reported dietary supplement use and then compare actual rates with admission documentation.

While 60% of the patients indicated that they used dietary supplements routinely, the clinicians fell short of expectations, documenting supplement use in only 36% of admission notes. In addition, only 20% of patients were asked about supplements, and just 18% actually told a health care professional about their supplement use. Overall, 6% of participants met all criteria of medication reconciliation, meaning they were asked about dietary supplementation, disclosed it, and had documentation on it.

Almost half of the patients said they planned to continue taking supplements. Older patients were less likely to be asked about or have documentation confirming supplement use, as were patients who self-identified as Hispanic or African-American.

The researchers noted that “failure to document infringes on Joint Commission standards and also opens the door for adverse reactions.” However, they acknowledged that communication barriers might cause the omissions, so they encouraged honest and comprehensive discussion about all medication, supplement, and health concerns.