Vitamins and Supplements: What Do Patients Need?

If pharmacists practice at the top of their licenses, they will integrate rewarding work conducted in OTC aisles by looking at each patient’s total pharmacotherapy regimen—prescription medications, OTC products, and dietary supplements.

The Pharmacy Times’ Vitamins and Supplements Condition Center comes at an ideal time for 2 reasons. First, patients are using OTC vitamins and supplements more often than ever, and in ways that are increasingly supported by good evidence. Second, those very same patients need guidance in the OTC aisles, and pharmacists are OTC experts.

If pharmacists practice at the top of their licenses, they will integrate rewarding work conducted in OTC aisles by looking at each patient’s total pharmacotherapy regimen—prescription medications, OTC products, and dietary supplements.

Most Americans aspire to eat well. They’d like to eat a well-balanced diet and they understand that diets rich in fruits and vegetables provide important vitamins, minerals, and fiber. Regardless, it's hard to eat a well-balanced diet every single day. Some people are too busy to eat well. Some can’t afford or don’t have access to fresh, wholesome foods. Many of the patients we see are (or have been) ill. Still others eat restricted diets by choice or necessity.

How do we know which patients are most likely to need vitamins and supplements? The FDA recommends we ask patients these questions:

• Do you eat fewer than 2 meals per day? (Patients who skip meals often rely on prepared foods or foods that are empty of nutrients and rarely eat 5 servings of fruits and vegetables daily.)
• Is your diet restricted? (Patients who identify as vegan or vegetarian and do not eat animal-based foods may need vitamin B₁₂ supplementation. Patients who have serious food allergies may also need various supplements.)
• Do you eat alone most of the time? (People who eat alone usually don’t eat as well as they would with a partner or family. Without mealtime conversation, they may eat too quickly, forgo balanced meals, or gobble mindlessly in front of the television. They lose or gain weight quickly.)
• Without wanting to, have you lost or gained more than 10 pounds in the last 6 months? (Unexpected weight gain or loss is often related to poor food choices.)
• Do you take 3 or more prescription or OTC medicines a day? (If one of those drugs is an anticoagulant, interactions are a concern. If it’s a proton pump inhibitor, metformin, or if the patient is elderly, vitamin B₁₂ may be warranted.)
• Do you have 3 or more drinks of alcohol a day? (Chronic alcohol use depletes vitamins.)

This condition center will address the growing trends related to vitamins and supplements. We’ll look at latest research, and direct you to resources that can also help you answer questions. It will help you do what pharmacists should do: help patients use all pharmacotherapy rationally and safely.