Analysis of transcripts of audio recordings from office visits by 1,477 patients to 102 primary care providers indicated that 37% of visits included a discussion of dietary supplements in 2009-2010, up from 22% in 1998-99.
The analysis focused on five major topics: The reason for taking the supplements, how to take supplements, their potential risks, their effectiveness, and their cost or affordability.
The most common discussion topic was the reason the patient was taking a dietary supplement (46.5%), followed by ‘how to take a supplement’ (28.2%).
"This is the first study to look at the actual content of conversations about dietary supplements in a primary care setting," said Dr Derjung Tarn, the study's primary investigator. "The bottom line was that discussions about meaningful topics such as risks, effectiveness and costs that might inform patient decisions about taking dietary supplements were sparse."
Commenting on the study’s findings, Judy Blatman, senior vice president, communications, for the Council for Responsible Nutrition (CRN), told us that she was pleased to see the researchers talk about the benefits as well as the risks of dietary supplements.
“Physicians should not scare patients into talking about their supplement use,” she said. “Two-thirds of adults in the US are taking supplements, and each of them has their own reasons for that. Physicians need to respect those reasons, and integrate them into their advice.
“There is a new crop of doctors, universities and medical schools who understand the important role of nutrition, and according to results of the CRN survey, doctors come up as top of the list of trusted sources for nutrition information.
“We are encouraged that consumers are being asked about their dietary supplement use.”
Blatman added that the association encourages consumers to think of their physicians and healthcare practitioners as partners in health. “You want your healthcare practitioner to know what you are putting into your mouth, not just because of drug-nutrient interactions, but also because some pharmaceuticals may deplete nutrient stores, like statins and CoQ10, for example.”
Healthy lifestyle choices
Results from the Life…Supplemented Healthcare Professionals Impact Study (HCP Impact Study) revealed that physician specialists are very likely to use dietary supplements (57 to 75%), and most of them may recommend dietary supplements to their patients (66 to 91%), she said.
In addition, recent data from the 2012 CRN Consumer Survey on Dietary Supplements indicated that supplement users seem to make healthier lifestyle choices compared to non-users, including exercising regularly, maintaining a healthy weight, and trying to eat a balanced diet.
The survey, which included a national sample of 2,006 adults aged 18 and older from Ipsos’ US on-line panel, revealed that 77% of all adults believe that taking supplements is a smart choice for a healthy lifestyle, with 53% of supplement users saying they took dietary supplements for overall health and wellness, and 35% saying it was to fill in nutrient gaps in their diet.
Results from the new UCLA study also indicated that more women than men discuss supplement use with their physicians. In addition, discussions were more likely to be about non-vitamin, non-mineral supplements such as herbs, compared with those about vitamins and minerals.
Commenting on the implications for practice, the authors wrote: “Since dietary supplements are available over the counter, patients can obtain them without a physician's knowledge. Yet some supplements may result in adverse events or interact with a patient's prescription medications.
“Physician–patient communication about a dietary supplement may influence a patient's decision to use a supplement, and may prevent patient harm.
“This study suggests that physicians could more frequently address topics that may influence patient dietary supplement use, such as the risks, effectiveness, and costs of supplements.”
Source: Patient Education and Counseling
June 2013, Volume 91, Issue 3, Pages 287-294, doi: 10.1016/j.pec.2013.01.021
“Physician–patient communication about dietary supplements”
Authors: D.M. Tarn, D.A. Paterniti, J.S. Good, I.D. Coulter, J.M. Galliher, R.L. Kravitz, A.S. Karlamangla, N.S. Wenger