Terra Sigillata

This is a recipe for disaster: a demographic prone by need to polypharmacy, also using supplements, etc., without informing their primary care provider.

A joint study by AARP and NIH’s National Center for Complementary and Alternative Medicine reveal that nearly three-quarters of patients over age 50 do not discuss their use of complementary and alternative medicines and other over-the-counter medicines with their doctors.

“We know that people 50 and older tend to be high users of complementary and alternative medicine, but this study was the first to explore gaps in communications regarding the use of CAM between patients and their physicians,” said Cheryl Matheis, AARP Director of Health Strategies. “Communication is important to ensure the wise use of all conventional and CAM therapies.”

Hmm..not sure how comfortable I am with age 50 being the entry age for “older Americans.”

Among the findings of the survey:

A nationally representative group of 1,559 people age 50 or older, revealed some reasons why doctor-patient dialogue is lacking. Respondents most often did not discuss their CAM use with doctors because the physicians never asked (42 percent); they did not know that they should (30 percent); or there was not enough time during the office visit (19 percent). Interestingly, men who had seen a doctor were more likely than women not to have discussed CAM because their doctors never asked (46 percent versus 38 percent).

Nearly three-fourths of respondents said they take one or more prescription medications; in addition, 59 percent of respondents said they take one or more over-the-counter medications. Twenty percent of respondents reported taking more than five prescription medications.

The question I have is, “How comfortable are docs with responding to such queries from their patient?” Surely, anyone on a medicine with a low therapeutic index (i.e., Coumadin/warfarin, methotrexate, or anything where you are routinely being monitored for blood levels) should be counseled away from unnecessary supplements.

But the bottom line is that whether the medical community likes it or not, a very large number of Americans are using supplements. Most are using them in combination with prescription drugs. When unexplained problems arise, we usually blame it on the prescription drug.

Now that NCCAM has conducted surveys out the wazoo, it is now time to investigate the interactions of supplements with prescription drugs, particularly in “older” populations.