Viewpoint: CAM-Drug Interactions Often Overlooked
Viewpoint: CAM-Drug Interactions Often Overlooked
Taylor DM, Walsham N, Taylor SE, Wong L
Pharmacotherapy. 2006;26:634-640
Complementary and alternative medicine (CAM) includes any product (herbs, vitamins, minerals, natural products) that can be purchased without a prescription for the purpose of self-treatment. A significant number of patients incorporate these therapies into their treatment regimens, but they may not tell their healthcare providers about it. This study was conducted to determine the nature and prevalence of drug-CAM interactions in emergency department patients in Australia. The investigators also recorded the reasons that patients do not advise their providers of CAM use.
Patients presenting to a tertiary referral center in Melbourne, Australia, between February 2002 and March 2003 were included in the cross-sectional survey. A self-administered questionnaire was designed for the study. A total of 404 patients with a mean age of 50.6 years were enrolled; most (68.1%) were CAM users and reported using a total of 103 distinct therapies. Of the 275 CAM users, 157 also reported taking prescription medications. Potential drug-CAM interactions were identified in 3.3% of CAM users (15 potential drug-CAM interactions in 9 patients). The combination of St. John's wort and warfarin was the most commonly identified CAM-drug interaction. Additionally, 97 theoretical potential interactions were identified in 51 patients; the most common involved aspirin and chamomile.
Of the patients who used CAM therapies, 71.6% had not informed their caregivers about their CAM use. The 3 most common reasons cited for not informing the provider included:
Although this study was conducted in Australia, the findings can be extrapolated to other countries, including the United States. This information supports the need for increased awareness and education of consumers regarding CAM therapies and the potential for drug-CAM interactions. Patients must be educated to respect CAM therapies, just as they do traditional pharmaceutical products. As pharmacists, we should use this information to support more widespread screening for interactions, and encourage patients to discuss CAM use with all of their healthcare providers.
Abstract (PubMed) URL:
www.medscape.com/medline/abstract/16637793
Potential Interactions Between Prescription Drugs and Complementary and Alternative Medicines Among Patients in the Emergency Department
Taylor DM, Walsham N, Taylor SE, Wong L
Pharmacotherapy. 2006;26:634-640
Study Summary
Complementary and alternative medicine (CAM) includes any product (herbs, vitamins, minerals, natural products) that can be purchased without a prescription for the purpose of self-treatment. A significant number of patients incorporate these therapies into their treatment regimens, but they may not tell their healthcare providers about it. This study was conducted to determine the nature and prevalence of drug-CAM interactions in emergency department patients in Australia. The investigators also recorded the reasons that patients do not advise their providers of CAM use.
Patients presenting to a tertiary referral center in Melbourne, Australia, between February 2002 and March 2003 were included in the cross-sectional survey. A self-administered questionnaire was designed for the study. A total of 404 patients with a mean age of 50.6 years were enrolled; most (68.1%) were CAM users and reported using a total of 103 distinct therapies. Of the 275 CAM users, 157 also reported taking prescription medications. Potential drug-CAM interactions were identified in 3.3% of CAM users (15 potential drug-CAM interactions in 9 patients). The combination of St. John's wort and warfarin was the most commonly identified CAM-drug interaction. Additionally, 97 theoretical potential interactions were identified in 51 patients; the most common involved aspirin and chamomile.
Of the patients who used CAM therapies, 71.6% had not informed their caregivers about their CAM use. The 3 most common reasons cited for not informing the provider included:
The providers had not asked about CAM use.
The patients did not think CAM use was important.
The patients did not perceive CAM as drugs.
Viewpoint
Although this study was conducted in Australia, the findings can be extrapolated to other countries, including the United States. This information supports the need for increased awareness and education of consumers regarding CAM therapies and the potential for drug-CAM interactions. Patients must be educated to respect CAM therapies, just as they do traditional pharmaceutical products. As pharmacists, we should use this information to support more widespread screening for interactions, and encourage patients to discuss CAM use with all of their healthcare providers.
Abstract (PubMed) URL:
www.medscape.com/medline/abstract/16637793
