Cardiology clinicians neglect to determine patient use of nutraceuticals and OTC agents

The use of nutraceuticals and nonprescription over-the-counter (OTC) drugs may be high; however, the use of these agents may largely be ignored by cardiovascular clinicians, according to research published in the July 6 issue of the Annals of Internal Medicine.

Patricia Uber, pharmacist and assistant professor of medicine, University of Maryland School of Medicine, Baltimore, and colleagues evaluated the accuracy of the efforts made by cardiovascular clinicians in determining patient use of nutraceuticals and OTC drugs. They also measured clinicians’ attitudes toward assessing the use of these agents. These measures were determined in a prospective, single-blind, observational study of attending cardiology specialists (10 providers; 40 patient encounters) and cardiologists-in-training (11 providers; 38 patient encounters).

Fifty-four patients were identified as using 86 nutraceuticals and 45 OTC drugs. Cardiovascular clinicians identified use of nutraceuticals and OTC drugs during only 7 patient encounters, however.

Researchers observed attending cardiology specialists querying patients about nutraceutical and nonprescription OTC drug use during 2% of patient encounters. Yet cardiovascular clinicians estimated that they questioned patients about nutraceutical and nonprescription OTC drug use during 47.1% of patient encounters (57% for attending cardiology specialists and 38.2% for cardiologists-in-training). Just 5 providers overall asked at least 1 patient about use of these agents.

“It is possible that providers neglect evaluation of these agents because they consider them innocuous; lump them with dietary measures and lifestyle interventions; or consider them to be ‘natural’ and, therefore, safe and effective,” the authors wrote.