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Complementary and alternative medicine

Drug interactions with dietary or herbal supplements could be cause of hospital stays

Around 1 in 55 hospital admissions may have been caused by an adverse event triggered by a reaction between a dietary or herbal supplement and another medicine or supplement, according to Israeli research.

As a result, the researchers say their findings suggest that medical staff need further education about the role dietary or herbal supplements may have in adverse events.

Reporting their findings in the British Journal of Clinical Pharmacology[1] (online, 25 November 2016), the authors looked at 947 patients admitted to 12 departments at a tertiary level medical academic centre in Haifa, Israel.

They discovered that 458 patients used supplements and that the supplements may have been the cause of an adverse event in 17 (or 3.7%) of cases.

They deemed another 14 interactions “probably” down to supplements, where another 11 cases were “possibly” down to supplements.

The team also discovered that adverse events were more common in older patients (P=0.025, 95% CI: 2.26–19.7) and patients born outside Israel (P=0.025, 95% CI: 0.03–0.42).

They were also more common in patients with ophthalmologic (P=0.032, 95% CI: 0.02–0.37) or gastrointestinal (P=0.008, 95% CI: 0.05–0.46) comorbidities and also amongst those patients who used higher numbers of supplements (P<0.0001, 95% CI: 0.52–2.48) or drugs (P=0.027, 95% CI: 0.23–3.77).

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20202016

Readers' comments (1)

  • "...supplements may have been the cause of an adverse event in 17 (or 3.7%) of cases.

    They deemed another 14 interactions "probably" down to supplements, where another 11 cases were "possibly" down to supplements..."

    Oh, really? That seems a little blinkered. I think we are being encouraged to come away with the wrong message there.

    Did this paper work out how many of those adverse reactions, those with supplements as the 'cause', would have happened in the absence of the medication(s) involved?

    And how many adverse reactions to those medications occur alongside normal healthy nutrition?

    There's an impolite term for the kind of conclusion that was reached.

    Yes, syllogisms occur, but it take two or more to tango.

    A basic distrust of the thing that isn't the familiar pharmaceutical is hardly helpful, and comes down to prejudice and sometimes superstition.
    Patients will just choose to conceal their supplement use if they meet with antipathy, which could lead to worse outcomes than recognising that it's the medications that are for the most part dangerous if used incorrectly.

    If patients choose to use supplements which they find are helpful or even curative, but alongside which prescribed medications may be dangerous in combination, then clearly the total situation should be monitored and the prescripton altered or dose adjusted.

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