Article Text
Abstract
Background Due to the increasing number of supplementary products and patients taking supplements (dietary supplements, herb drugs, vitamins, etc) and OTC medications during their therapy, healthcare professionals have to take up the challenge of getting to know these products and identify any unwanted effects and drug–supplement interactions.
Purpose In association with the department of psychiatry and psychotherapy we purposed to identify patients’ motivation for supplement use, and evaluate and analyse potential interactions between drugs and supplement products in a patient group with unipolar major depression. We also aimed to estimate patient adherence to medical treatment.
Material and methods In our study, we involved 54 inpatients and outpatients (men 16, women 38) in a point of care survey of 40–50 min. After voluntary interviews with a pharmacist, we checked the medical records of the patients. To identify interactions, we used four English language interaction checker databases (Micromedex Interaction Checker, Lexi-Interact, Medscape Interaction Checker and Drugs.com). Regarding the heterogenous nomenclature of the active ingredients of supplements and the fact that a few medicines were only available in our country and in central Europe, we had to standardise our screening methods. For pharmacokinetic and pharmacodynamic properties, and chemical structure of the drugs, we substituted these active ingredients with others presented in the databases above. To estimate adherence, we asked patients to complete the Morisky Medication Adherence Scale-4 survey.
Results The average number of products taken by patients were 8.7 prescribed medicines and 4.7 supplements. 90.8% of the patients took at least 1 supplement during 1 month prior to the survey. We identified in these 49 patients 68 supplement ingredients, 123 interactions and, in case of 5 patients (9.3%), we analysed potential severe interactions related to the use of supplements. By screening for adherence, we found a rate of 25.5% of non-adherent patients.
Conclusion Pharmacists should consider that a significant number of patients are taking supplements without any control of healthcare professionals, so they are exposed to the risk of severe interactions. We should aim to educate patients and improve interaction checker databases regarding supplement screening.
References and/or acknowledgements This work was supported by the MGYT-KGYSZ.
No conflict of interest