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Lucinda's Pearls: Supplementation Safety

Lucinda Harms, RPh, is the director of pharmacy at CarePro Compounding and Advance Health. I was reading the journal Hospital Pharmacy this morning and in the section entitled ISMP Adverse Drug Reactions was a short article about a study that was printed in the British Journal of Pharmacology in 2010. The study looked at 1000 consecutive hospital admissions and the frequency with which these 1000 patients were re-admitted to the hospital within 1 year of the original admission for an adverse drug reaction. The results are staggering. What they found was that 20.8% of patients were re-admitted to the hospital on an emergent basis due to an adverse drug reaction (ADR). Even more frightening is that almost all of the ADRs were classified as Type A-expected effects related to regular dosing of medications. A total of 64 different medications were involved in these ADRs. They ask the question, ‘What can we do about this valuable use of resources?’ Medications have a place in healthcare but sometimes we act like they are the only tool we have at our disposal.

Contrast this with the 2008 annual report of the American Association of Poison Control Centers, in which there were no reports of death related to a vitamin, mineral, amino acid or herb. Probably there were even fewer admissions to a hospital related to one of these substances! Nutritional supplements are a valuable tool that we can use in assisting our patients with their health concerns, prevention of chronic disease, treatment or amelioration of symptoms and other aspects of their health and well-being. We can view supplements as one more valuable tool in our toolbox in caring for our patients.

The question I would like to ask in response to the article I cited above is, ‘How can we better utilize our health care dollars by incorporating nutritional supplements into our personal health habits and those of our patients?’