CME: Dietary Supplements & ED Visits

CME: Dietary Supplements & ED Visits

Herbal products, complementary nutritionals, and micronutrients are all considered to be dietary supplements. The Dietary Supplement Health and Education Act is a 1994 law that defined supplements as food rather than drugs. A consequence of this act is that manufacturers of these supplements are not required to prove that their products have benefits or demonstrate their safety. “Although these products cannot be marketed to treat or prevent disease, they are often taken to address symptoms or illnesses or to maintain or improve overall health,” says Andrew I. Geller, MD. The estimated number of supplement products has increased significantly over the past 2 decades. Recent reports show that about half of all adults in the United States have reported using at least one dietary supplement in the past month. Post-marketing reporting of adverse events from manufacturers of these supplements is required only for serious adverse events, and voluntary reporting may underestimate the adverse events associated with these products. There has been increasing public attention regarding post-marketing removal of some supplement products, which in turn has led to calls for changes in oversight.   Taking a Closer Look “Few clinical studies have examined the safety of dietary supplements that are still available on the market, and data are lacking to quantify the frequency of adverse events associated with dietary supplements in the U.S.,” says Dr. Geller. To address this issue, he and his colleagues had a study published in the New England Journal of Medicine that aimed to estimate the number of ED visits for adverse events relating to dietary supplements. They also sought to identify the associated characteristics of patients,...
Dietary Supplements & ED Visits

Dietary Supplements & ED Visits

Herbal products, complementary nutritionals, and micronutrients are all considered to be dietary supplements. The Dietary Supplement Health and Education Act is a 1994 law that defined supplements as food rather than drugs. A consequence of this act is that manufacturers of these supplements are not required to prove that their products have benefits or demonstrate their safety. “Although these products cannot be marketed to treat or prevent disease, they are often taken to address symptoms or illnesses or to maintain or improve overall health,” says Andrew I. Geller, MD. The estimated number of supplement products has increased significantly over the past 2 decades. Recent reports show that about half of all adults in the United States have reported using at least one dietary supplement in the past month. Post-marketing reporting of adverse events from manufacturers of these supplements is required only for serious adverse events, and voluntary reporting may underestimate the adverse events associated with these products. There has been increasing public attention regarding post-marketing removal of some supplement products, which in turn has led to calls for changes in oversight.   Taking a Closer Look “Few clinical studies have examined the safety of dietary supplements that are still available on the market, and data are lacking to quantify the frequency of adverse events associated with dietary supplements in the U.S.,” says Dr. Geller. To address this issue, he and his colleagues had a study published in the New England Journal of Medicine that aimed to estimate the number of ED visits for adverse events relating to dietary supplements. They also sought to identify the associated characteristics of patients,...

Guidance for Using CAM to Manage Pain

There are many different treatment options available to lessen the effects of chronic pain, improve functioning, and enhance quality of life. According to current estimates, more than 116 million Americans are living with chronic pain. Physicians who manage patients with chronic pain often find it challenging to treat because what works for one person doesn’t always work for another (see also, Striving Toward Quality Pain Management). Effective pain management plans must be individualized, and integrative approaches—which include a combination of treatment options—are often needed. CAM Use More Common to Manage Pain Complementary and alternative medicine (CAM) is increasingly being used by patients to assist in their fight against chronic pain. CAM has been defined as a group of diverse practices and products that are not generally considered part of conventional medicine as practiced by physicians and allied health professionals. CAM practices are often grouped into two broad categories: 1) natural products and 2) mind and body medicine. “More than 83 million people in the United States use some form of CAM therapy to manage and treat their health problems, including pain.” It’s estimated that more than 83 million people in the United States use some form of CAM therapy to manage and treat their health problems, including pain. More than $33.9 billion a year is spent on out-of-pocket visits to CAM practitioners and for the purchase of CAM products, classes, and materials. Some of the most common pain-related reasons people seek CAM therapies are for back, joint, and neck pain, arthritis, severe headaches or migraines, and fibromyalgia. An Important Initiative on CAM Education To further educate healthcare providers, the...