Doctors far from talking herbals to patients, survey

Another survey has highlighted a need for better communication between consumers and their physicians over the use of herbal supplements.

In a survey of 1,559 people age 50 and older, while 63 percent have used one or more complimentary and alternative medicine (CAM) therapies, only 31 percent of these have discussed it with their doctors. The survey, conducted by the National Center for Complementary and Alternative Medicine (NCCAM) and the nonprofit AARP, defined CAM as including products and practices such as herbal supplements, meditation, chiropractic care and acupuncture.

The survey adds to the body of reports and studies raising the issue of a lack of sufficient communication and information on herbals, which could hamper both the efficacy of these supplements - and, in some instances, result in interactions.

For example, a recent study at Yale School of Medicine suggested that black cohosh, a plant commonly used by breast cancer patients to alleviate the menopause-like side effects of therapy, may alter the effects anticancer drugs.

Other studies have linked herb drug interaction between St Johns Wort and selective serotonin re-uptake inhibitors or the contraceptive pill.

Yet, if the medical establishment does not address the practice of taking herbals, patients will not feel comfortable raising the issue with their doctor.

The main reason respondents cited for not telling their doctors about CAM therapies was that their doctors never asked.

The lack of dialogue is even more noteworthy when combined with findings from the study that pinpoint word-of-mouth as the predominant method respondents used to get CAM information.

Twenty-two percent of those surveyed said friends and family were their primary source of information on CAM. Next in line as a source of information on the subject was physicians, at 12 percent.

As such, the medical establishment could help to bridge the knowledge gap between consumers and their supplements.

"…communication between patients and physicians about CAM and conventional therapies is vital to ensuring safe, integrated use of all health care approaches," said the report. "It allows patients and physicians the opportunity to identify CAM practices that might be beneficial and also minimizes risks to a patient from potential therapy interactions."

The report also reveals that consumers with a higher education are more likely to take herbals, as part of their greater tendency towards all CAM therapies. Seventy-one percent of respondents using CAM therapies had a college degree or higher.

Those who graduated from college were also more likely to discuss CAM therapies with their doctors - 30 percent - compared with high school graduates - 16 percent.

While the use of CAM therapies is very slowly making inroads into mainstream Western medicine, it remains still very much isolated as an 'alternative' viewpoint and is therefore not taught in medical schools..

"Many physicians feel uncomfortable discussing CAM with their patients," said the study authors. "They cite a lack of knowledge about CAM."

The survey is entitled "Complementary and alternative medicine: what people 50 and older are using and discussing with their physicians" and was conducted in spring of 2006.