The incidence of potential interactions between dietary supplements and prescription medications in cancer patients at a Veterans Administration Hospital.

OBJECTIVE: The concurrent use of dietary supplements and prescription medications is common among patients with cancer. This study examines potential interactions between dietary supplements and prescription medications in a Veteran Hospital cancer population. METHODS: Eligible patients seen at the Hematology/Oncology clinic at the Veterans Administration Medical Center in Cincinnati, OH, were administered a survey to determine their use of dietary supplements. Medication profiles were compiled from patients' medical charts and pharmacy records. It was also noted whether supplementation was previously documented. Potential interactions between dietary supplements and prescription medications were identified from a literature search of documented interactions. Several demographic factors, including age, race, marital status, education and income, were assessed for differences between patients found to be at risk for interactions and those for whom no risks were identified. RESULTS: Dietary supplements were used by 61% of patients. Multivitamins were the most common supplement (80.3%) followed by minerals (40.6%) and herbal preparations (24.8%). Of the 121 patients taking supplements, 65 patients (54%) reported taking more than one. A potential risk for interaction between dietary supplement and prescription medication was identified in 12% of patients taking supplementations. Three patients were at risk for multiple interactions. Veterans who were not currently married were more likely to be at risk for interactions (P = 0.024). Only 28% of patients taking dietary supplements had this supplementation documented in their medical record. CONCLUSION: Dietary supplementation by a veteran cancer population is common. Interactions between the supplement and prescription medication is a potential problem. Patient-physician discussion and documentation of these issues should be systematically addressed.

The impact of cancer diagnosis on the lifestyle and habits of patients served at a Veterans Administration Hospital.

BACKGROUND: Cancer diagnosis is associated with many changes in the life of the patients. However, the impact of cancer diagnosis on the lifestyle and habits of veterans has not been reported. METHOD: We conducted a cross-sectional study of veterans with cancer to evaluate the impact of cancer diagnosis on their lifestyle including diet, habits, and exercise. We correlated habit changes with demographic and disease-related factors. RESULTS: We surveyed 200 patients. Most patients were males (98%), with median age of 68 years (range, 36-87) and with the following types of malignancy: genitourinary (39.5%); lung (19.5%); gastrointestinal (14.5%); hematologic (16%); skin, head, and neck (6.5%); and others (4%). Of the patients, 83.5% were current or former smokers with a median smoking history of 54.4 pack-year (range, 2-198). Less than a quarter of the patients changed behaviors positively (decreased smoking, drinking, and fat consumption; increased exercise and fruit/vegetable consumption). Up to two thirds of the patients did not change any of these habits. CONCLUSION: Although many veterans may adopt healthier habits after cancer diagnosis, a larger portion of them do not, which highlights the need for further evaluation and implementation of educational interventions.

The use of dietary supplements by veterans with cancer.

OBJECTIVE: To study the patterns of dietary supplement use in veterans with cancer. DESIGN: Using a detailed questionnaire, a cross-sectional study was conducted to determine the patterns of dietary supplement use by patients with cancer. SETTING/LOCATION: The study was conducted at the Hematology/ Oncology Clinic at the VA Hospital in Cincinnati, OH. SUBJECTS: Patients with malignancy who were attending the above clinic and willing to participate and sign a consent form were enrolled in the study. OUTCOMES/MEASURES: The use of dietary supplements, the type, frequency, and reason for use was captured, along with the source of dietary supplements and perceived benefits. RESULTS: Two hundred (200) veterans were surveyed, with a median age of 68 years (36-82). The type of malignancy included cancer of the genitourinary system (39.5%), lung (19.5%), gastrointestinal tract (14.5%), hematologic system (16%), skin/head/neck (6.5%), and other (4%). One hundred and twenty-two patients (122) used dietary supplements (61%). Multivitamins were the most commonly used dietary supplement reported by 98 patients (80.3%), followed by mineral use by 52 patients (40.6%). Ten (10) patients used herbal supplements. Patients who were employed and patients with higher education were more likely to use dietary supplements. Different reasons were given for dietary supplement use and 74% of the users reported perceived benefits, such as improved overall health and energy. While 38% of the patients did not disclose dietary supplement use to their physicians, 37.8% of them learned about dietary supplements from their physicians and 25% obtained their dietary supplements from the VA hospital. CONCLUSION: The use of dietary supplements is common among veterans with cancer. Health care professionals should inquire about them in a systematic fashion and be prepared to provide counseling to their patients about them.