A Literature Review and Development of Clinical Practice Guidelines for the Use and Disclosure of Herbal/Dietary Supplements in the Elderly Population

Abstract

Background and Significance: There is an increased use of herbal and dietary supplements among the elderly population that has become a major phenomenon in primary care. Primary care providers must now address issues of “polypharmacy” and “polyherbacy” when managing chronic diseases to avoid drug-herbal interactions. Although, elderly patients encounter more medical visits secondary to their multiple co-morbidities, they are less likely to communicate their home usage of herbal/dietary supplements to the providers. In addition, elderly patients may often discontinue their prescribed medications in lieu of herbal/dietary supplements because of the desire to be in control of their own health (Gupchup et al., 2006). The Theory of Planned Behavior by Icek Ajzen (1991) was used as theoretical framework to understand elderly patient’s “intention” and motivations to foster a therapeutic provider-patient relationship to enhance communication. Problem Statement: The use of herbal/dietary supplements are not disclosed to providers by the elderly population in primary care as a result patients are at increased risk for adverse drug/herbal interactions. The purpose of the project was to complete an extensive literature review and develop a clinical practice guideline for the full disclosure of herbal/dietary supplements in the elderly population for primary care providers. Methodology: The criteria included searching major medical and complementary/alternative medicine databases (2006 to 2016) by selecting keywords (ie. herbal/dietary supplements, elderly, aging, Complimentary Alternative Medicine (CAM) and nondisclosure). Evaluation Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used for final analysis of the literature review.