When is an herbal tea a safe and effective sleep aid, and when is that same tea a risky pharmaceutical choice?
Health care professionals face such questions daily, and a University of Arkansas researcher cautions that they may need to acquire advanced clinical skills in order to assure patient safety.
In a peer-reviewed commentary in the current issue of the Journal of Allied Health Professions, Jerald C. Foote advises health professionals to “be prepared to ask for and evaluate pharmacological and toxicological information” when patients ask about using dietary supplements.
“The wise consumer will expect a health care adviser to address issues of effectiveness and side effects with dietary supplements. If someone says ‘there are no side effects,' that should be a red flag,” Foote said.
The Dietary Supplement Health and Education Act of 1994 created a new legal category of dietary supplements, and Federal Drug Administration education materials frequently advise consumers to consult with a health care provider before using such supplements. The law leaves it to the dietary supplement industry to conduct pre-market evaluations of products, and Foote's commentary cites several examples of supplements that were withdrawn from the market only after consumers were harmed.
After years of making presentations to consumers and health care professionals and answering their many questions, Foote came to the conclusion that health professionals need to become more pharmaceutically oriented in order to advise clients responsibly.
“Today we recognize that herbs interact with drugs, something we didn't talk about 10 or 15 years ago. For some products, there is no information on dosage or how the product is metabolized, which makes it difficult to evaluate,” Foote said.
He suggests that health professionals be proactive with their clients when it comes to using supplements that lack scientific evidence for safety or effectiveness. In fact, he says, such products are experimental pharmaceuticals, and an allied health professional has to consider whether to make a recommendation or to refer the client to someone with more expertise.
“Allied health professionals should either not recommend an experimental product, or if they do recommend it, they have a responsibility to monitor their patient for side effects,” Foote said.
In his commentary, Foote also calls for each allied health discipline “to determine the level of competency needed by its members to ensure consumer safety.”
Foote is a registered dietitian and an assistant professor of food and human nutrition in the School of Human Environmental Sciences in the Dale Bumpers College of Agricultural, Food and Life Sciences at the University of Arkansas.