Complementary and Alternative Medicine:
The Importance of the Doctor-Patient Relationship
Recent studies have shown that 69% of Americans use at least
one type of complementary and alternative medicine (CAM) therapy in any given
year and 70% to 90% of physicians consider CAM therapies to be legitimate
medical practices.1,2 However, it has been reported that
approximately 60% to 70% of patients who use CAM therapies on a regular basis
do not inform their physicians of such utilization—even before an important
surgery.3,4 In fact, prior to surgery, over 22% of patients reported
using herbal remedies, while over 51% of patients reported using vitamins and
other nutritional supplements.5
According to Dr. Tsen, “The use of such remedies in the
presurgical population has implications because of the potential for drug
interactions, side effects, and medical liability.”5 Therefore,
while
numerous studies have confirmed the beneficial health
effects and safety of herbal remedies and nutritional supplements, the importance
of informing your physician of such use cannot be understated.
Despite the fact that adverse reactions to prescription
drugs cause over 100,000 deaths annually, presurgical patients who take herbal
remedies and/or nutritional supplements tend to forget or overlook the fact
that herbal and nutritional therapies are considered pharmacologically
powerful, effective, and capable of interacting with anesthetic drugs. For
instance, a recent study showed that 27% of surgical patients consumed
alternative medicines that are known to inhibit blood clotting and thin the
blood, a potentially life threatening situation in a surgical setting.6
These alternative medicines included vitamin E, garlic, ginkgo, ginseng, fish
oil, and chamomile.7
CAM therapies have been extensively demonstrated and
recognized as safe, effective, and nontoxic additions to conventional
healthcare. However, as with any self-administered medication, it is important
to inform your physician of any and all use of herbal remedies and nutritional
supplements, especially before surgery. This will allow your physician to
prevent any possible adverse side effects associated with their use.
References
- Kessler W, Goodkind M.
(1999, September 23). Americans mingle complementary techniques with traditional
medicine. Stanford Online Report. Retrieved from http://www.stanford.edu/dept/news/report/news/september23/altsurvey923.html.
- Berman BM, Singh BK,
Lao L, et al. Physicians’ attitudes toward complementary or alternative
medicine: a regional survey. J Am Board Fam Pract 1995;8(5):361-66.
- Eisenberg DM, Davis RB,
Ettner SL, et al. Trends in alternative medicine use in the United States,
1990-1997: results of a follow-up national survey. JAMA
1998;280(18):1569-75.
- Gulla J, Singer AJ. Use
of alternative therapies among emergency department patients. Ann Emerg
Med 2000;35(3):226-28.
- Tsen LC, Segal S,
Pothier M, et al. Alternative medicine use in presurgical patients. Anesthesiology
2000;93(1):148-51.
- Norred CL, Brinker F.
Potential coagulation effects of preoperative complementary and
alternative medicines. Altern
Ther Health Med 2001;7(6):58-67.
- Norred CL, Zamudio S, Palmer SK. Use of
complementary and alternative medicines by surgical patients. AANA
2000;68(1):13-18.