Bleeding DisordersCAM EducationCAM InteractionsHerbals

Use of herbal supplements by people taking blood thinners

During the American Heart Association meeting, Dr. Jennifer Strohecker, at the Intermountain Medical Center, in Salt Lake City, Utah, reported that documentation of supplement use in the medical chart is poor.

First, the details.

  • 100 patients taking warfarin (Coumadin) were surveyed for information on the frequency of herbal and dietary supplement use.
  • Gaps in communicating this information to the healthcare provider were recorded.

And, the results.

  • More than two-thirds of these patients used herbal and dietary supplements.
    • Yet, only one-third reported that their healthcare provider asked them about herbal and dietary supplement use.
  • 47% of the patients didn’t view herbal supplements as drugs and thus used them in combination with high-risk medications.
  • 63% said they didn’t consult with their physician or pharmacist before using a supplement.
    • They learned about supplements from other sources, such as the Internet or friends.
  • 92% said they would readily disclose information about supplement use if asked.

The bottom line?

Dr. Strohecker concluded, “The findings show that documentation of supplement use in the medical chart is poor and a dangerous communication gap exists — compromising patient safety and placing them at risk for bleeding or stroke complications.”

She continues, “Efforts to bridge this communication gap should focus on consumer education, policy changes (cautionary statements on herbal and dietary supplements that they may interact with certain medications), and improved patient-clinician communication.

OK, but I view this as more of a healthcare provider problem than a patient problem. Healthcare providers need better education about drug-herbal risks, and include questions about herbal use in medication interviews.

Healthcare providers need to advance beyond asking general questions to targeted inquiries that identify specific potential interactions related to ongoing prescription drug treatment.

11/18/10 20:38 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.