Communicating with Patients About Dietary Supplement Use

When communicating with patients about dietary supplement use, the most tenuous relationships are that of the doctor and the cancer patient. The use of dietary supplements among patients affected by cancer is extensive, with an estimated 20-90 % of patients using these products. Their use of these products is often not shared with the treating physician.

Doctors need to understand why patients with cancer use dietary supplements in the first place. Patients tend to use these supplements because they want to do everything possible to feel hopeful, empower themselves, enhance the body’s natural defenses, use less toxic treatments, or reduce side effects of mainstream treatments,” said Dr. Victor Sierpina, UTMB professor of family medicine. “In fact, most patients choose to use dietary supplements to improve their quality of life rather than seeking a cure for their disease.”

In the September issue of Current Oncology Reports, researchers at University of Texas Medical Branch, Sierpina describes a patient centered approach to managing dietary supplement use in cancer care. By Moshe Frenkel and Victor Sierpina, published in Current Oncology, Sept. 2014.

 

Communicating with Patients About Dietary Supplement Use This approach makes use of all available scientific data relating to the safety and efficacy of these supplements combined with how to have an open, patient-centered discussion with patients about their needs and expectations. Patients can be given appropriate information from reliable sources about dietary supplements such as mentioned in study or they can use peer-reviewed documents such as the 2009 guidelines of the Society of Integrative Oncology (see attached below). For many physicians, dietary supplement information is not readily available, and this is the point where other members of the treatment team can help out, such as nurses, pharmacists, and dieticians who have expertise in exploring these options of care further.

Dr. Sierpina and fellow author Dr. Moshe Frenkel, UTMB clinical associate professor of family medicine, emphasize that doctor-patient communication is an interactive process, not merely a focused dialogue of questions and answers. The doctor who is open to patient inquiries and is aware of subtle, nonverbal messages can create an environment of safety in which a patient feels and is protected.

Doctors must use a sensitive approach when communicating with a patient who has an interest in the use of dietary supplements,” said Dr. Frenkel. “A communication approach that fosters a collaborative relationship that includes ample information exchange, empathy and compassion, responding to emotional needs and managing uncertainty can lead to informed decisions about dietary supplement use.”

This discussion is crucial in building a personalized treatment plan that is safe and based on reliable information. The article contains a list of the most common dietary supplements and basic information related to these as well as a table containing reliable sources of information on dietary supplements for both doctors and patients, for further reference.

Here is a summary of the advice:

1. The patient–clinician dialogue involves not just “words”; it also involves the “voice.” The ways in which one expresses oneself—using a soft or loud voice, slow or fast speech, and verbal and nonverbal cues—are all connected and are part of communication between two people. Clinicians must use a sensitive approach in communication with the patient who has an interest in the use of dietary supplements. This approach uses effective communication skills and experience in attentive listening.
2. Communication can relate to previous visits, family and caregiver involvement, other health care providers, and personal and professional experiences of the clinician and the patient. Family, employment, emotions, desires and wants, hidden wishes and concerns, where one finds meaning in life, health beliefs, and social, religious, and spiritual issues are all part of effective communication.
3. The physician who is receptive to patient inquiries and is aware of subtle, nonverbal messages can create an environment of safety in which a patient feels and is protected.
4. A communication approach that fosters a collaborative relationship that includes adequate information exchange, empathy and compassion, responding to emotional needs, and managing uncertainty can lead to informed decisions about dietary supplement use.

Editor’s Note: The attached guidelines from a 2009 report is somewhat outdated, since it’s publication, there has been a significant level of progress in peer-reviewed research regarding integrative approached to cancer therapies. And, the study authors cite a lack of scientific evidence to support dietary supplement use. Nonetheless, this document is a useful guide to the importance of listening to patient needs regarding dietary supplement use in cancer treatments.