May 23, 2023
Complementary and alternative medicines (CAM) are popular among patients because they’re readily available and perceived to be safe since they can be purchased over-the-counter without a prescription.1 While these products are relatively easy to obtain, they aren’t regulated like traditional medications. Importantly, CAM manufacturers aren’t generally required to demonstrate that products are safe or effective.1,2 Besides lack of regulation, there’s little evidence-based guidance on how to use and benefit from CAM.1,2
Healthcare providers are often left in the dark about patients’ CAM use. It’s estimated that over 30% of patients with heart failure (HF) use CAM, but they only tell their providers about it half of the time, making it difficult for clinicians to provide education about any risks (or benefits) associated with their use.1,2
The American Heart Association recently released a statement summarizing published safety and efficacy data related to the use of vitamins, herbal supplements, and other non-traditional therapies used by patients with HF and highlighted some that can be detrimental (Table 1).1,2
Clearly, it’s not uncommon for hospice clinicians to encounter patients using CAM. It’s important that hospice clinicians ask about CAM use because some products may be ineffective, unnecessarily increase pill burden, interact with other medications, or cause harm. Deprescribing CAM is generally recommended for hospice patients and these products, in particular, warrant additional scrutiny and deprescribing efforts for hospice patients with heart failure.
Written by: OnePoint Patient Care Clinical Team