Comparing patients’ prescribed, self-reported, and actual intake of supplemental eicosapentaenoic acid + docosahexaenoic acid

Abstract

Dietary fish oil supplements containing the omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are frequently used for cardiovascular benefit. However, several factors may limit the intake of prescribed doses. The objective of this study is to compare the prescribed, patient self-reported, and actual intake of supplemental EPA+DHA doses in a lipid-specialty clinic and identify common barriers and influences to therapy. Seventy-six patients prescribed supplemental fish oil were randomly selected to participate in a 28-item cross-sectional survey for evaluating patient knowledge and intake of prescribed supplemental EPA+DHA doses. Self-reported data were collected during a follow-up clinic visit, whereas actual intake was determined when patients had access to their fish oil bottle. These data were compared with their chart-documented prescribed EPA+DHA dose. Many patients were well-educated and had attended the lipid-specialty clinic for approximately 2years but only 28.9% were confident that they could accurately recall their daily EPA+DHA dose. There were statistically significant differences between the prescribed doses and patients' self-reported doses (3600mg vs 2750mg, P=.014), as well as between prescribed doses and actual intake (3600mg vs 1575mg, P<.001). Patients reported multiple barriers and influences to explain their use of fish oil products. Most patients using supplemental fish oil in a lipid-specialty clinic were not taking the prescribed amount of EPA+DHA, with many using markedly lower than prescribed doses. This is likely because of several factors including the complexities of supplemental fish oil doses and labeling, product availability, and discount sales. These findings suggest that supplemental fish oil requires continuous education and dosing guidance.