Abstract

BackgroundThe use of Complementary Medicines (CMs) has significantly increased in Australia over the last decade. This study attempts to determine the extent to which complementary and alternative medicines are recorded, ceased or initiated in the acute hospital setting and investigate which health professionals have a role in this process.MethodsA cross-sectional study of inpatients was conducted at a major tertiary teaching hospital. Patient’s medical records were examined to determine the rates of complementary medicine (CM) use and recording on medication charts and discharge prescriptions. Patient progress notes were audited to determine which health professionals were involved with the initiation or cessation of CMs during the inpatient stay.ResultsThree hundred and forty-one patients were included for analysis of which 44.3% (n = 151) participants were recorded as utilizing a CM. Patients were admitted on a mean of 2 (±1.4[Sd]; 0–9[range]) CMs and discharged on a mean of 1.7 CMs (±1.3[Sd]; 0–5[range]). 274 individual CMs were recorded on inpatient medication reconciliation forms with multivitamins, magnesium, fish oil and cholecalciferol recorded the most frequently. One hundred and fifty-eight changes to patient CM usage were recorded during the patient hospitalisation. One hundred and seven of these changes (68%) were not accounted for in the patient progress notes.ConclusionPatients use of CM in this hospital setting do not reflect the national estimated usage. On the occasions that CM products are included in patient records, they are subsequently deprescribed following patient examination in hospital. It is currently unclear which health professionals have a role in this deprescribing process.

Highlights

  • The use of Complementary Medicines (CMs) has significantly increased in Australia over the last decade

  • On the occasions that CMs were ceased during the inpatient stay, progress reports were audited by the corresponding researcher (JL or FW) to determine whether a clinical pharmacist or other health professional was involved during this process and had subsequently made note

  • CM usage A total of 426 patient files were assessed; 85 (20%) were excluded from further analysis as either no medication reconciliation forms were completed during their stay, the patient was aged less than 18 years, the patient’s inpatient stay was less than 5 days or the patient deceased during their inpatient stay

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Summary

Introduction

The use of Complementary Medicines (CMs) has significantly increased in Australia over the last decade. In a national study published in 2007, a survey found that complementary medicine use has increased with 68.9% of Australians having used at least one form of complementary medicine in the preceding year [2]. This increase has been attributed to people’s desire to seek alternative ways to improve their health and wellbeing, relieve symptoms associated with chronic ailments and to reduce side effects from conventional therapies [3]. Many CMs have been associated with severe adverse effects or interact dangerously with other CMs and/or prescription medications through affecting metabolism or interactions with transport proteins [6]

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