Abstract
BackgroundGiven an increased global prevalence of complementary and alternative medicine (CAM) use, healthcare providers commonly seek CAM-related health information online. Numerous online resources containing CAM-specific information exist, many of which are readily available/accessible, containing information shareable with their patients. To the authors’ knowledge, no study has summarized nor assessed the quality of content contained within these online resources for at least a decade, specifically pertaining to information about adverse effects or interactions.MethodsThis study provides summaries of web-based online resources that provide safety information on potential interactions or adverse effects of CAM. Specifically, clinicians are the intended users of these online resources containing patient information which they can then disseminate to their patients. All online resources were assessed for content quality using the validated rating tool, DISCERN.ResultsOf 21 articles identified in our previously published scoping review, 23 online resources were eligible. DISCERN assessments suggests that online resources containing CAM-specific information vary in quality. Summed DISCERN scores had a mean of 56.13 (SD = 10.25) out of 75. Online resources with the highest total DISCERN scores across all questions included Micromedex (68.50), Merck Manual (67.50) and Drugs.com (66.50). Online resources with the lowest total scores included Drug Information (33.00), Caremark Drug Interactions (42.50) and HIV Drug Interactions (43.00). The DISCERN questions that received the highest mean score across all online resources referred to whether the risks were described for each treatment (4.66), whether the aims were clear (4.58), whether the source achieved those aims (4.58), and whether the website referred to areas of uncertainty (4.58). The DISCERN questions that received the lowest mean score across all online resources assessed whether there was discussion about no treatment being used (1.29) and how treatment choices would affect quality of life (2.00).ConclusionThis study provides a comprehensive list of online resources containing CAM-specific information. Informed by the appraisal of these resources, this study provides a summarized list of high quality, evidence-based, online resources about CAM and CAM-related adverse effects. This list of recommended resources can thereby serve as a useful reference for clinicians, researchers, and patients.
Highlights
Given an increased global prevalence of complementary and alternative medicine (CAM) use, healthcare providers commonly seek CAM-related health information online
Step 1: Selecting eligible online resources The research questions for the present study were as follows: “What web-based online resources are typically available and accessible to clinicians that contain patient information about adverse interactions or side effects associated with CAM?” and “What is the quality of patient health information provided by these aforementioned resources?”
Acknowledging that the DISCERN instrument was originally designed to assess the patient health information of a treatment choice, we conducted a general quality assessment for each eligible online resource, where we looked at a large enough proportion of CAMrelated patient information surrounding adverse events and side effects across each online resource to provide a holistic DISCERN score
Summary
Given an increased global prevalence of complementary and alternative medicine (CAM) use, healthcare providers commonly seek CAM-related health information online. Online resources that provide information about adverse interactions or side effects associated with complementary and alternative medicine (CAM) are paramount for obtaining updated and complete information for both clinicians who encounter patients who inquire about CAM, as well as researchers with an interest in this area [1]. Though adverse events and side effects can arise from the use of a wide-range of CAM therapies, the majority of them involve natural products, such as dietary supplements and herbal therapies [3, 4]. While limited data exists regarding the prevalence of adverse events associated with dietary supplements, it has been found that the rate of natural product users who report adverse effects is approximately 12–14% in Canada and the United States [4, 7]. Clinicians and researchers have a responsibility to utilize CAM-related electronic resources that are accurate, up-to-date, and of high quality
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