Healthcare Professionals' Perspectives on Improving Dietary Supplement Documentation in the Electronic Medical Record: Current Challenges and Opportunities to Enhance Quality of Care and Patient Safety

Zachary O Kadro; Aisha Chilcoat; Jacob Hill; Stephanie Kenney; Catharine Nguyen; Elana Post; Amanda H Corbett; Gary N Asher; Keturah Faurot

doi:10.1177/27536130231215029

Healthcare Professionals' Perspectives on Improving Dietary Supplement Documentation in the Electronic Medical Record: Current Challenges and Opportunities to Enhance Quality of Care and Patient Safety

Glob Adv Integr Med Health. 2023 Dec 19:12:27536130231215029. doi: 10.1177/27536130231215029. eCollection 2023 Jan-Dec.

Authors

Zachary O Kadro^{1

2

3

4}, Aisha Chilcoat¹, Jacob Hill⁵, Stephanie Kenney⁶, Catharine Nguyen⁷, Elana Post⁸, Amanda H Corbett⁹, Gary N Asher¹⁰, Keturah Faurot¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
² Integrative Medicine Program, Division of Supportive Care, Fred Hutch Cancer Center, Seattle, WA, USA.
³ Division of Public Health Sciences, Cancer Prevention Program, Fred Hutch Cancer Center, Seattle, WA, USA.
⁴ Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA, USA.
⁵ Department of Wellness and Preventive Medicine, Cleveland Clinic, Cleveland, OH, USA.
⁶ University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA.
⁷ Janssen Pharmaceutical Companies of Johnson and Johnson, Titusville, NJ, USA.
⁸ Clinical Pharmacologist, Vertex Pharmaceuticals Inc, Boston, MA, USA.
⁹ Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA.
¹⁰ Department of Family Medicine, Director Integrative Medicine Services, Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Abstract

Background: Around half the US population uses dietary supplements (DS), and concomitant use with medications is common. Many DS include bioactive substances that can interact with medications; therefore, accurate tracking is critical for patient safety. Unfortunately, documentation of patients' DS use is often missing or incomplete in the electronic medical record (EMR), leaving patients susceptible to potential adverse events. Novel approaches to assist healthcare professionals (HCPs) in capturing patients' DS use are needed.

Objective: To assess HCPs' perspectives on challenges and facilitators of DS documentation in the EMR and their opinions on a proposed mHealth application (app) to aid in DS capture.

Methods: HCPs, recruited from professional networks, largely in North Carolina, using purposive sampling, took part in semi-structured interviews. We inquired about HCPs' experiences with DS documentation in the EMR and their opinions about our proposed mHealth app. Interviews were recorded, transcribed, and coded. Thematic analysis included deductive codes based on the interview guide, and inductive codes that emerged during transcript review.

Results: HCPs (N = 30) included 60% females, mean age 46 ± 10; 70% White. Pharmacists (20%), nurses (17%), and physicians (17%) were the most represented professions. Years in practice ranged from 3-35 years. Most HCPs were concerned about DS safety and potential supplement-drug interactions, and cited several barriers to accurate EMR DS documentation including time constraints, database inconsistencies, and poor patient-HCP communication about DS. HCPs' views on our proposed mHealth app were generally positive. They expressed that our proposed mHealth app could streamline documentation processes and enhance patient-provider communication. HCPs expressed desire for a high-quality mHealth app that includes access to evidence-based DS information, integrates with the EMR, and does not increase time burdens.

Conclusion: HCPs believe documentation of patients' DS use is important but not accurately captured in the EMR. Support was expressed for our proposed barcode-scanning DS mHealth app.

Keywords: dietary supplements; integrative medicine; medication reconciliation; mobile health; qualitative research.

Abstract

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