Abstract
Background
Although the use of health supplements is frequently reported, patients’ understanding of health supplement use and related safety concerns are least reported from the developing world.
Aim
This study was aimed to assess the understanding of health supplement use in patients with chronic diseases visiting a public healthcare institute of Quetta city, Pakistan.
Methods
A cross-sectional study with a proportioned based sample of 460 patients with chronic diseases attending a tertiary care hospital of Quetta city was carried out. A pre-validated questionnaire was used to assess patients’ understanding of health supplement use. SPSS version 21.0 was used for data analysis. Both descriptive and inferential statistics were used. For all analyses, p < 0.05 was taken as significant.
Results
Most of the patients were more than 47 years of age, with a mean age of 51.62 ± 12.71 years. Thirty-three percent of the patients were diagnosed with hypertension, followed by 17.1% with hypertension + diabetes mellitus Type II. Friends and relatives (195, 42.3%) were the most common source of information regarding health supplements, and multivitamins & minerals (n = 268) were the most used health supplements. Almost 80% of the respondents have neither discussed nor disclosed the use of health supplements with their doctors or pharmacists. Nearly the same percentage (80%) of the respondents were unaware of the safety concerns of health supplements, nor were they aware of either interactions or side–effects. Education and disease state were significantly associated with certain items of the questionnaire. Bonferroni correction revealed graduates and patients with hypertension + diabetes mellitus Type II agreeing to the mentioned statements.
Conclusion
Inadequate understanding of health supplements was reported by the study respondents. As health supplement use is linked with certain safety concerns, enhancing patients’ understanding about misconceptions with regard to the safety and efficacy of supplements and their appropriateness is needed and must be addressed as a priority.
Similar content being viewed by others
Data availability
The datasets used and analyzed during the current study are available from the corresponding author at fahaduob@gmail.com on request.
References
Afolayan AJ, Wintola OA (2014) Dietary supplements in the management of hypertension and diabetes-a review. Afr J Tradit Complement Altern Med 11:248–258
Anjum F (2017) The use of vitamins in Pakistan. ARC J Pharm Sci 3:3–4
Ben-Arye E, Attias S, Levy I, Goldstein L, Schiff E (2017) Mind the gap: disclosure of dietary supplement use to hospital and family physicians. Patient Educ Couns 100:98–103
Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155:97–107
Boston Medical Center (2015) BMC finds adults do not report dietary supplement use to physicians. Available at: https://medicalxpress.com/news/2015-05-bmc-adults-dietary-supplement-physicians.html
Consumer Association of Penang (2016) Food: better than supplements. Available at: https://www.consumer.org.my/index.php/food/nutrition/130-food-better-than-supplements
Daniel WW (1999) Biostatistics: a foundation for analysis in the health sciences, 7th edn. Wiley, New York
Feinstein L, Sabates R, Anderson TM, Sorhaindo A, Hammond C (2006) What are the effects of education on health. Available at: http://www.oecd.org/education/innovation-education/37425753.pdf
Fletcher RH, Fairfield KM (2002) Vitamins for chronic disease prevention in adults: clinical applications. JAMA 287:3127–3129
Food & Drug Administration (2015) Dietary supplements: questions and answers. Available at: https://www.fda.gov/drugs/questions-answers/dietary-supplements-questions-and-answers
Food & Drug Administration (2017) What you need to know about dietary supplements? Available at: https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-dietary-supplements
Forestier B, Anthoine E, Reguiai Z, Fohrer C, Blanchin M (2019) A systematic review of dimensions evaluating patient experience in chronic illness. Health Qual Life Outcomes 17:1–13
Gardiner P, Graham RE, Legedza AT, Eisenberg DM, Phillips RS (2006) Factors associated with dietary supplement use among prescription medication users. Arch Intern Med 166:1968–1974
Guzman JR, Paterniti DA, Liu Y, Tarn DM (2019) Factors related to disclosure and nondisclosure of dietary supplements in primary care, integrative medicine, and naturopathic medicine. J Fam Med Dis Prev 5. https://doi.org/10.23937/2469-5793/1510109
Hannon BA, Fairfield WD, Adams B, Kyle T, Crow M, Thomas DM (2020) Use and abuse of dietary supplements in persons with diabetes. Nutr Diabetes 10:1–12
Irwig MS, Fleseriu M, Jonklaas J, Tritos NA, Yuen KC, Correa R et al (2020) Off-label use and misuse of testosterone, growth hormone, thyroid hormone, and adrenal supplements: risks and costs of a growing problem. Endocr Pract 26:340–353
Jasti S, Siega-Riz AM, Bentley ME (2003) Dietary supplement use in the context of health disparities: cultural, ethnic and demographic determinants of use. J Nutr 133:2010S–2013S
Keat O (2009) Factors influencing consumer purchase intention of dietary supplement products in Penang island. Available at: http://eprints.usm.my/25496/1/factors_influencing_consumer_purchase_intention_of.pdf
Khalid W, Zahid S, Jamaluddin M, Alam MT (2019) A cross sectional study-knowledge, attitudes and practices of general population regarding herbal products and dietary supplements in Karachi. Pak J Surg 35:106–113
Khan A, Iqbal Q, Haider S, Khalid A, Hassali MA, Saleem F (2019) Acute diarrheal Management in Adults: a simulated client study at community pharmacies of Quetta City, Pakistan. J Pharm Pract Community Med 5:13–17
McKerricher L, Petrucka P (2019) Maternal nutritional supplement delivery in developing countries: a scoping review. BMC Nutr 5:8
Mehta DH, Gardiner PM, Phillips RS, McCarthy EP (2008) Herbal and dietary supplement disclosure to health care providers by individuals with chronic conditions. J Altern Complement Med 14:1263–1269
National Institute of Health (2020) Dietary supplement health and education act of 1994: Public Law 103–417. Available at: https://ods.od.nih.gov/About/DSHEA_Wording.aspx
Olshansky SJ, Antonucci T, Berkman L, Binstock RH, Boersch-Supan A, Cacioppo JT et al (2012) Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Aff 31:1803–1813
Pallant J (2011) SPSS survival manual: a step by step guide to data analysis using IBM SPSS. Open University Press, Maidenhead, UK
Pampel FC, Krueger PM, Denney JT (2010) Socioeconomic disparities in health behaviors. Annu Rev Sociol 36:349–370
PharmaGuide (2020) Parmaguide systems. PharmaGuide, Karachi
Rafique I, Saqib MA, Munir MA, Qureshi H, Rizwanullah KS, Khan SA et al (2018) Prevalence of risk factors for noncommunicable diseases in adults: key findings from the Pakistan STEPS survey. East Mediterr Health J 24:33–41
Rasmussen CB, Glisson JK, Minor DS (2012) Dietary supplements and hypertension: potential benefits and precautions. J Clin Hypertens 14:467–471
Reports and Data (2019) Dietary supplements market to reach USD 210.3 billion by 2026. Available at: https://www.globenewswire.com/news-release/2019/03/25/1760423/0/en/Dietary-Supplements-Market-To-Reach-USD-210-3-Billion-By-2026-Reports-And-Data.html
Research and Markets (2020) Dietary supplements market size, share & trends analysis report by ingredient (vitamins, minerals), by form, by application, by end user, by distribution channel, by region, and segment forecasts, 2020–2027. Available at: https://www.researchandmarkets.com/reports/4479727/dietary-supplements-market-size-share-and-trends?utm_source=dynamic&utm_medium=GNOM&utm_code=3cdr2l&utm_campaign=1362686+-+Global+Dietary+Supplements+Market%3a+Size%2c+Share+%26+Trends+(2020-2027)&utm_exec=joca220gnomd
Saleem F, Hassali MA, Shafie AA (2010) Hypertension in Pakistan: time to take some serious action. Br J Gen Pract 60:449–450
Satia-Abouta J, Kristal AR, Patterson RE, Littman AJ, Stratton KL, White E (2003) Dietary supplement use and medical conditions: the VITAL study. Am J Prev Med 24:43–51
Shahzad F, Saleem F, Iqbal Q, Haque N, Haider S, Salman M et al (2018) A cross-sectional assessment of health literacy among hypertensive community of Quetta City, Pakistan. Biomed J Sci Tech Res 11:1–9
StatsDirect Limited (2017) An explanation of different epidemiological study designs in respect of: retrospective; prospective; case-control; and cohort. Available at: www.statsdirect.com/help/content/basics/prospective.htm
The NEWS (2020) Who will break the pharma–physician nexus in Pakistan? Available at: https://www.thenews.com.pk/latest/503026-who-will-break-the-pharma-physician-nexus-in-pakistan
Von dem Knesebeck O, Verde PE, Dragano N (2006) Education and health in 22 European countries. Soc Sci Med 63:1344–1351
Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A et al (2005) Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health 8:94–104
Zemel MB (2013) Dietary supplements in management and prevention of chronic disease. J Nutr Dis Therapy 3:e107
Zimmerman E, Woolf SH (2014) Understanding the relationship between education and health. In: Kaplan RM et al (eds) Population health: behavioral and social science insights. Institute of Medicine of the National Academies, Rockville, MD, USA
Acknowledgments
We acknowledge the patients for their participation and cooperation during the data collection process.
Author information
Authors and Affiliations
Contributions
All authors have contributed equally to the research and this manuscript. QI, MA, and RI conceived the study and framework of the current manuscript. SH and AR conceptualized the study design, and development of the study tool. FK and AMT were involved in data collection, analysis, and interpretation. MAM, SUJ, and FS conducted the literature review, drafted the preliminary manuscript, and supervised the research process. All authors read, critically revised, and approved the final manuscript.
Corresponding author
Ethics declarations
Ethical approval
The Institutional Ethical Committee at the Faculty of Pharmacy & Health Sciences, University of Baluchistan approved the study (UoB/Reg:/GSO/345).
Consent to publish
This manuscript does not report personal data such as individual details, images, or videos. Therefore, consent for publication is not applicable.
Consent to participate
Written consent of participation was received from the patients.
Competing interests
The authors have no conflict of interest to declare.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Khan, F., Anwar, M., Ishaq, R. et al. Understanding the use of health supplements in patients with chronic diseases: findings and implications. J Public Health (Berl.) 31, 179–186 (2023). https://doi.org/10.1007/s10389-021-01500-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-021-01500-6