Hilde Risvoll recently obtained a PhD in health sciences. She investigated the use of dietary supplements among people with dementia, and how different health professionals relate to the safety challenges of the use among dementia patients.
People with dementia forget easily and may lack overview and judgement, and this can affect the safety when using medicines, and dietary supplements. The project includes also herbs and compound preparations in the concept of dietary supplements. Many people have a perception of dietary supplements as natural and harmless, but in combination with medicine it can lead to negative side effects.
- My job as a physician and neurologist at a dementia clinic led to questions from patients and relatives about the use of nutritional supplements. They wanted to know if the remedies worked, were safe, and if they were ok to combine with medicines that were prescribed by a physician. These questions were the starting point for my PhD project, says Risvoll.
Chaos in the use of dietary supplements
Risvoll believes that improving memory is the main reason for people who has dementia to use dietary supplements. But precisely the failing memory means that there can be a trouble in the intake.
- Relatives explained chaotic conditions at home, there were medicines and dietary supplements interchangeably in drawers and cupboards, even in the microwave. When combining medicine with dietary supplements, they are of a greater risk taking too many supplements or not taking the medicine needed. Or consume supplements who have negative effect on the medicine. The side effects can be increased when taking too many tablets caused of forgetfulness.
Through this project, Risvoll carried out several investigations, partly to survey the use of dietary supplements among dementia patiens, and partly to collect experiences from relatives and healthcare professionals.
Pharmacy staff, home care staff and GPs were included in the research project, and it turned out that healthcare staff had noticed the unsafe use of dietary supplements among people with dementia. Several were concerned and some had taken measures to increase security.
- The most important findings are that all types of healthcare professionals have registered a risk of incorrect use of dietary supplements among patients with dementia. A large amount of people with dementia were not assisted to take the dietary supplement correctly. We also found that 11% of those who used dietary supplements had a potential negative interaction with medicine. This poses a significant risk of misuse and patient injuries.
Who is responsible for the security?
There are no guidelines for who is responsible for following up the use of supplements in people with dementia, and the groups of health professionals who participated in the studies had different opinions on this subject: Pharmacy employees and home care employees believed that GPs should have the main responsibility, while The GPs themselves believed that the home care service and relatives should take more responsibility.
The GPs are not prepared to have overall responsibility, because of the lack of laws and regulations of dietary supplements. This means that there is no requirement for studies regarding effect and risk. The active substances of dietary supplements are not always easy know. Thus, none of the health workers were willing to take full responsibility for the problem.
Risvoll have a future hope that the security perspective in the education of health professionals will be more actualized. And as a result, there will be more focus on direct and indirect risk of dietary supplements. Including side effects, interactions and risk of economic exploitation.
- I would encourage healthcare professionals to start asking patients and their relatives about the use of dietary supplements to ensure the safest possible use, she says.
Risvoll's supervisor, Professor Frauke Musial, have the same hope.
- Hilde has uncovered a significant challenge in caring for people with dementia. The results uncover that there is a need for increased awareness of the problem, and a clearer clarification of the responsibilities related to the use of dietary supplements in people with dementia, says Musial and continues:
- I believe it is important to offer the right education to the professional groups involved and provide access to independent information about the effects and potential side effects of dietary supplements.
Read Risvoll's thesis here: "Health care professionals' caring of persons with dementia who use dietary supplements"
