Did you know that 66% of adults take prescription drugs?1 That number rises to 89% in adults over 65.2 Because many of these patients are on more than one prescription, managing potential drug-drug interactions is critical to promote positive patient outcomes. This is where pharmacists fill the gap. They are often the most accessible healthcare professionals and serve as a vital source of information and guidance for patients taking multiple prescriptions.
One often overlooked aspect of medication management is addressing potential drug-nutrient interactions (DNI). The pain point lies in the complexity of (DNI) online resources. Entering a drug and a herb into an online query will likely retrieve a list of “possible” or “potential” interactions. It’s hard to know which interactions matter or are merely educated guesses. This creates a gap in pharmacy value-based care strategies, considering 4 in 5 adults take dietary supplements3. This blog will define drug-nutrient interactions and detail pharmacists’ difficulties when seeking online DNI resources. We’ll then discuss how Pure Encapsulations® Drug-Nutrient Interaction Checker can alleviate these pain points, by providing pharmacists with a meaningful tool to support patients and prescribers.
What Is a Drug-Nutrient Interaction?
Drug-nutrient interactions refer to the ways in which medications and nutrients can influence each other’s effects on the body. These interactions can occur at various stages, including absorption, distribution, metabolism and elimination of the drug and the nutrient. Drug-nutrient interactions can lead to changes in the effectiveness of a medication, or they can alter the body’s nutritional status.
Many Other Online Drug-Nutrient Interaction Checkers Aren’t Particularly Helpful
Understanding drug-nutrient interactions is a vital yet elusive component of pharmacy practice. Unfortunately, finding reliable and translatable information isn’t always easy despite abundant online resources. Here are some problems that many pharmacists face when using online drug-nutrient interaction resources.
- There could be too many warnings. Interaction checkers may generally provide too many interaction warnings, many of which are merely hypothetical because of a sparse evidence base. This “over-alerting” or “crying wolf” phenomenon leads to precaution fatigue, which could lead to errors when real warnings present themselves. All herbs contain compounds that can inhibit cytochrome p450 enzymes in vitro, but they typically fail to interact with their cognate p450 drug substrates in subsequent clinical trials. While preclinical predictions generally don’t translate to the clinic, interaction checkers often display them anyway, diluting the clinically relevant information.
- You don’t have time. To discern real warnings from guesses, you need time to do the reading and some formal pharmacology training (and let’s be honest – you probably don’t have the time or interest). The purpose of checkers revolves around convenience and accuracy to meaningfully support the pharmacist at the point of care. A good checker should be based on clinically relevant scientific analyses.
- Inconsistent and conflicting information is endemic in interaction checkers. Coverage of dietary ingredients varies widely. More problematic, different tools describe interactions differently, sometimes giving contrasting information when the same drug and supplement ingredient is entered. For example, one checker may warn that an herb may increase drug toxicity, while another tool might only caution that the herb could decrease drug efficacy.
It’s important to understand that the frequency of drug-nutrient interactions may not be as high as initially perceived, especially when a patient is taking supplements orally. It is also worth mentioning that many of these interactions are in fact based on theoretical assumptions and lack solid evidence to support them. Therefore, your expertise plays a vital role in determining which interactions can be confidently disregarded.
Introducing Pure Encapsulations Drug-Nutrient Interaction (DNI) Checker
To navigate the growing complexity of conventional pharmacopeia and expansions in dietary supplement ingredient portfolios, checkers will become indispensable decision-support tools. Currently, there are no scientific guidelines or industry standards for developing drug-nutrient interaction checkers. Most practitioners lack the time and/or training to critically assess their strengths and weaknesses to make an informed decision. But as with any clinical tool, it all comes down to accuracy and reliability. A checker that provides a large, unfiltered volume of interactions for a given compound may give the impression of being reliable, complete and comprehensive. The reliability of a checker isn’t about the volume of information. Instead, it’s about delivering relevant information based on appropriate evidence to minimize integrative dispensing errors. Here is where Pure Encapsulations® Drug-Nutrient Interaction Checker can help pharmacists fill the gap. Our DNI tool delivers only relevant interactions based on a thorough review of the evidence, including assessment of the 4E (Evidence, Effect Size, Extrapolation, Exposure) criteria for the clinical significance of each interaction. In addition, the tool only displays interactions that could happen at clinically achievable blood levels, excluding interactions that require off-label dosing to reach these levels. Simply enter the name of the medication and receive up-to-date information on significant potential interactions. Identifying interactions is quick and easy, with clinically relevant details for meaningful support in a busy point-of-care setting.
DNI Support Builds Trust with Local Prescribers
Open and effective communication is vital to building trust between pharmacists and prescribing physicians. By proactively sharing information about potential drug-nutrient interactions and offering recommendations for management, pharmacists can demonstrate their expertise and willingness to collaborate in the patient’s best interest. Also, when pharmacists and prescribing physicians work together to address drug-nutrient interactions, they can develop comprehensive treatment plans that take into account medications, lifestyle factors and dietary considerations. This holistic approach to patient care showcases the value of each professional’s expertise and strengthens their working relationship.
Nurture Patient Trust with DNI Support
Pharmacists play a critical role in educating patients about their medications. They can add depth to their consult by identifying potential drug-nutrient interactions that patients may need to be made aware of. This proactive approach demonstrates the pharmacists’ expertise and commitment to optimizing the patient’s medication therapy and overall health. Additionally, pharmacists can illustrate their ongoing commitment to customer care by following up with patients and monitoring their progress. This also provides an opportunity to address any new drug-nutrient interactions that may have arisen since the last consultation, further enhancing patient trust in their community pharmacist.
Pharmacists’ understanding of drug-nutrient interactions is vital for ensuring effective and safe medication use, providing patient education, personalizing care, and collaborating with other healthcare professionals. This knowledge ultimately contributes to better patient outcomes and fosters trust between the pharmacist and the community they serve. Click here to start using the DNI Checker.
For Further Information
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The Pure Encapsulations® Drug-Nutrient Interaction Checker is for general wellness informational purposes only and is not intended to provide any diagnosis, cure, mitigation, prevention or recommendation for medical treatment of any disease. It is not a substitute for medical, diagnosis, treatment or other professional advice or the independent clinical judgment of a healthcare professional.
- Health Policy Institute, 2021
- Statistics on OTC use. Consumer Healthcare Products Association website. chpa.org/MarketStats.aspx. Accessed 19 Dec 2022)
- CRN survey