title: Mind the gap: Disclosure of dietary supplement use to hospital and family physicians.
abstract: We aim to compare patients' perspectives on communication with their hospital physicians (HPs) and primary care physicians (PCPs) on patients' dietary and herbal supplements (DHS) use.
  
  
  
  We conducted a cross-sectional prospective study among in-patients using structured questionnaires on DHS use. Multivariate logistic regression models assessed variables influencing doctor-related reasons for patients' nondisclosure of supplement use.
  
  
  
  Of 452 DHS users identified, 133 (29.4%) used herbs and 319 (70.6%) used non-herbal supplements. DHS users reported that PCPs were more aware of DHS consumption than HPs (70.1% vs. 34.1%, P<0.0001). PCPs initiative to detect supplement use was higher compared with HPs (P<0.0001). Doctor-related reasons for non-disclosure of DHS use were more prominent in a hospital setting. Multivariate logistic regression model suggested association between older patient age and doctor-related non-disclosure (p=0.03). DHS use was recorded in only 33 patients medical files.
  
  
  
  Doctor-patient communication concerning DHS use is significantly poorer during hospitalization compared with primary-care settings. A significant barrier for in-hospital disclosure is doctor-related.
  
  
  
  Continuity of care between community and hospital physicians regarding patients' DHS use should be improved due to the safety implications of such use. Educating physicians on DHS and improving communication could bridge this gap.
authors: Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: eranben@netvision.net.il.
authors: Eran
authors: E
authors: Ben-Arye
authors: Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel; School of Public Health, University of Haifa, Israel.
authors: Samuel
authors: S
authors: Attias
authors: Department of Internal Medicine, Bnai-Zion Hospital, Haifa, Israel.
authors: Ilana
authors: I
authors: Levy
authors: Clinical Pharmacology Unit, HaEmek Medical Center, Afula, Israel.
authors: Lee
authors: L
authors: Goldstein
authors: Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel; Department of Internal Medicine, Bnai-Zion Hospital, Haifa, Israel.
authors: Elad
authors: E
authors: Schiff
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D005194:Family Practice; D005260:Female; D041743:Herb-Drug Interactions; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D007557:Israel; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011446:Prospective Studies; D014342:Truth Disclosure
keywords: Complementary medicine; Doctor-patient communication; Evidence-based medicine; Family medicine; Integrative medicine; Patient-centered care