NCCAM Materials Can Help You Discuss CAM With Patients

A recent FDA advisory about dietary supplements from China that are considered illegal illustrates why it's important for physicians and patients to discuss complementary and alternative medicine, or CAM. To encourage such discussions, the National Center for Complementary and Alternative Medicine, or NCCAM, is offering free materials for doctors and consumers through its "Time to Talk" campaign.

The Dec. 28 FDA advisory warns patients to avoid certain products from China that are labeled as dietary supplements but that contain sildenafil, the active ingredient in prescription drugs for erectile dysfunction, known as ED, or a specific sildenafil analog. Neither ingredient is listed on the product labels.

The products listed in the FDA advisory are Super Shangai; Strong Testis; Shangai Ultra; Shangai Ultra X; Lady Shangai; and Shangai Regular, also marketed as Shangai Chaojimengnan. They have been marketed for the treatment of ED and for sexual enhancement.

According to the advisory, the products are illegal drugs because they lack FDA approval.

The advisory specifically targets patients with diabetes, high blood pressure, high cholesterol or heart disease, who often take nitrate-containing prescription medications such as nitroglycerin to control their symptoms. According to the advisory, ED is common among men with these conditions, yet sildenafil and its analogs can interact with nitrates, resulting in dangerously low blood pressure levels.

Because men who use nitrates for these health conditions may have been advised to not take ED drugs, "they may seek out products like these because they are marketed as 'all natural' or as not containing the active ingredients in approved, prescribed ED drugs," says the advisory.

Physicians who discuss CAM with their patients are more likely to know which patients might try such supplements, but doctors need to do a better job of initiating CAM discussions, according to a recent AARP/NCCAM survey of Americans 50 and older.

Almost two-thirds of survey respondents reported they had used one or more CAM therapies, but fewer than one-third of those respondents said they had discussed their CAM use with their physicians. The top reason cited was that the doctor never asked (42 percent).

To encourage CAM discussions, NCCAM offers a free toolkit containing educational materials for physicians, their staff members and their patients. The kit includes a backgrounder; posters; tips for discussing CAM; and a patient wallet card for tracking medications, including CAM therapies. A "patient packet" is available as well. Both items may be ordered online or from the NCCAM Clearinghouse at (888) 644-6226. When ordering by phone, use reference code D392 for the health care professional toolkit; use code D393 when ordering the patient packet.

In general, NCCAM offers these CAM discussion tips for physicians:

More information about "Time to Talk" is available online.