Counseling Patients and the HERBAL Guide Overview – DNI/DSI Webcast Part 3

Transcript - Part 3

Counseling Patients and the HERBAL Guide Overview

An important part of this equation is how often do we discuss it because that's a primary tool for preventing interactions and depletions. Although the numbers have improved over the last decade or so in this one study from 30% arena to over 40%, we're still doing a very low job of getting the actual disclosure of supplements. And again, there are factors here that can be overcome and we're going to give some tools for that.

First, it's important to understand why this topic does not come up. From the patient's standpoint, the two most common reasons are the physician did not ask, and therefore, they assume it's not important, or they believe that the physician did not need to know. In their mind, it was not a critical factor, so they did not bring it up on their own. Both of these are areas that can be overcome as we'll talk about.

So, when we are trying and preparing in this second aspect of this overview to prepare for ourselves for counseling and to have the discussion and the disclosure moment, it's important to keep a few things in mind to prepare for that.

The environment is quite important. Having a framework in mind is quite important and having resources. All areas, which we are going to talk about.

This is a reference that I would highly suggest that goes into more of the detail of how to prepare for counseling. It's looking at a specific arena of patients going in a menopausal symptom management, but it's a general important topic. The two key points from this and other articles on the topic are that you need to have a framework and you need to have an environment that is conducive to having that discussion.

As far as the first aspect of this, we're going to talk about the HERBAL Guide. The HERBAL Guide is part of a book that I was involved with editing called "The HERBAL Guide." And the "HERBAL" mnemonic is Hear the patient out, Educate and Evaluate, Record, Be aware, Agree to discuss, and Learn. And we're going to go through each of these steps one by one as one type of framework, although there are many out there that help us remember the key points when we are trying to counsel.

So, when we talk about disclosure and the environment, one of the key things we need to keep in mind is how conducive is our environment and the staff that's interacting with the patient, how conducive is the paperwork that the patient receives, etc. This study points this out very clearly. This is a multisite study as part of women's health, eating, and living study.

What they found was that there was quite a disparity between different sites and the level of disclosure when the investigators went back and discussed the level of dietary supplement use. What they found was that the patients who did disclose in certain environments felt more open about disclosing it, they felt there was less stigma in disclosing it, and there was more openness to wanting that information.

So, the key point from this study and one similar is that the environment we create, starting at the check-in, starting with how the MA [medical assistant] or nurse is discussing the medications with the patient, and how we bring up the topic are all critical factors on improving the disclosure rate.