Abstract PS9-12: Vitamin and supplement use and documentation in a breast cancer survivorship clinic
Authors: Moore Anne , Silver Julia , Goldenberg Alyson 
Published: February 2021

Abstract
Introduction: Breast cancer survivors take vitamins and supplements to bolster their general health and to try to decrease the risk of cancer recurrence. Healthcare professionals are frequently unaware of the specific type and dose of vitamins and dietary supplements taken by their patients. This information is often poorly documented in the electronic medical record (EMR). The aim of this study was to document accurately patients’ dietary supplements and vitamins in the EMR and to inform patients’ medical teams of this important information.Methods: All patients seen between May 5th and June 24th, 2020, with a history of nonmetastatic breast cancer (mean years since diagnosis=13.9) were invited to participate in the study prior to their routine visits at the Weill Cornell Breast Cancer Survivorship Clinic. 50/51 women consented (ages 46 to 87, mean age=70). The nurse practitioner called each patient the day before their visit to obtain informed consent and to document their use of supplements and vitamins. The labels for each vitamin and supplement were reviewed and patients were asked the reason why they were taking each supplement. Study data were collected and managed using REDCap electronic data capture tools hosted at Weill Cornell Medicine. Due to COVID-19, 48/50 patient visits were conducted through telemedicine.Results: Of the 50 patients enrolled in the study, 72% were taking two or more vitamins and/or supplements (mean=2.4, range= 0-9). 82% were taking a Vitamin D supplement, 42% were taking a calcium supplement, and 24% were taking a vitamin C supplement. 16% were taking a daily multivitamin and 8% were taking no supplements or vitamins. Some of the rare supplements patients were taking included ginseng root tea, shiitake extract, and kamwo tea (one patient each). Patients reported a variety of reasons for their vitamin and supplement use. Some patients stated the supplement was recommended by their physician or a friend, some did not know why they were taking a specific supplement, some reported that they had “always taken it”, and many stated that the supplement was a preventative measure against bone loss or catching a cold. Five patients mentioned immunity or prevention of COVID-19. We compared the patient reported list with the medication list in the EMR. The majority of the participants had multiple providers who entered medications in the EMR. Of the 50 participants in our study, none had an accurate list of the vitamins and supplements in the EMR. Conclusion: 46 of the 50 breast cancer survivors in our study were taking vitamins and/or supplements. No study participant had a complete list of their vitamins and supplements in the EMR. Accurate vitamin and supplement documentation is important for optimal patient care. For example, vitamins and supplements may interfere with prescription medications taken by patients with a history of breast cancer. The inaccurate EMR documentation also precludes the investigation of vitamin and supplement use in future retrospective analyses. As a result of this study, we strongly recommend more attention to accurate vitamin and supplement recording by providers and the development of a more tailored and convenient method for documentation of vitamins and supplements in the EMR.
Citation Format: Anne Moore, Julia Silver, Alyson Goldenberg. Vitamin and supplement use and documentation in a breast cancer survivorship clinic [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-12.