Vitamin and supplement use anddocumentation in a breast cancer survivorship clinic
Authors: A. Moore, J. Silver, A. Goldenberg
Journal: Cancer Research (2021)

Introduction: Breast cancer survivors take vitamins and supplements to bolster their general health and to try todecrease the risk of cancer recurrence  Healthcare professionals are frequently unaware of the specific type anddose of vitamins and dietary supplements taken by their patients  This information is often poorly documented in theelectronic medical record (EMR)  The aim of this study was to document accurately patients' dietary supplementsand vitamins in the EMR and to inform patients' medical teams of this important information  Methods: All patientsseen between May 5th and June 24th, 2020, with a history of nonmetastatic breast cancer (mean years sincediagnosis=13 9) were invited to participate in the study prior to their routine visits at the Weill Cornell Breast CancerSurvivorship Clinic  50/51 women consented (ages 46 to 87, mean age=70)  The nurse practitioner called eachpatient 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 weretaking each supplement  Study data were collected and managed using REDCap electronic data capture toolshosted at Weill Cornell Medicine  Due to COVID-19, 48/50 patient visits were conducted throughtelemedicine  Results: Of the 50 patients enrolled in the study, 72% were taking two or more vitamins and/orsupplements (mean=2 4, range= 0-9)  82% were taking a Vitamin D supplement, 42% were taking a calciumsupplement, and 24% were taking a vitamin C supplement  16% were taking a daily multivitamin and 8% weretaking 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 didnot know why they were taking a specific supplement, some reported that they had “always taken it”, and manystated that the supplement was a preventative measure against bone loss or catching a cold  Five patientsmentioned immunity or prevention of COVID-19  We compared the patient reported list with the medication list in theEMR  The majority of the participants had multiple providers who entered medications in the EMR  Of the 50participants in our study, none had an accurate list of the vitamins and supplements in the EMR  Conclusion: 46 ofthe 50 breast cancer survivors in our study were taking vitamins and/or supplements  No study participant had acomplete list of their vitamins and supplements in the EMR  Accurate vitamin and supplement documentation isimportant for optimal patient care  For example, vitamins and supplements may interfere with prescriptionmedications taken by patients with a history of breast cancer  The inaccurate EMR documentation also precludesthe investigation of vitamin and supplement use in future retrospective analyses  As a result of this study, westrongly recommend more attention to accurate vitamin and supplement recording by providers and thedevelopment of a more tailored and convenient method for documentation of vitamins and supplements in the EMR