Ethnic Differences in Herb and Vitamin/Mineral Use in the Elderly

Use of complementary and alternative medicine (CAM)is growing. The prevalence of CAM use ranges be- tween 30 % and 68 % of US adults, yet most people do notreport this practice to their physicians.1-8 The physicians, in turn, rarely ask patients about the use of CAM therapies, of which there are at least 27 types including acupuncture, biofeedback, osteopathy, prayer, herbs, vitamin–mineral supplements, and others.2,3,5 For the elderly, who may be taking several drugs for coexisting multiple diseases, this “don’t-ask-don’t-tell ” approach can mask potential health benefits of alternative medicine use and provide subopti-mal monitoring for potential adverse effects.9,10 Nondisclo-sure of CAM use is even more perilous in very old people (aged ≥80 y), a population with pronounced age-related decline in drug metabolism. Patients do not disclose CAM use because they do not consider such information important, clinicians do not ask, and they think they may be misunderstood by traditionally trained physicians.2 Similar to ongoing efforts of many pharmacy and nursing schools to enhance patient–clinicia