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Effective Health Care Program

Topic Suggestion Description

Date submitted: April 1, 2009

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

For the elderly taking cardiovasculare medications, what are the comparative risks and benefits of commonly used herbal supplements.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

no

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

most common cardiovascular medications and most commonly used herbal supplements

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Elderly men and women, over the age of 65 on cardiovascular medications.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Are there herbal supplements that augment the most common cardiovascular medications.

Describe any health-related risks, side effects, or harms that you are concerned about.

Does addition of the most commonly used herbal supplements decrease the effectiveness of cardiovascular medications or increase the adverse event profile of the medication?

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
  • Cardiovascular disease, including stroke and hypertension
AHRQ Priority Populations
  • Elderly
Federal Health Care Program
  • Medicaid
  • Medicare

Importance

Describe why this topic is important.

I am involved in the health care of elderly. So many of these elderly patients are on cardiovasculare e medication and so many of them also spend their very limited funds on herbal supplements and many different vitamins. It should be determined the risks and benefits of these supplements so that clear information can be provided and funds for health care are maximized.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

Personal experience in taking care of the elderly.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

To my knowledge, very few actual peer-reviewed, stringent, statistically powered clinical studies have been performed to really determine efficacy or side effects of these supplements on cardiovascular therapies. Additionally, herbal supplements are not regulated by the FDA but the quantities that are consumed in the US amount to billions of dollars spent.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

The information will be used to guide patients as to the risks or benefits of taking these herbal supplements.

Describe the timeframe in which an answer to your question is needed.

Within a 5 year period.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Elderly patients are at significant risk for effects on their health and also their limited funds. Understanding if herbal supplements are beneficial or harmful will allow clinicians to make appropriate recommendations and spur further discussions about the quality of these supplements and whether they should be regulated by the FDA.

Nominator Information

Other Information About You: (optional)
Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

The information will be used to guide patients as to the risks or benefits of taking these herbal supplements.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program
Dietary Supplements in Adults Taking Cardiovascular Drugs