Use and safety of dietary and herbal supplements among hospitalized patients: What have we learned and what can be learned?—A narrative review

Introduction The use of Dietary and Herbal Supplements (DHS) is on the rise. It has important safety ramifications, especially among inpatients. We aimed at summarizing the major findings on DHS use among inpatients and identifying areas for future research in the field. Methods A literature search for combinations of keywords related to “DHS” and “hospitalization” was conducted for English, French, Spanish and Hebrew papers in Medline, Embase, CISCOM, Cochrane Library, Clinical Key and Google Scholar with no restrictions in term of country of study. Results We identified 472 articles, 42 of which met our criteria. Narrative analysis of these articles revealed several findings: DHS use is common worldwide among inpatients from various socio-economic and medical backgrounds. DHS are consumed mostly by women, older and educated patients with the goal of relieving medical conditions. Patients tend not to disclose DHS use to primary care and hospital medical staff and physicians generally do not document their use in hospital files. Risks from DHS include side effects, potential and actual interactions with prescription drugs and substitution for medications. Conclusions Gaps in knowledge regarding DHS include their use by hospitalized patients in developing countries; specific association between comorbidities and DHS use; assessment of actual side effects from DHS; barriers to physician inquiry on DHS use; and DHS documentation. DHS use by inpatients is extensive and involves safety as well as medicolegal considerations. Although much has been learned on this topic, further research is needed on the conduct of both patients and physicians regarding DHS.