by BH Ashar, et al.
October 24, 2008

Introduction: The widespread use of complementary and alternative medicine modalities such as dietary supplements has prompted many medical schools to offer courses covering such topics. To date, little is known about the impact of these courses on medical graduates' knowledge.

This study was designed to evaluate resident physicians' level of understanding of popular dietary supplement regulation and to determine whether an interactive online curriculum could aid in improving such knowledge.

Methods: A multicenter online educational intervention was developed and administered to physicians at 15 internal medicine residency programs throughout the United States, between March 1, 2006 and June 30, 2006.

Pretest performance was used to measure baseline knowledge of commonly used dietary supplements. Post-test performance compared with pretest performance measured the effectiveness of the educational intervention.

Results: A total of 335 physicians completed the module.

�?Baseline knowledge of dietary supplements was low (average pretest score 59.7%). More than one-third of respondents were unaware of the reasons for use of saw palmetto and black cohosh.

�?Results for questions on safety and drug-supplement interactions were similarly low. Only 57% of physicians knew that kava kava has been associated with hepatitis. Only 15% were aware that St. John's wort can lower cyclosporine levels [cyclosporine is an immunosuppressant agent used in organ transplant patients, for example].

�?With regard to knowledge of efficacy, only 36% were aware that fish oil has been shown to lower triglyceride levels.

After completion of the curriculum, scores improved significantly (P < 0.001) in all question/content areas.

Conclusions: Residents' knowledge of dietary supplements is poor. An online didactic module may improve knowledge and potentially enhance patient-physician communication regarding the use of such products.

Source: Southern Medical Journal, Oct 2008;101(10):996-1000. PMID: 18791539, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

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