Vitamins and other supplements: Pharmacists should collaborate with trainers

November 10, 2008

Physical and personal trainers recommend supplements and OTC products to their clients without considering possible interactions with other supplements or meds. By becoming an information resource to trainers, pharmacists can take the lead in promoting safe use of these products.

Key Points

While many personal trainers are licensed healthcare professionals or rehabilitation therapists, others are phys ed baccalaureates or personnel trained by the local chain fitness center. I don't think fitness is a bad idea, but adding dietary supplements and herbs like Hoodia, used to control appetite, without checking with one's pharmacist - that's a bad idea.

Pharmacists should engage these trainers and collaborate with them. They recommend the vitamins, minerals, herbs, and dietary supplements to be added their clients' routines. The question is whether pharmacists can identify and unveil opportunities to become involved in these programs while creating a complementary service to provide medication safety to our wellness-seeking clients and customers.

Start by ensuring reputable products from reputable manufacturers. Become familiar with the health products sitting on your shelves. Learn what they claim to accomplish or enhance, whether there is any clinical evidence of their effectiveness, appropriate dosing parameters (especially for teens and seniors), common side effects, and interactions with other supplements or (most important) with prescription medications used by individual consumers.

Reach out to those personal trainers advertising in your community and offer to be an information resource on the safe use of adjunct over-the-counter (OTC) medications and supplements used in their programs. As a pharmacist, you are an integral part of your community's health and wellness. While trainers are coaching on approaches to exercise and other external methods applied to the body, you should take your rightful place as the best coach for what goes into the body. Build relationships with trainers and coaches, learn what they recommend to win referrals. Ask to set up consultation appointments - and of course, charge a fee for your expertise (in keeping, of course, with your employer's business policies). Pharmacists' knowledge and licensure surpass the knowledge of the 18-year-old, part-time associate who works at the general vitamin store and makes product recommendations without asking all the right questions.

To promote the safe use of dietary supplements, you can offer fliers on common herb-disease, herb-drug interactions. Check whether your computerized dispensing system has an herbal drug-screening capability for duplicate therapy, drug interactions, and drug allergy interactions. Try to maintain a profile of these OTC products as your clients, old and new, and purchase them.

As a stakeholder to good pharmaceutical practice, keep on top of the latest medication-error and side-effect information available from such sources as the Institute of Safe Medication Practices (ISM) and the USP-ISMP Medication Error Reporting Program. Enroll in the U.S. Food and Drug Administration's listserve to receive automatic e-mail alerts on product recalls, cautions, and adverse drug reaction information gleaned from the MedWatch program. Become a grassroots stakeholder in medication safety and participate in the reporting process for OTC adverse drug interactions.

While the pharmacist is often the last healthcare professional sick patients see before they take their medications home in hopes of healing and feeling better, you should be the first person consumers want to see when they purchase OTC wellness products. Most of the time, pharmacists are called to fill and monitor prescriptions after patients have experienced a negative outcome. We should take advantage of an opportunity to support our patients as they seek to avoid them. We can help them stay well and thrive.

NANCY L. LOSBEN is chief quality officer at Omnicare Inc.