Dietary Supplements: Inpatient Policies in US Children's Hospitals

A recent study found that there is substantial variation in policies and policy quality in regard to dietary supplement use in children's hospitals even though more than 30% of children in the United States take dietary supplements regularly according to a review of nationally representative data from the 1999–2002 National Health and Nutrition Examination Survey (Picciano, 2007).

Researchers at the Osher Center at Harvard University and their colleagues undertook a study to examine pediatric hospital policies regarding dietary supplements. They administered a survey to pharmacy directors of 186 eligible member organizations of the National Association of Children's Hospitals and Related Institutions (NACHRI) to assess: written policies addressing dietary supplements; how such policies are made; and responsibilities for storage, administration, documentation, and checking for potential interactions.

Out of the 109 survey respondents, 44% had written policies on vitamins, minerals, herbs, and other dietary supplements. Few hospitals had herbs or other dietary supplements on formulary. However, most allowed patients to use their home supply of dietary supplements under defined circumstances. The researchers created a 10-point hospital policy and practices quality score to assess the quality of each policy. They found that 11% of the hospitals satisfied the 10 criteria necessary for a perfect hospital policy and practices quality score. The researchers also noted that policy development is complicated by the lack of assurance of quality and standardization of dietary supplements, the lack of safety and efficacy data for pediatric patients, and the difficulty of standardized pharmacy practices.

The authors conclude that National guidelines for dietary supplement polices need to be developed to ensure the safe use of dietary supplements in pediatric hospital settings.

Reference

• Gardiner P, Phillips RS, Kemper KJ, et al. Dietary Supplements: Inpatient Policies in US Children's Hospitals. Pediatrics (2008) 121, 775–781.
• Picciano MF, Dwyer JT, Radimer KL, et al. Dietary Supplement Use Among Infants, Children and Adolescents in the United States, 1999 – 2002. Archives of Pediatrics & Adolescent Medicine (2007) 161(10), 978–985.

Additional Resource

• More information on dietary supplements.
• More information on dietary supplements from the Office of Dietary Supplements.

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