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Doody's Review ServiceReviewer: Paul R Hutson, Pharm.D., M.S.(University of Wisconsin)
Description: This is an up-to-date summary and assessment of clinical studies of dietary supplements. Although the list of supplements is not exhaustive, the authors succeed in addressing those that are both most likely to have therapeutic benefit and to be accessible to most patients. The book is divided into rational groupings of supplements as chapters (e.g., "Heart Health Supplements") that contain short monographs of individual supplements. These monographs include a short overview, a summary of the scientific support for common applications, safety, and common doses. Each monograph begins with a qualitative rating of the quality of the evidence for the applications presented, and ends with separate clinical trial references and in some cases suggestions for additional reading.
Purpose: The purpose is to provide a synopsis of clinical studies of the more commonly used dietary supplements. The stated goal is to enable healthcare professionals to converse with patients or clients about the clinical evidence supporting or refuting the use of single dietary supplements. In reviewing the more than 120 supplements, the authors provide some discrimination in identifying applications of supplements that do not appear at this time to have strong merit. A strength of the book is the reference of foreign studies (e.g., German or Chinese) for supplements that do not yet have a clinical trial record in the English literature.
Audience: Although the book is intended as a tool for healthcare professionals to improve their appreciation of the peer-reviewed clinical research literature on dietary supplements, in fact, it appears most helpful for nutritionists, sports trainers, and nurses. Inadequate evaluation is provided for pharmacists to weigh the merits of specific combinations or criteria for product selection. Physicians are provided with little if any guidance on the added benefit of supplements with respect to prescribed medications, nor are they given specific monitoring or counseling guidelines.
Features: The scope of dietary supplements addressed is very practical. Coverage of the various uses of supplements is also generally complete, with qualitative assessments of the relative merits of the supplement in the monograph introduction and text. The text is not data-rich, with numbers found almost exclusively in the presentation of doses. There are no tables comparing the effects of similar or complementary therapies to obtain a quantitative understanding of the likely treatment effect. The authors reflect the level of scientific evidence with their overall ranking for various applications. Information that is not consistently presented that would be helpful in patient counseling includes laboratory and clinical monitoring criteria and time points for assessing benefit and/or toxicity of the supplement, particularly if combined with prescription drugs.
Assessment: This is an excellent source of summaries of clinical trials of single-agent dietary supplements in a host of applications. It provides the motivated practitioner with current citations of relevant clinical trials that can be consulted if additional details or information is needed. Other resources may be more helpful, depending on the information required. The Natural Medicines Comprehensive Database (Pharmacist's Letter, 2006) also provides grouping of supplements by indication, and an index of the known ingredients of combination products. Monographs available in the online version address the relative merits of supplements for various applications. However, this guide is a good value and a very helpful resource for many healthcare professionals who are seeking a readable, organized summary of the utility, common doses, and safety issues associated with common dietary supplements.