Quality Improvement Project to Detect Use of Complementary and Alternative Medicine (CAM) in Patients at the Sepulveda VA Geriatric Medicine Clinic

Background/Objectives: The purpose of this project is to identify complementary and alternative medicine (CAM) use by patients seen at the VA Sepulveda ambulatory care center geriatric clinic. Failure to disclose CAM use to primary care providers may result in adverse interactions with prescribed medical treatments. We hope to increase detection of CAM use, and thus improve the safety of our patients by reducing potentially harmful polypharmacy. Geriatric clinic nurses provided patients and/or their caregivers a one-page questionnaire asking about to use of CAM while patients checked in to clinic. Once the questionnaire was collected, the geriatric fellow reviewed whether or not the questionnaire was appropriately documented in the electronic medical record. Results: Out of 137 patients who were seen at the VA Sepulveda geriatric clinic, 115 patients use some form of CAM. 56.2% of the CAM were over-the-counter medications, 34.2% alternative, herbal or natural supplements and 9.4% complementary therapy. 54% of the CAM were not documented in the EMR. Conclusion: The vast majority of the patients at the VA Sepulveda geriatric clinic use CAM and more than 50% were not documented, resulting in potential adverse interactions. Our goal is to encourage discussion about CAM in order to prevent medical complications arising from interactions between prescribed medications and CAM treatment, thereby improving patient safety.