ideasIdea
An open supplement-drug interaction checker built into oncology prescribing
Most patients take supplements and rarely tell their oncologist. Ask routinely and check automatically for interactions with chemotherapy and targeted drugs.
Herbal and dietary supplement use is common in cancer patients and can alter drug metabolism (St John's wort, curcumin, green tea extract with certain kinase inhibitors) or interfere with treatment. Data are scattered across MSK's About Herbs, pharmacology references and case reports. The proposal is a curated open database of supplement-anticancer drug interactions with evidence grades, integrated into electronic prescribing so that documented supplement use triggers an alert, plus a standard intake question at every prescribing visit.
Hypothesis
Routine intake and automated checking increase documented supplement use severalfold and reduce clinically relevant interactions and unexplained toxicity or subtherapeutic exposure.
Rationale
Disclosure rises when asked non-judgementally; interaction knowledge exists but is not at the point of care.
What would test it
Implement in two centres; measure documentation rates, alert frequency and pharmacist-confirmed interactions before and after.
Maturity
early clinical
Who has to act
data
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks
- Misinformation and unproven therapies · Patients are sold unproven treatments and frightened away from proven ones.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.