Nutraceutical Use among Patients with Chronic Disease Attending Outpatient Clinics in a Tertiary Hospital

Impact of nanotechnology on the oral delivery of phyto-bioactive compounds

Nanotechnology is an advanced field that has remarkable nutraceutical and food applications. Phyto-bioactive compounds (PBCs) play critical roles in promoting health and disease treatment. However, PBCs generally encounter several limitations that delay their widespread application. For example, most PBCs have low aqueous solubility, poor biostability, poor bioavailability, and a lack of target specificity. Moreover, the high concentrations of effective PBC doses also limit their application. As a result, encapsulating PBCs into an appropriate nanocarrier may increase their solubility and biostability and protect them from premature degradation. Moreover, nanoencapsulation could improve absorption and prolong circulation with a high opportunity for targeted delivery that may decrease unwanted toxicity. This review addresses the main parameters, variables, and barriers that control and affect oral PBC delivery. Moreover, this review discusses the potential role of biocompatible and biodegradable nanocarriers in improving the water solubility, chemical stability, bioavailability, and specificity/selectivity of PBCs.

C. B, Shrestha S. Evaluation of nutritional supplements prescribed, its associated cost and patients knowledge, attitude and practice towards nutraceuticals: A hospital based cross-sectional study in Kavrepalanchok, Nepal

BACKGROUND

There is substantial increment in nutraceutical consumption in Nepal, although the data on its efficacy and safety is scarce. The practices of nutraceutical supplements users in Nepal remain undocumented. Therefore, this study was conducted to study the prescription pattern, cost, knowledge, attitude and practice (KAP) of the patient towards nutraceutical.

METHODS

Descriptive cross-sectional study with stratified purposive sampling (n = 400) (patients from the out-patient departments of Scheer Memorial Adventist Hospital, Kavre, Nepal) was performed using a validated structured questionnaire assessing the socio-demographic characteristics, knowledge, attitude, practice of nutraceutical and total cost patients spent on nutraceutical alone. Pearson Chi-square test (x2) was used to investigate the association between socio-demographic variables and patients' KAP (knowledge, attitude and practice) towards nutraceutical. One way ANOVA was performed to compare the cost of nutraceutical among the different outpatient departments.

RESULTS

More than 80% of patients were found to be consuming nutraceutical on their own. The mostly prescribed nutraceutical were vitamins (40.7%), minerals (23.7%), enzymes (21.1%), proteins (8.8%), probiotics (4.2%) and herbals (2.0%). With the most common reasons for consuming nutraceutical were to maintain good health (70.0%) and healthcare professionals (57.85%) were the most approached source of information for nutraceutical. Nearly half of the patients (46.5%) had an inadequate level of knowledge whereas more than two-third (71.5%) showed a moderate positive attitude towards nutraceutical use. The average amount patients spent was NRs.575.78 [equivalent to USD 4.85] per prescription on nutraceutical alone. The maximum cost amounted to NRs 757.18 [equivalent to USD 6.43] in Orthopedics, and the minimum cost was NRs 399.03 [equivalent to USD 3.36] in Obstetrics and gynecology, respectively. There was a significant difference (p <0.001) in cost of nutraceutical prescribed between the OPD clinics.

CONCLUSION

The higher prevalence of inadequate knowledge despite moderate positive attitude towards nutraceutical among patients regarding some significant issues such as safety and interactions of nutraceutical consumption and its' substitution for meals reflects the need to develop an educational strategy to increase general public awareness on the rational use of nutraceutical.