Editorial
Welcome to the first homepage edition of i2P for 2012.
In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011.
One of those items for i2P was that a third-party provider to the site did not advise of a code change to the security section in our subscribe panel, creating a range of frustrated subscribers not able to get on board.
We apologise to all those potential subscribers who were unable to register with us in the second half of 2011, but if you try once more you should have no problem.
Columns
Rollo Manning: Pharma-Goss
Linda Bryant: Inside NZ
Loretta Marron BSc: Health Watch
Barry Urquhart: Marketing Focus
Mark Neuenschwander: I`ve been thinking about...Recent Comments
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Volume 2012 Number 1
Health Politics
Neil Johnston: Friends of Science in Medicine
Peter Sayers: Confessions of a Frustrated Pharmacist
James Ellerson: $75.5 million in 5CPA lying idle. Why is it so?EPublications
Complementary and alternate medicines
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Introducing current ideas, perspectives and issues, to the profession of pharmacy | |
There are many views held in pharmacy as to the efficacy and value of complementary and alternate medicines. i2P asked Mark Coleman to make a comment which appears below the news item that originally appeared in Pharmacy News on June 24 2010.
At i2P we endeavour to cater for all perspectives by publishing the views of skeptics such as Loretta Marron, who takes a “no holds barred” approach, and insist that the only perspective for medical professionals to prescribe/sell drugs be evidence-based.
On the other side, we recently published an article by Chris Wright (a regular i2P author), who is not a pharmacist but has a good working knowledge of pharmacy.
He opted to take acupuncture treatment from his GP instead of consuming anti-inflammatory drugs.
His GP gave him the choice.
Chris’s article drew strong comments from the “evidence-based perspective”.
(Follow this link to view comments at the end of the article)
Chris chose acupuncture because he felt it would work for him.
Acupuncture is mentioned in the last line of that news item.
Complementary medicines could be key to treating chronic diseases
Australian research shows patients with chronic health diseases who use complementary and alternative medicines (CAMs) are more confident in managing their conditions.
The study led by researchers from Monash University, Melbourne, revealed people with type 2 diabetes and cardiovascular conditions who consulted with CAM practitioners feel they were more knowledgeable about managing their illness.
Leader of the Complementary and Alternative Medicine, Economics, Lifestyle and Other Therapeutic approaches for chronic conditions (CAMELOT) project, medical anthropologist Professor Lenore Manderson believes the use of complementary approaches should not be overlooked when treating chronic diseases.
“The survey results so far indicate that most people who consult with CAM practitioners believe the treatment relieves their symptoms (74 per cent), increases their knowledge about their problem (60per cent), and makes them feel more confident about managing their condition (56 per cent).
“Given these results and efforts being made to educate the public to better manage their health, it may be an oversight to overlook CAM in the current national health reform agenda,” Prof Manderson said.
The majority of people with chronic conditions who use CAMs do so in conjunction with pharmaceutical treatments and do not tell their doctor, because of the belief their doctor would not support the complementary treatment.
“A common reason for not informing doctors is because of a perception that doctors are anti-CAM.
“This suggests that there is some way to go to build better understanding between the medical profession and the growing CAM industry,” she said.
The study estimated that 70 per cent of the Australian population use CAMs ranging from vitamin supplements to spiritual healing and acupuncture.
Mark Coleman comments:
There is no doubting the popularity of CAM’s and complementary therapies, and the fact that many people claim benefit from taking them.
In the case of Chris Wright, we have two intelligent and consenting adults being able to make an informed choice.
On the one hand, the GP would not be inclined to offer acupuncture therapy unless he felt within his clinical discretion that it would work, otherwise his practice would suffer accordingly.
One the other hand, Chris Wright was well aware of the corrosive side effects of the anti-inflammatory drugs coupled with extensions into heart failure.
Yet this evidence-based treatment was rejected because the patient was well aware of the dangers and did not want to injure his health further.
So he made an informed choice as to what he preferred, and that is his right.
My reading of the skeptics position is that they are totally opposed to practitioners not giving informed choices and who exploit vulnerable patients, particularly cancer patients.
Nobody wants to see cynical exploitation of patients for profit making purposes, and I would never support that type of activity.
While Chris Wright may have a chronic condition, he is intelligent enough to recognise exploitation. His relationship with his doctor has been long standing and sufficient to have had a trust developed.
Government in Australia is fostering the concept that patients take control of their health conditions. As this process develops there may be a journey into non evidence-based processes and medications.
That may have to be accepted if we are to have a low cost and workable health system.
The other problem in the evidence-based arena is that a lot of the “evidence” has been massaged by global manufacturers, and distorted research reports are accepted as valid in the medical community.
Indeed this happened with the anti-inflammatory product Viox with product deregistration, drug recalls and class actions against the manufacturer the result.
Many patients are aware that this has happened and trust is the casualty here.
Because some therapies and medications (particularly CAM’s) are not evidence-based, it does not mean that they lack efficacy.
They languish until funds become available from a source such as government before they can be tested and become evidence-based.
Anecdotal results and experiences remain the only measure here.
Professional discretion from a trusted and recognised health professional can help fill some gaps for patients.
As Chris points out, acupuncture has been around for 5000 years so surely a body of disgruntled patients would have resulted in that time for a revolt to occur.
My view is that extreme perspectives exist on both sides of the “evidence-based” arguments and that with caution it is possible to introduce complementary medicines and therapies to patients, provided they request them and they are provided with appropriate information to make an informed choice.
Unless exploitation exists, that decision is a private one between the patient and the trusted health professional.
Freedom of choice is the imperative.
Research Reports
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Information Technology
Dr David More: Australian Health Information Technology LinksIndigenous Health
Preventive Medicine
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Submitted by Peter Kennedy on Wed, 30/06/2010 - 16:45.
Astrology has been around for 5000 years too. That doesn't mean there is any basis to it. The fact that a therapy has been around a long time with no large body of disgruntled patients is not evidence of its efficacy. It may in fact be evidence of its inefficacy. If a treatment doesn't work the "alternative doctor" says you haven't used it for long enough, and so people keep on using it until, as invariably happens with chronic diseases, there is a regression to the mean and the "doctor" claims that his treatment caused the 'improvement". And the story of the "cure" gets passed down to the next generation.
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