Publication Date 30/04/2012         Volume. 4 No. 4   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.

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Why universities should teach alternative medicine

Staff Writer

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Editing and Researching news and stories about global and local Pharmacy Issues

Editor's Note: There is a major debate under way, as to whether universities should accredit complementary and alternate (CAM) practitioners and their treatments.
The group called Friends of Science in Medicine which is mostly comprised of medical academics is seeking to have courses such as chiropractic, homeopathy etc removed from a university's curriculum.
There are many and varied modalities comprising CAM, and they are all popular in varying degrees.
In asking a medical doctor about his singular viewpoint he responded "Without a doubt, CAM practitioners who hold a degree simply devalue the medical degree I worked so long and hard to acquire".
The opposite view from CAM practitioners is that they treat mostly rejects from the medical stream and apparently respond to patient needs more appropriately.

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This is perhaps the debate we had to have to clear the air once and for all. Maybe both sides will learn from each other, maybe not.

Why universities should teach alternative medicine

Author:   Evelin Tiralongo    *Senior Lecturer at Griffith University

Linking research and teaching, universities are best placed to teach evidence-based CAM.

Qz64kg4q-1328236484Most readers would know of the current debate about universities teaching complementary and alternative medicine (CAM). A core question not being addressed in this debate is what other institution is better placed to deliver evidence-based knowledge of CAM.
The latest controversy started when a group called Friends of Science in Medicine (FSM) wrote to vice chancellors across the country asking them to review their health science courses. FSM rightly says that rigorous academic standards and evidence for scientific conclusions and health-care practices are of the essence and should be the basis of all university teaching.

I’m sure that any university lecturer would agree with these principles; most would consider themselves as friends of science in medicine. But it’s a matter of concern when the debate and terminology become simplistic, generalised and uninformed.

CAM is a term for many different practices and medicines and there’s scientific evidence for a number of them. Some of the modalities are derived from ancient sciences, for instance, and have a very long history of successful traditional use. FSM mentions acupuncture as a therapy it considers pseudo-scientific and argues that it shouldn’t be taught at university. But this isn’t entirely true.

There’s clinical evidence for acupuncture as effective treatment for various conditions, including migraines, tension-type headaches and chronic low-back pain. What’s more, there’s a Medicare rebate available for acupuncture if it’s part of a doctor’s examination. Why shouldn’t medical practitioners learn about the evidence for this treatment option at universities to increase consumer choices and improve patient outcomes?

The National Prescribing Service’s “Review of the Quality of Complementary Medicines Information Resources” can be used to identify which CAM information resources are of high quality, evidence-based, unbiased and well structured. The use of such high-quality resources is available and encouraged at universities.

In Australia, complementary medicines are regulated as medicines by the Therapeutic Goods Administration (TGA). The TGA’s ambit includes homeopathic and traditional medicines, such as Traditional Chinese Medicines. According to the TGA’s guidelines general and medium-level claims (such as the temporary relief of minor self-limiting conditions) for complementary medicine’s efficacy can be based on certain traditional use evidence. The guidelines allow the use of such medicines until high-level evidence, that would allow for high-level claims, is available.

A balanced view in this debate is particularly important because about 70% of Australians already use CAM, mostly alongside conventional medicines and treatments.

So the community expects health professionals to be able to provide information and guidance about the quality use of all medicines, which, according to Australian’s National Medicines Policy, includes complementary medicines. To be able to do that, health professionals need to be knowledgeable, at least, about the principle, paradigm and available evidence for all complementary medicines, including homeopathic and traditional medicines.

And where else would health professionals gain this knowledge if not at university, during their degree? One of the advantages universities have is the close relationship between research and teaching – students are more engaged and inspired by research-led teaching, and research is informed by queries from students while teaching. Many universities research CAM to generate an evidence base or prove their lack of efficacy.

So why support research but exclude teaching of CAM from universities? Aren’t we obliged to translate our research results into practice – starting by teaching new practitioners?

At Griffith University, evidence-based CAM education is integrated throughout the whole pharmacy curriculum. Our teaching research has shown that pharmacy students perceive education about CAM as a core part of their professional degree. We found that CAM research and education had a moderating effect on students' attitudes towards CAM. The training also encouraged students to look at and evaluate evidence and make informed decisions in the best interests of their patients.

We also offer a specifically designed “Short Course in Integrative Medicine for Pharmacists,” which has been accredited for continuous professional development. The course addresses the shortage of CAM knowledge among practicing Australian pharmacists as identified in a recent Pharmacy Guild-funded project, which surveyed Australian pharmacists nationally.

The survey found most pharmacists supported undergraduate CAM education (76%), and the majority (85%) were interested in additional CAM education themselves.

Research also suggests that CAM education may also teach practitioners greater self-awareness, improved core competencies (such as evidence-based practice), enhanced cultural competency and patient-centred care.

So should we turn our back on the consumer-driven trend toward holistic and integrative healthcare, or should we work together to understand, research and teach different principles, practices and evidence to improve health outcomes for customers and patients? I, for one, would prefer the latter.

This article was originally published at The Conversation. Read the original article.

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Submitted by Peter Kennedy on Thu, 09/02/2012 - 09:43.

Your argument would have a point if the universities (Southern Cross is the main offender) were actually teaching evidence-based "alternative" medicine. But in fact the vast majority of the "alternative" medicine that they are teaching has no relation to and is even contradictory to the evidence, and even teaches treatments which have not even any possible theoretical scientific basis, such as homeopathy and iridology.

Now it's true that the fact that a subject is taught at a government-funded university does not mean that governments endorse it. For example government funded universities in Australia teach everything from Marxist philosophy to Catholic theology. Taught by those who are acknowledged by others in those fields as having expert knowledge of them. Nobody sees this as the government endorsing such things.

However in the case of "alternative" medicine, those teaching and promoting them quite deliberately set out to convince people that these methods are a genuine "alternative" to scientific evidence based medicine. Sometimes with tragic consequences for the patients, and always with emotional and financial damage to the patients and their families. The average person sees the fact that someone has a slip of paper from a university as evidence that the government health authorities think that the treatment he is offering is safe and effective. Either these irrational "therapies" should be not taught at universities, or if they are then the universities should state very clearly, on their websites, and on diploma certificates etc, that the university and health authorities do NOT endorse the use of such treatments.

Submitted by Manisha on Thu, 16/02/2012 - 11:06.

Hi Peter can you explain your phrase "have not even any possible theoretical scientific basis" a little more with evidence?

Submitted by Loretta Marron on Thu, 09/02/2012 - 09:07.

Government funded 'Faith healing' has no place in medical or health related degrees.
The real questions that no-one who supports quackery is prepared to answer are:
"Should tertiary institutions be teaching homeopathy, iridology, tactile healing, reiki, reflexology, kinesiology, 'fundamentalist' chiropractic and 'energy medicine' as belief systems?"
"Should they be indoctrinating 17 year olds (as first year students) that "innate intelligence", qi, meridians and chakras as a fact?"
&"Should we be paying for these services in our health funds?"
If it is 'allied health' (such as hypnotherapy and massage) call it that, instead of CAM, which is an umbrella that covers all sorts of nonsense.
Of course test herbal remedies in universities but why not put "Trick or Treatment" (Ernst & Singh) as a text for all health students (some universities are already doing so) - so that students can learn about CAM from Prof Edzard Ernst the first Chair of CAM in the world, instead of from texts full of mumbo-jumbo.

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