Call for research into CMs

Complementary medicines research is needed to build the evidence base about the safety, efficacy and public health benefits of these products and better inform health care policy decisions, ASMI has said.

The submission to the Federal Government on funding priorities for the $20 billion Medical Research Future Fund, prepared by the National Institute of Complementary Medicine with input from ASMI, advocates for funding of complementary medicine research projects to facilitate informed policy decisions on the use of CMs in preventive health and promoting general health and wellbeing.

Brenda Davy, ASMI’s strategy manager, complementary medicines, told the AJP that it’s vital to understand how CMs are used in the community.

“One area we need information about is how CMs are currently used in the health care sector; they’re taken not only by consumers as self care but used in hospitals, prescribed by GPs and used in allied health, so what do we know about that?” she says.

“How are they used – what are the outcomes? There’s a lot of anecdotal evidence, but how do you get systemic, across-the-health-care-system evidence about CMs?”

She says research does exist about CMs’ possible contribution to outcomes, but more was needed into a wider range of conditions and CMs.

“Imagine if more research was done, and analysis, to say of these CMs – which consumers are paying for out of their own pocket, with no cost to Government – and look at the potential positive outcomes, and therefore positive economic help or decreased burden to Government.”

Part of investigating consumer behaviour with CMs would be an investigation into their health literacy on the subject, she says.

“Health literacy is a big challenge. That’s not just with CMs, but definitely includes CMS; so what do we know about the health literacy of Australians, and the best way to provide information and access to information, to inform their health care decisions?

“When it comes to anything I’m taking for a therapeutic purpose, do I as a consumer understand why I’m taking it, or the role it should play in my health care? Am I looking out for any issues or reactions – and most importantly, am I talking openly to my health practitioner about the medicines that I’m taking?”

There is ample evidence to show that many consumers still do not talk to health professionals about their CM use, Davy says.

As interest in self care and self-management of preventive health continues to grow, pharmacists are well placed to advise on complementary medicines, including interactions with other medicines, and levels of evidence which range from gold-standard trials to “less robust” evidence.

“As with any of the medicines they offer in their pharmacies, pharmacists should be seen as a resource for consumers on CMs,” says Davy.

“They will need to have access to good information themselves, which is part of the challenge currently, because there’s such a breadth of CMs available.

“To have detailed expertise on so many ingredients and products is quite challenging, but there’s room to shift that from where it is today.

“CMs continue to be the fastest-growing segment in health care, and pharmacy is the biggest place to go – that’s where consumers prefer to get their CMs. These are consumers who want to do things to prevent sickness and improve their general health – the number-one reason people take CMs is for general health and maintenance, and prevention of getting sick – and that’s a great consumer base to have.

“Any way they can serve and provide information, assist education and help to that base is going to be beneficial – for pharmacists, for industry, for consumers and for government.”

The submission addresses the main impediments to effective use of CMs, resulting from inadequate incentives for manufacturers to undertake high quality research, lack of knowledge about the decision-making, information seeking, motivations, behaviours and communications of CM users nor the way in which such issues are mediated in different circumstances (based upon preventative use or specific condition/illness of user as well as other factors); and an inadequate understanding of the current and potential public health contribution of well-evidenced CMs.

It proposes research into potential contribution of CMs to outcomes; support for implementation of research-informed changes in health and health care systems towards an integrative system of health care; to undertake synthesis and dissemination of existing research; undertake collaborative new research; and build capacity within the research community to do applied research in CM, and within the health system to use this research to ensure their safe and efficacious use.

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