Pharmacy criticised as diabetes trial launches

The launch of the Pharmacy Diabetes Screening Trial has been warmly welcomed by some stakeholders – and less so by others

The Pharmacy Guild welcomed the launch but Australian Doctor clinical news editor Michael Woodhead wasn’t so keen, slamming pharmacy for selling a complementary medicine containing chromium and cinnamon.

Guild Victorian branch president Anthony Tassone suggested a more constructive approach to diabetes, but Woodhead was not to be swayed.

Tassone told the AJP today that it would be useful for doctors and other stakeholders to instead focus on screening for diabetes.

“The diabetes screening pharmacy trial is a good thing for the Australian public, as it will help increase the detection of diabetes – it has been well documented that there is a significant number of Australians who may be suffering from diabetes but may not know it,” he pointed out.

“This pharmacy trial program will help assess an expanded role pharmacists can play in primary care, improve community awareness about chronic disease and refer patients to their GP for further treatment.”

Pharmacy’s accessibility makes it a key strategic channel to screen Australians for the disease, he says.

“The Pharmacy Guild’s geo-spatial analysis, that was provided as part of our submission to the Harper Competition Policy Review and further updated for the Review of Pharmacy Remuneration and Regulation, has demonstrated that community pharmacies are the most accessible major service in Australia,” says Tassone.

“This is about making the most of the opportunities that community pharmacy has with the Australian public, being not only the most accessible but the most visited primary health care destination.

Pharmacist and AJP contributor Jarrod McMaugh also waded into the Twitter discussion.

“My issue with Woodhead’s comments is that they are treating pharmacists as if they are a homogenous group, when clearly we are very diverse,” McMaugh told the AJP.

“Should a whole industry be judged because some sell products that others wouldn’t?

“For instance, I feel that homeopathy is inappropriate to sell; and I don’t. Others in my industry believe that the patient has the right to choose their treatment, and that selling it in pharmacy provides an opportunity to discuss the failings of the modality.

“Yet more pharmacists believe it works, despite evidence to the contrary.

“If we were to say that all pharmacists should be judged on the practice of some, then this means all health professionals will be in the same position; from nurses judged on the behaviour of those who are members of AVN, to therapists who base their treatment on hypnosis techcniques.

“Should we also say that all medical editors be judged in the same category as those why try to create the news, rather than reporting on it? Clearly, it’s not justifiable.”

McMaugh says that he also has concerns about the suggestion of “deception”.

“Another issue I had with Mr Woodhead’s technique is that controversial treatment options will generate strong opinions and strong statements.

“Is it deceptive to recommend chromium? That depends on your understanding of the condition being treated, and the outcomes being sought with the application of that treatment.

“The link Mr Woodhead provided is a meta-analysis that suggests that chromium use isn’t useful for people with normal glucose metabolism. It also suggests there is some evidence for its use on patients with diabetes and that further investigation of this evidence would be warranted.

“Does that provide the level of certainty required to label the sale of these products as deceptive? I’d suggest not, and that making such a comment is driven by a desire to create controversy more than a genuine belief in the accusation being levelled at pharmacy.”

Tassone points out that it is not helpful to attack the Pharmacy Guild over complementary medicines, as it is not a medicines regulator.

“Complementary medicines have formed a significant part of the discussion following the Pharmacy Remuneration and Regulation Review, however they aren’t really a part of the terms of reference of that review.

“Whether or not CMs should be sold from community pharmacies may not be the key health priority or issue affecting Australians on a day to day basis.

“I’d also like to say that the Pharmacy Guild is supportive of a more stringent and robust registering system by the TGA with regard to their register of therapeutic goods – they are the regulator when it comes to therapeutic goods, and we look to them for guidance on the requirements for evidence to back up health claims.

“We can move past this by returning to what the pharmacy trial program is trying to achieve, and the fact that it’s a collaboration of university researchers using a randomised controlled trial methodology.”

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  1. Karalyn Huxhagen

    getting back to the trial. I hope the trial highlights just how much work pharmacy and pharmacists put into management of diabeletes in general practice. In my area of practice I do a lot of the leg work and paperwork for the patients as the GPs tell me they are not reimbursed for the amount of time that the current NDSS system causes them. This expands to meter selection and follow up on issues such as wound care, urinary trct infections and a plethora of issues. we no longer have an endocrinologist in town so issues such as divers licences and diabetes becomes an issue for miners and truck drivers who need their licences.
    Diabetes management is so much more than pricking a finger and keeping BSL records. Keeping records is as useless as tits on a bull if no one reviews them and manages the condition to prevent or arrest decline in areas such as microalbuminurea.
    I agree with Michael that evidence based products should be kept in pharmacies but like Jarrod said the evidence to condemn is not good as yet. I attended two cardiology lectures in one week this month and each cardiologist had a different view point on CoQ10. you need evidence that is using human cells. I am not a mouse. let us use the trial to gain a program tha improves patient outcomes and gives a fair remuneration for all of us who do the leg work to achieve this outcome.

  2. In reply to Michael Woolhead regarding pharmacies supplying complimentary medicines. I work in an aged care environment and pack a large number of medication profiles. These profiles often contain complimentary medicines that are not evidence based charted by the general practitioner. General practitioners have legitimised and promoted the use of complimentary medicines by behaving in this manner. How credible is this practice and why is there an obsession with pharmacists following the directions of general practitioners in supplying these products?

  3. olga

    I watched a university trial in the UK on homeopathic antibiotics on blood samples. Guess what, they only worked 59% of the time and the regular antibiotics worked better on the blood samples but only 1% better. Homeopathics have a place along side traditional medicines. If you don’t believe this, that’s your prerogative, but don’t tell the rest of us that it doesn’t work in some applications because some of us believe it does. Give us some real evidence to back up your belief. Explain then why placebos work in some applications when the patient believes they are the real thing. Isn’t it better to take something that has no side effects?

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