We need to get real on CAMs

red and yellow capsules

Pharmacists have to make up a lot of ground to meet the expectations of consumers and other health professionals in the advice offered on complementary medicines, a leading clinical pharmacist believes 

Other health professionals would incur serious reputational harm if they provide products devoid of clinical benefit and if they fail to advise on possible interactions between CAMs and mainstream medicines said Dr Geraldine Moses, accredited pharmacist and pharmacy educator.

Pharmacy needs to develop the same levels of peer judgement or it will collectively face the judgement of its fellow health professions, she said.

Speaking at ConPharm 2018 in Brisbane recently, Dr Moses said pharmacists shouldn’t dismiss patient’s requests for information on CAMs, rather they needed to provide informed, objective advice, and help consumers understand the role these products could, and could not, play.

“I think we need to develop our role in helping consumers to have realistic expectations about CAMs, to choose wisely and to expect realistic outcomes.”

“Increasingly other health professionals will know that we have training in complementary medicines, so if we let people take remedies that may interact with their medicine regime, our reputation with our colleagues will suffer,” she said.

Dr Moses said it was important to question patients on what they expected from taking a CAM.

“You can’t know what their expectations are until you ask,” she said. 

“These can range from very specific and accurate to having absolutely no idea why they are taking one of these products. From my experience in conducting HMRs or RMMRs probably the most common expectation is simply that ‘it’s good for me'”.

“But they will often have no special reason for taking those particular remedies or for the dose they are taking.”

In one case she highlighted, the patient had self-selected all the CAM products she was using, and she told Dr Moses that she “liked the sound of them”. 

Dr Moses said chronic conditions that wee prone to lead to complementary medicine use include:

  • Osteoarthritis
  • Diabetes
  • Hypertension
  • Cancer
  • Depression
  • Chronic pain
  • Macular degeneration

“These conditions tend to be those with no easy cure, requiring long term treatment, and the patients feel “controlled” by their medication regime and treatment, and they also get bored with endless cycles of treatment,” she said.

“The important thing is to be giving them accurate information to make an informed decision about what they are buying, and then taking, addressing the perception that there is no potential harm, ie. ‘i’ve got nothing to lose’, and quantifying both sides of the risk/benefit equation”.  

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