P.Harm specialists are often the most accessible healthcare professionals, and for many Americans, their expertise can be especially valuable when it comes to advice on complementary and alternative medicine (CAM).
CAM is an umbrella term encompassing a wide variety of treatments and practices that can range from supplements to vitamins to herbal products. Thanks in part to the COVID-19 pandemic, the popularity of these products has increased significantly in recent years.
According to Nutrition Business Journal,1 the supplements market added $4.15 billion in sales in 2021 and exceeded pre-COVID-19 projections by more than $5 billion. Despite the ACM’s commercial growth, more can be done to better educate pharmacists about this area, which will, in turn, help patients achieve their own health goals, experts say.
“We could certainly do a lot better in pharmacy education in general by teaching these treatment modalities,” said Alice Scaletta, PharmD, associate professor of clinical pharmacy at the Philadelphia College of Pharmacy at St. Joseph’s University in Pennsylvania. She noted that this lack of education creates a domino effect: “My teachers were never trained in this, so they won’t be able to teach us, and then it continues,” she said.
In her role, Scaletta offers an elective course on herbal products, natural medicines and dietary supplements to all professional year pharmacy students – a crucial elective course, given that a study of 2020 national consumer survey data shows that individuals want pharmacists to have a better understanding of these medications.2
This 2020 study also found that respondents had positive perceptions of these medications compared to Western medications.2 Based on these findings, the researchers concluded: “It is important that pharmacists are better prepared to provide advice to patients using CAM on their appropriate use (adverse effects). ) effects and interactions with other remedies.
When it comes to increasing pharmacist and patient education about these treatments, keep several things in mind. On the one hand, it’s important to keep in mind how terms are defined. For example, replacing alternative medicines with integrative medicines may be a more accurate and inclusive way to discuss treatment with supplements, herbal products, and other medications.
According to Scaletta, most of the time, patients do not use only conventional or unconventional medicine; they use both. Therefore, complementarity refers to patients using conventional and unconventional approaches at the same time – sometimes without the knowledge of all their health care providers – whereas “integrative medicine is when there is actually coordination of care between all their treatment modalities, including conventional and non-conventional.” ” she says.
Additionally, use of the term CAM may imply that these treatments are “second tier to traditional allopathic approaches,” said Lara Zakaria, PharmD, CNS, IFMCP, an integrative pharmacist and nutritionist in New York, New York. Zakaria typically uses the term nutraceutical to describe these types of therapies.
Moving away from the alternative label may also allow pharmacists to discuss medications in more detail, with an emphasis on basic biochemistry and metabolic function. “The pharmacy has the opportunity to step in (and be) the patient’s chemistry expert and be part of their clinical team,” said Kathy Campbell, PharmD, a community clinical pharmacist in Owasso, Oklahoma. “What pharmacists need to understand is that it’s essentially chemistry and pharmacists are the chemistry experts in medicine. No one is trained in the depth of chemical interactions at the cellular level like a pharmacist is. We have a very specific point of view when it comes to drugs and metabolic functions.
It is also crucial to be open-minded about these medications and convey accurate information to the patient without judgment, especially when treatments may do more harm than good. Campbell emphasized that in the end, “it doesn’t matter what I know. It’s what the patient knows and what they can do every day that really creates results.
Additionally, patients may be hesitant to ask pharmacists about these medications because they fear being judged or fear they will be immediately stopped, Scaletta said. “For us to have a patient that actually opens up to us about these things is actually a huge privilege (because) it opens that door and an opportunity for us to educate them.” So it’s very important to recognize this and approach them without judgment, whatever your goal. the points of view are.
It is estimated that less than 40% of patients who use herbal supplements tell their healthcare providers.3 Creating a trusting environment where patients feel comfortable consulting with their pharmacist about their use of these medications can also help prevent negative herb-drug interactions. For example, using St. John’s Wort with a selective serotonin reuptake inhibitor could lead to a potentially fatal interaction, according to the National Center for Complementary and Integrative Health.4
“As someone (who is) responsible for checking drug interactions or the appropriateness of treatment, it’s really important that pharmacists are trained in this area,” Zakaria said.
When it comes to regulation, supplements fall under the food arm of the FDA and receive far less review and oversight than pharmaceutical products. This can be a problem when proprietary blends are marketed with labels that do not disclose all of the product’s ingredients. Supplements also do not need to be safe or effective before being released to the market.
One source pharmacists can turn to for information is NatMed Pro, a comprehensive subscription-based service with a drug interaction and effectiveness checker, all backed by scientific evidence.
Providing patients with advice based on evidence rather than opinion can help foster this trusting relationship. It is also important to dispel misconceptions that these treatments have no proven benefit. “You don’t want to make a blanket statement saying things like, ‘If it’s an herbal product, if it’s unconventional, then you shouldn’t take it,'” Scaletta said.
Drug-induced nutritional deficiencies are just one example in which supplements can benefit the patient. “On any given day, pharmacists would not dispense a thiazide diuretic without a potassium supplement,” Campbell noted. Some patients may also be deficient in certain vitamins or minerals due to an underlying illness or injury.
“It’s not about choosing sides. It’s about recognizing that our patients use both sides,” Scaletta said. “And if I want to be most helpful to them, I must be a reliable, non-judgmental source of education for them – not an adversary – for the approach they choose to their lives.”
