By Lisa Leighton
VICTORIA — Pharmacists need to be more careful when it comes to selling complementary medicines, doctors in B.C. warn.
At its annual meeting in June, delegates of the B.C. Medical Association (BCMA) approved a motion calling on “the B.C. College of Pharmacists to implement measures requiring members of that College to recommend only products shown to be effective in well-designed scientific trials.”
An “increasing and significant number” of pharmacists are selling and displaying alternative medicines that are not supported by scientific evidence, says physician Brian Dixon-Warren, chair of BCMA’s committee for alternative therapies and allied health. “The appearance is given of them being advocated. That doesn’t square with scientific prescription practices from the medical point of view.”
While patients have a right “to choose within the realms of what is available to them,” continues Dixon-Warren, “that doesn’t remove from professionals the responsibility to give good advice. It’s certainly responding to public pressure, but just as good doctors don’t automatically prescribe things because their patients want them, we would feel the same thing should be true for pharmacists.”
Coincidentally, the pharmacy College’s board has already developed a policy for the distribution of alternative therapies in pharmacies. The policy states that pharmacists “must understand the indications, contraindications, risks and expected outcomes of the products offered to the public,” but does not address the issue of clinical proof of remedies. “I don’t think our policy will meet the expectations of the BCMA, but we will look at the matter when it comes to us because we do have a good working relationship with the doctors,” Linda Lytle, the College’s registrar, was quoted as saying in The Vancouver Sun.
The quality assurance conundrum comes as consumer demand for non-pharmaceutical remedies continues to grow. Recent research suggests that more than one-third of Canadians are using complementary medicines, resulting in a market that’s estimated to be worth as much as $1 billion. Demand is expected to continue to grow as Canadians become more educated about the products.
B.C. pharmacists have been quick to respond to the changing market. Ian Lloyd, a pharmacist and chartered herbalist (and a Pharmacy Post columnist), estimates that 50% of his patient enquiries are about herbal products. Lloyd, of the Pharmasave Health Centre in Victoria, says that one of pharmacy’s greatest challenges is dealing with conflicting opinions and skeptics within health care.
“I find that as long as my claims are reasonable and backed up by proven results,” he says, “most health care professionals are open to new ideas.”
Bob Kucheran, executive director of the B.C. Pharmacy Association, agrees. “The provision of sound scientific knowledge and professional skills is where we can have the most valuable impact upon the sale of complementary medicines,” he says. “What is desperately needed is knowledgeable, professional advice and guidance about how to best utilize them.”
Recognizing this need, the Tzu Chi Institute for Complementary and Alternative Medicine was established in Vancouver in 1996. Part of its mandate is to be an information centre for professionals as well as the public.
As well, some suppliers are working to help pharmacists become more knowledgeable.
At Unipharm Wholesale Drugs Ltd., pharmacists are advised to ask suppliers a series of questions before deciding to stock their complementary product. “The fact that there are so many manufacturers, along with the limited regulation of natural health products by Health Canada, makes it difficult for pharmacists to decide what products to stock and recommend to their patients,” says Jane Gillis, Unipharm’s manager of professional services.
Regardless of standards, increasing consumer demand for complementary products is going to force doctors and pharmacists to respond. “We’re trying to find common ground,” says Dixon-Warren.” The intent of the resolution was not intended to be critical in any way of the profession. We value our relationship with pharmacy.”
The resolution must now pass a second round of approval, from the full board of the BCMA, expected this fall.