16 March 2009

Health professionals and consumers can now refer to certain complementary medicine information resources with confidence, following a review and categorisation of existing databases commissioned by the National Prescribing Service Ltd (NPS).

The study was conducted by the Mater Health Services Brisbane, Bond University and the University of Queensland between June and November 2008.

Researchers considered the technical and content quality and clinical utility of 26 short-listed complementary medicine information resources, and ranked the most useful sources in two tiers. Of those reviewed, six were identified as being of highest quality (Tier One) and three were identified as being of high quality (Tier Two).

“Research conducted by NPS in 2008 found that in spite of widespread use of complementary medicines, both health professionals and consumers struggle to find reliable and accurate information about the safety and efficacy of these medicines,” NPS CEO, Dr Lynn Weekes said.

“Information gaps about complementary medicines were first identified in 2003 by the Expert Committee on Complementary Medicines in the Health System. People have been waiting a long time for an independent review of existing resources and trusted recommendations on which sources to use.”

A number of recommendations have been made by the authors including that the highest quality sources be made available in a number of formats for health professionals and consumers.

“Formats might include online and paper-based versions with brief monographs, and complementary medicine-drug interaction alerts incorporated into clinical software,” research Project Manager, Dr Treasure McGuire said.

“We also believe organisations responsible for providing complementary medicine information to consumers and health professionals should have access to either the Natural Standard Professional Database or Natural Medicines Comprehensive Database (Health Professional Edition), and actively refer people to the resources ranked as Tier One or Tier Two,” Dr McGuire said.

Review rankings:

Tier One

1. Natural Standard (online subscription database package with access to detailed and brief complementary medicine monographs.
2. Natural Medicines Comprehensive Database (Health Professional Edition).
3. Natural Standard - Professional monographs (subset of Natural Standard).
4. Herbal Medicines & Dietary Supplements package (via MedicinesComplete).
5. Natural Standard - Bottom Line monographs (subset of  Natural Standard).
6. MedlinePlus: Drugs, Supplements & Herbal Information.

Tier Two

1. Barnes et al. Herbal Medicines. 3rd ed 2007 (via Medicines Complete).
2. Natural and Alternative Treatments  (EBSCO).
3. Braun and Cohen. Herbs and natural supplements: An evidence-based guide 2nd ed. 2007.

Background information

In December 2008 NPS published two reports into the complementary medicine information needs and uses of consumers and health professionals. In these studies consumers, general practitioners (GPs) and pharmacists identified a number of gaps in the quality use of complementary medicines.

Individuals in all groups lacked knowledge about the safety and effectiveness of complementary medicines and many were unaware of independent and reliable sources of information about complementary medicines. GPs and pharmacists reported their need to access summary information while consulting with patients. They also reported a need to access more detailed information to answer specific clinical questions.

The recommendations from these reports were that health professionals and consumers have access to independent, regularly updated and evidence-based resources on the Internet, in clinical software, phone advisory services and/or in paper format.

Informed by this work, published in 2008, NPS commissioned further work to investigate ways to meet the demand for high quality information about complementary medicines. An independent evaluation of complementary medicines information resources was competed with a view to helping Australians make better informed decisions around the use of complementary medicines.

The evaluation involved four phases:

1. Identifying a list of complementary medicines information resources linked from reputable sources which met the objectives of the review.
2. Testing resources against broad criteria encompassing currency, coverage, transparency and content quality to produce a manageable short-list of complementary medicines information resources to be subjected to more rigorous detailed review.
3. Conducting an in-depth review of the short-listed complementary medicines information resources in the three areas:
1. Technical quality.
2. Content quality.
3. Clinical utility.
4. Synthesising findings and making recommendations: short-listed resources were scored and compared across the three areas of quality, with a total score calculated for each resource. Key features of each resource, its intended target audience, profile format, strengths, weaknesses and costs were also compared.

In the first phase, 52 complementary medicines information resources were identified. After short-listing, this was reduced to 26 resource variants for the in-depth review.

ENDS

The National Prescribing Service Limited (NPS) is an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.