18 November 2008

GPs and pharmacists believe they don’t have enough access to evidence-based information about complementary medicines* and as a result are not confident discussing complementary medicines with their patients, according to preliminary findings from research into the information needs of consumers, GPs and pharmacists conducted by the National Prescribing Service Ltd (NPS).

The NPS research included determining the attitudes of consumers, GPs and pharmacists towards complementary medicines; communication about complementary medicine use; information sources; and information gaps and needs. Reports on the research findings are due for public release in early December.

“Our preliminary findings suggest while there is information on complementary medicines out there for healthcare professionals, the quality is variable and some health professionals may not know how to access evidence-based information from trusted sources,” NPS CEO, Dr Lynn Weekes said. 

“GPs and pharmacists are trained to seek evidence. What we are seeing is that the important information for healthcare professionals is getting lost among all the other information out there, which is impacting on their confidence when it comes to discussing complementary medicines with patients.”

“When you couple this with the fact that consumers don’t consider complementary medicines to be real medicines and many don’t think to tell their GP or pharmacist when they are taking a complementary medicine, it could become a serious issue,” Dr Weekes said.

Preliminary findings from this study include:

• Most GPs and pharmacists recognise the growing use of complementary medicines in the community.
  
  
• As current information sources vary greatly in their quality and ease of use, health professionals expressed a need for easily accessible, independent and evidence-based information provided in a range of formats.
  
  
• More than 80 percent of GPs and community pharmacists surveyed feel that complementary medicines need more scientific testing.
  
  
• GPs and pharmacists are not always proactive in enquiring about their patients’ complementary medicine use.
  
  
• Some focus group participants from both professions suggested they lack confidence in discussing complementary medicines with consumers as complementary medicines were not included in their university education, there are limited opportunities for professional development in this area, and there is limited access to high quality information resources.
  
  
• Both groups identified similar challenges around communication with patients about complementary medicines: patients often don’t see complementary medicines as medicines; a lack of time; and a lack of knowledge and resources about complementary medicines.

*Complementary medicines, also known as natural or alternative medicines, include herbal medicines, vitamin and mineral supplements, other nutritional supplements, traditional medicines such as Ayurvedic medicines and traditional Chinese medicines, homoeopathic medicines, and aromatherapy oils (where they make therapeutic claims).

ENDS

Background information

This NPS research evolved following a series of regulatory changes to the framework of complementary medicine in Australia.

The Office for Complementary Medicines was established in 1999 within the Therapeutic Goods Administration (TGA) and it created a world first regulatory framework for complementary medicines. In 2003, the Expert Committee on Complementary Medicines in the Health System was commissioned to report on the status of complementary medicines and therapies in Australia. In the report ‘Complementary Medicines in the Australian Health System’, the Expert Committee identified a number of concerns and made a series of recommendations to facilitate safe, appropriate and effective use of complementary medicines.

The Committee identified the need for consumers and health professionals to have ‘accurate, reliable and independent information’ about complementary medicines and to have appropriate skills to ‘interpret available information’ and ‘discriminate between reliable and unreliable information’ to allow them to make informed decisions about the use of complementary medicines. The lack of research about consumer and health professional complementary medicines information needs and skills was also identified in the report.

Recommendation 25 in the report suggested that “the Department of Health and Ageing commission a study to determine the complementary medicines information and skills needs of healthcare professionals and consumers, options for conveying this information to stakeholders, and the costs and resources necessary to meet these needs”. The research conducted by NPS goes some way to addressing this recommendation.

Research methods

A number of research methods have been used in this study. Preliminary research was conducted in 2005 and 2006 and drew on a range of sources and activities, such as:

• A review of relevant literature from common health and medicine databases
• Qualitative research with consumers suffering from a chronic condition
• A review of calls to NPS medicines information telephone services
• Inclusion of questions on complementary medicines in NPS surveys
• Telephone surveys
• A review of data from the Bettering the Evaluation and Care of Health (BEACH) Project and IMS wholesale data on CM sales in 2005 provided by the Complementary Healthcare Council
• Two Supplementary Analyses of Nominated Data (SAND) studies.

The consumer research consisted of a cross-sectional computer-assisted telephone survey conducted in mid 2007 and in-depth interviews with users of complementary medicines across Australia.

Health professional research focused on GPs and community pharmacists. Mail surveys and focus groups were carried out between March and September 2008.

A review of complementary medicines information sources and fact sheets was carried out between June and November 2008.

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.