Pharmacists have been urged by their professional organisation not to recommend homeopathic remedies or other complementary therapies unsupported by evidence.
In its first Choosing Wisely list of recommendations around ‘low value care” the Pharmaceutical Society of Australia (PSA) says pharmacists “should present clear information to consumers about the safety of and evidence for complementary and alternative medicines and only recommend these products when the known benefit outweighs the potential harm.”
“In regards to homeopathic products there is no reliable evidence of efficacy. All health professionals should take the time to discuss with health consumers, who are taking or considering taking these products, the lack of efficacy and the risks in rejecting or delaying other treatments known to be safe and effective,” said PSA National President Dr Chris Freeman.
NPS MedicineWise Client Relations Manager, Dr Robyn Lindner, said pharmacist medication reviews could play a major role in reducing the high numbers of hospital admissions due to medication misadventure.
“As experts in medicines, pharmacists have the ability to provide specialised review of a person’s medication regimen, resulting in recommendations or actions to help people get the most out of their medicines. Any person taking multiple medicines, high-risk medicines, or who is at high risk of medicine misadventure, including transitioning between care settings, should have their medicines reviewed,” Dr Freeman said.
The six PSA recommendations are:
1. Do not initiate medications to treat symptoms, adverse events, or side effects (unless in an emergency) without determining if an existing therapy or lack of adherence is the cause, and whether a dosage reduction, discontinuation of a medication, or another treatment is warranted.
2. Do not promote or provide homeopathic products as there is no reliable evidence of efficacy. Where patients choose to access homeopathic treatments, health professionals should discuss the lack of benefit with patients.
3. Do not dispense a repeat prescription for an antibiotic without first clarifying clinical appropriateness.
4. Do not prescribe medications for patients on five or more medications, or continue medications indefinitely, without a comprehensive review of their existing medications, including over-the-counter medications and dietary supplements, to determine whether any of the medications or supplements should or can be reduced or discontinued.
5. Do not continue benzodiazepines, other sedative hypnotics or antipsychotics in older adults for insomnia, agitation or delirium for more than three months without review.
6. Do not recommend complementary medicines or therapies unless there is credible evidence of efficacy and the benefit of use outweighs the risk. Choosing Wisely Australia encourages people to ask questions around any test, treatment or procedure being recommended to them and offers a list of 5 Questions people can ask their doctors or other healthcare providers.