Focus on Alternative and Complementary Therapies

Cover image for Vol. 21 Issue 2

Edited By: Edzard Ernst, Peninsula Medical School, UK

Online ISSN: 2042-7166

Virtual Issue: CAM for Pharmacists

Edzard Ernst

Pharmacists are often the only healthcare professionals who might advise consumers about CAMs. We know from many surveys in this area that large proportions of patients who are tempted to try some form of CAM do not tell their doctor about their plan. They might be encouraged by what they find on the internet, by what they read in the papers, or by what they hear from neighbours, friends and relatives. Subsequently, they go to the next pharmacy to find out more.

Most pharmacies offer CAM-products for sale; the range is wide and includes herbal and homeopathic remedies, aromatherapy oils and Bach Flower Remedies as well as magnetic bracelets and non-herbal supplements. Most consumers tend to trust their pharmacist; if they see a product for sale in their local pharmacy they are likely to believe that it does more good than harm. This “seal of approval” is thus important and might be decisive for patients’ decision to use the CAM in question.

This scenario places considerable responsibility on the shoulders of the pharmacists. Arguably, they should only sell CAM products which are backed by some evidence. However, this might not be realistic; after all, pharmacists have to make a living. This shop-keeper role puts pharmacists in a difficult position because, undeniably, they are also healthcare professionals who have to adhere to ethical standards. The ethical codes of pharmacists differ from country to country, but uniformly they demand that pharmacists inform their clients responsibly and truthfully about the medical products they sell.
One conclusion from all this is fairly obvious: pharmacists need to be informed about the evidence in CAM. This virtual issue is dedicated to this subject. It provides several evidential pieces as well as a few cautionary and thought-provoking comments. Where should pharmacists stand on homeopathy, for instance? Their dual role as shop-keepers and healthcare professionals is difficult to integrate when selling remedies which are not supported by good evidence. If they do sell such remedies, what information should they provide? If they truthfully say that a product is not supported by good evidence, they are acting against their own financial interests. How can pharmacists resolve these conflicts?

I hope that the articles in this virtual issue stimulate pharmacists to reflect about the difficult issues at hand. The ultimate goal here is to improve healthcare in the interest of patients and consumers.

Virtual Issue Contents

Commentary: the law, unproven CAM and the two-hats fallacy
Caulfield, T.

Homeopathy for insomnia and sleep-related disorders: a systematic review of randomised controlled trials
Ernst, E.

Why homeopatohy is unethical
Smith, K.R.

The ethics of using homeopathy in clinical practice
Jonas, W.B.

Is evidence-based complementary and alternative medicine a contradiction in terms? 'Yes'
Toneli, M. R.

Is evidence-based complementary and alternative medicine a contradiction in terms? 'No'
Holt, S.

Efficacy of herbal supplements containing Citrus aurantium and synephrine alkaloids for the management of overweight and obesity: a systematic review
Onakpoya, I., Davies, L. and Ernst, E.

Why pharmacists should not sell homeopathic products
Pray, W. S.

Factors affecting the pharmacokinetics of herbal preparations and their impact on the outcome of clinical trials
Clement, Y. N.