Abstract

BackgroundProvision of clinically relevant information about complementary and alternative medicine (CAM) to health care professionals is not well described. The aim of the study was to assess questions about CAM to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS).MethodsAll question-answers pairs (QAPs) in the RELIS database indexed with alternative medicine from 2005-2010 constituted the study material. A randomly selected sample of 100 QAPs was characterized with regard to type of question (category, patient-specific or general), occupation and workplace of enquirer, the type of information search performed (simple or advanced), and if the answers contained information to provide factual or consultative replies (facts about or advice on clinical use of CAM, respectively). Proportions were compared with Fisher’s exact test with significance at the 0.05 level.ResultsOne thousand and thirty-eight (7.7%) out of 13 482 questions involved CAM. Eighty-two out of 100 questions concerned products containing one or more herbs, vitamins and minerals as well as other substances. Thirty-eight out of 100 questions concerned the category documentation (substance identification and/or literature reports about clinical effects), 36 interactions, 16 adverse effects, 9 pregnancy and lactation, and 1 question concerned contraindications. Sixty-three questions were patient-specific and 37 general. Fifty-four questions came from physicians, 33 from pharmacists and 13 from others (including nurses, midwives, students, CAM practitioners, and the public). Pharmacists asked more frequently about interactions while physicians asked more frequently about adverse effects (p < 0.05). Seventy-six of the questions came from outside hospital, mainly general practice and community pharmacies. Fifty-nine answers were based on a simple and 41 on an advanced information search. Thirty-three factual and 38 consultative answers were provided. In 29 answers, search provided no information. Lack of information to provide an answer was not significantly different between patient-specific (31.7%) and general questions (24.3%).ConclusionsGeneral practice and community pharmacies are the main sources for questions about CAM to RELIS. Physicians are concerned about adverse effects while pharmacists are concerned about interactions. Lack of information to provide answers to patient-specific and general questions about CAM represents a problem.

Highlights

  • Provision of clinically relevant information about complementary and alternative medicine (CAM) to health care professionals is not well described

  • We found sparse documentation of problem-oriented drug information and need of decision support associated with CAM in the literature, and believe the present pilot study could identify some challenges and areas of improvement for medicines information centres

  • The drugs involved in a Question-answer pair (QAP) are registered according to their generic name, trade name and ATC-number according to the Anatomical Therapeutic Chemical (ATC) classification developed by the World Health Organization [11]

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Summary

Introduction

Provision of clinically relevant information about complementary and alternative medicine (CAM) to health care professionals is not well described. The aim of the study was to assess questions about CAM to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS). The centres are localised at university hospitals in Norway, where pharmacists and clinical pharmacologists answer questions from health care professionals (mainly physicians and pharmacists) working in hospitals, hospital pharmacies, general practice and community pharmacies [1]. In 2005, 151 questions among 1876 involved CAM compared to 189 among 2420 in 2010 This reflects the use of this type of medicine both for acute symptoms, and chronic diseases among the public. Questions from health care professionals about CAM typically concern patients with chronic diseases where alternative medicine is added to an established drug therapy and decision support is requested. Availability of high quality evidence-based databases is of major importance to facilitate literature searches, and this is of importance regarding questions about CAM [3,4]

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