s Why universities should teach alternative medicine | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Why universities should teach alternative medicine

Staff Writer

articles by this author...

Editing and Researching news and stories about global and local Pharmacy Issues

Editor's Note: There is a major debate under way, as to whether universities should accredit complementary and alternate (CAM) practitioners and their treatments.
The group called Friends of Science in Medicine which is mostly comprised of medical academics is seeking to have courses such as chiropractic, homeopathy etc removed from a university's curriculum.
There are many and varied modalities comprising CAM, and they are all popular in varying degrees.
In asking a medical doctor about his singular viewpoint he responded "Without a doubt, CAM practitioners who hold a degree simply devalue the medical degree I worked so long and hard to acquire".
The opposite view from CAM practitioners is that they treat mostly rejects from the medical stream and apparently respond to patient needs more appropriately.

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This is perhaps the debate we had to have to clear the air once and for all. Maybe both sides will learn from each other, maybe not.

Why universities should teach alternative medicine

Author:   Evelin Tiralongo    *Senior Lecturer at Griffith University

Linking research and teaching, universities are best placed to teach evidence-based CAM.

Qz64kg4q-1328236484Most readers would know of the current debate about universities teaching complementary and alternative medicine (CAM). A core question not being addressed in this debate is what other institution is better placed to deliver evidence-based knowledge of CAM.
The latest controversy started when a group called Friends of Science in Medicine (FSM) wrote to vice chancellors across the country asking them to review their health science courses. FSM rightly says that rigorous academic standards and evidence for scientific conclusions and health-care practices are of the essence and should be the basis of all university teaching.

I’m sure that any university lecturer would agree with these principles; most would consider themselves as friends of science in medicine. But it’s a matter of concern when the debate and terminology become simplistic, generalised and uninformed.

CAM is a term for many different practices and medicines and there’s scientific evidence for a number of them. Some of the modalities are derived from ancient sciences, for instance, and have a very long history of successful traditional use. FSM mentions acupuncture as a therapy it considers pseudo-scientific and argues that it shouldn’t be taught at university. But this isn’t entirely true.

There’s clinical evidence for acupuncture as effective treatment for various conditions, including migraines, tension-type headaches and chronic low-back pain. What’s more, there’s a Medicare rebate available for acupuncture if it’s part of a doctor’s examination. Why shouldn’t medical practitioners learn about the evidence for this treatment option at universities to increase consumer choices and improve patient outcomes?

The National Prescribing Service’s “Review of the Quality of Complementary Medicines Information Resources” can be used to identify which CAM information resources are of high quality, evidence-based, unbiased and well structured. The use of such high-quality resources is available and encouraged at universities.

In Australia, complementary medicines are regulated as medicines by the Therapeutic Goods Administration (TGA). The TGA’s ambit includes homeopathic and traditional medicines, such as Traditional Chinese Medicines. According to the TGA’s guidelines general and medium-level claims (such as the temporary relief of minor self-limiting conditions) for complementary medicine’s efficacy can be based on certain traditional use evidence. The guidelines allow the use of such medicines until high-level evidence, that would allow for high-level claims, is available.

A balanced view in this debate is particularly important because about 70% of Australians already use CAM, mostly alongside conventional medicines and treatments.

So the community expects health professionals to be able to provide information and guidance about the quality use of all medicines, which, according to Australian’s National Medicines Policy, includes complementary medicines. To be able to do that, health professionals need to be knowledgeable, at least, about the principle, paradigm and available evidence for all complementary medicines, including homeopathic and traditional medicines.

And where else would health professionals gain this knowledge if not at university, during their degree? One of the advantages universities have is the close relationship between research and teaching – students are more engaged and inspired by research-led teaching, and research is informed by queries from students while teaching. Many universities research CAM to generate an evidence base or prove their lack of efficacy.

So why support research but exclude teaching of CAM from universities? Aren’t we obliged to translate our research results into practice – starting by teaching new practitioners?

At Griffith University, evidence-based CAM education is integrated throughout the whole pharmacy curriculum. Our teaching research has shown that pharmacy students perceive education about CAM as a core part of their professional degree. We found that CAM research and education had a moderating effect on students' attitudes towards CAM. The training also encouraged students to look at and evaluate evidence and make informed decisions in the best interests of their patients.

We also offer a specifically designed “Short Course in Integrative Medicine for Pharmacists,” which has been accredited for continuous professional development. The course addresses the shortage of CAM knowledge among practicing Australian pharmacists as identified in a recent Pharmacy Guild-funded project, which surveyed Australian pharmacists nationally.

The survey found most pharmacists supported undergraduate CAM education (76%), and the majority (85%) were interested in additional CAM education themselves.

Research also suggests that CAM education may also teach practitioners greater self-awareness, improved core competencies (such as evidence-based practice), enhanced cultural competency and patient-centred care.

So should we turn our back on the consumer-driven trend toward holistic and integrative healthcare, or should we work together to understand, research and teach different principles, practices and evidence to improve health outcomes for customers and patients? I, for one, would prefer the latter.

This article was originally published at The Conversation. Read the original article.

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Submitted by Peter Kennedy on Thu, 09/02/2012 - 09:43.

Your argument would have a point if the universities (Southern Cross is the main offender) were actually teaching evidence-based "alternative" medicine. But in fact the vast majority of the "alternative" medicine that they are teaching has no relation to and is even contradictory to the evidence, and even teaches treatments which have not even any possible theoretical scientific basis, such as homeopathy and iridology.

Now it's true that the fact that a subject is taught at a government-funded university does not mean that governments endorse it. For example government funded universities in Australia teach everything from Marxist philosophy to Catholic theology. Taught by those who are acknowledged by others in those fields as having expert knowledge of them. Nobody sees this as the government endorsing such things.

However in the case of "alternative" medicine, those teaching and promoting them quite deliberately set out to convince people that these methods are a genuine "alternative" to scientific evidence based medicine. Sometimes with tragic consequences for the patients, and always with emotional and financial damage to the patients and their families. The average person sees the fact that someone has a slip of paper from a university as evidence that the government health authorities think that the treatment he is offering is safe and effective. Either these irrational "therapies" should be not taught at universities, or if they are then the universities should state very clearly, on their websites, and on diploma certificates etc, that the university and health authorities do NOT endorse the use of such treatments.

Submitted by Manisha on Thu, 16/02/2012 - 11:06.

Hi Peter can you explain your phrase "have not even any possible theoretical scientific basis" a little more with evidence?

Submitted by Loretta Marron on Thu, 09/02/2012 - 09:07.

Government funded 'Faith healing' has no place in medical or health related degrees.
The real questions that no-one who supports quackery is prepared to answer are:
"Should tertiary institutions be teaching homeopathy, iridology, tactile healing, reiki, reflexology, kinesiology, 'fundamentalist' chiropractic and 'energy medicine' as belief systems?"
"Should they be indoctrinating 17 year olds (as first year students) that "innate intelligence", qi, meridians and chakras as a fact?"
&"Should we be paying for these services in our health funds?"
If it is 'allied health' (such as hypnotherapy and massage) call it that, instead of CAM, which is an umbrella that covers all sorts of nonsense.
Of course test herbal remedies in universities but why not put "Trick or Treatment" (Ernst & Singh) as a text for all health students (some universities are already doing so) - so that students can learn about CAM from Prof Edzard Ernst the first Chair of CAM in the world, instead of from texts full of mumbo-jumbo.

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