A Review of the Use of CAM Therapy and the Sources of Accurate and Reliable Information

OBJECTIVES: To describe how pharmacists can answer the call by the Institute of Medicine (IOM) of the National Academies to become more involved in evaluating complementary and alternative medicine (CAM) and to suggest resources pharmacists can access to be better prepared to advise their patients about these therapies. SUMMARY: Information published by the IOM in January 2005 clearly indicates that the American public considers CAM therapies increasingly to be conventional lifestyle choices rather than alternative practices. Some managed care organizations (MCOs) have offered CAM services for at least 8 years, and one of the nation's largest MCOs created a network of CAM providers in 2003 with a 30% discount on provider fees. Pharmacists report an increase in questions regarding the use of herbal products and dietary supplements. As experts in drug-drug interactions, there is the expectation that pharmacists are a source of information for drug-herb interactions. Yet some surveys show pharmacists are uncomfortable answering questions about these products because, although there is an increase in the integration of CAM and conventional medicine, there are few scientific studies available to guide the clinical decisions that are necessary. The Office of Dietary Supplements (ODS) and the National Center for Complementary and Alternative Medicine (NCCAM) have increased funding of CAM research. There is a particular need for clinicians to become involved in assessing the safety and efficacy of these products. At least one health plan has created, through its pharmacy and therapeutics committee, a scientifically based, pocket-sized CAM guide that clinicians rated as somewhat to very helpful as a counseling aid. CONCLUSIONS: With the increasing volume of information on CAM aimed at consumers by the press, television, Internet, and other media, it is critical for pharmacists to remain current in their knowledge. Pharmacists should know what the IOM is saying about CAM and develop relationships with the CAM providers in their communities. Pharmacists should know what reliable information resources are available and be able to evaluate the literature to help patients and providers interpret what they read and hear. It is important for pharmacists to have access to and be involved in ongoing evaluation of CAM therapies being used by so many people.