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Misleading patients (part 1)

Finding reliable information on complementary medicines can be a minefield for patients, says Professor Edzard Ernst



Patients don't have an easy job trying to inform themselves about health matters. When it comes to CAM, this task gets even more difficult.

Of course, there is plenty of information, for instance ~50 million websites related to CAM exist. But, on closer inspection, the vast majority of all this turns out to be seriously misleading. In the first part of this blog I will highlight the role of CAM providers in misinforming the public.

Acupuncturists

A survey of consumers consulting UK non-medically trained acupuncturists showed that a considerable number of these patients had received advice from these therapists about prescribed medicines [1]. Acupuncturists are not qualified to issue such advice.

When we directly asked UK acupuncturists about electroacupuncture as a treatment for smoking cessation, our findings pointed in the same direction. The advice issued was frequently not based on current best evidence, and some of it raised serious safety concerns [2].

Chiropractors

Chiropractors often make unsustainable therapeutic claims on their websites [3], and several professional organisations of chiropractic did the same [4]. In 2002, at the height of the MMR scare, a sizable proportion of UK chiropractors would advise mothers against having the MMR jab for their children [5]. A survey of UK chiropractors revealed that a high percentage of UK chiropractors fail to provide advice about the risks of spinal manipulation before commencing treatment [6].

Herbalists

Virtually no good evidence exists to show that the prescriptions of individualised herbal mixtures by traditional herbalists generate more good than harm [7] .Despite this uncertainty, herbalists do not seem to offer this information voluntarily to his/her patients. When we, as part of a research project, directly asked UK herbalists for advice on a specific clinical case, we found that the recommendations issued were 'misleading at best and dangerous at worst' [8].

Homeopaths

Many non-medically trained homeopaths seem to advise their clients against the immunisation of children. Instead, these practitioners often recommend using 'homeopathic vaccinations' for which no good evidence exists [5].

For instance, the vice-chair of the Board of Directors of the Society of Homeopaths (UK), had a site (www.thehomeopath.org.uk) with the following statements [9]:

• 'Homeopathic alternatives to children's immunisation are now available'

• 'Our clinic offers alternative immunisation programmes for the whole family'.


Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter

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