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Misleading patients (part 2)

In the second posting looking at how patients are misled over complementary medicine, Professor Edzard Ernst addresses the role played by healthcare professionals and the media.

In the second posting looking at how patients are misled over complementary medicine, Professor Edzard Ernst addresses the role played by healthcare professionals and the media.

Pharmacists

UK pharmacists have a code of ethics which tells them that they 'must' provide 'necessary and relevant' information to customers who are interested in buying homeopathic remedies [1].

Clearly, it is necessary and relevant to know firstly that such preparations contain no active ingredients and secondly that they are both implausible and clinically unproven [2]. Yet, UK pharmacists not only fail to advise their customers reliably on this issue, many even provide leaflets on homeopathy that are overtly misleading. One well-known UK homeopathic pharmacy chain supplies around a dozen 'homeopathic vaccines' - for anything from AIDS to hepatitis or even leukaemia.

What follows is simple: pharmacists who act in this way violate their very own ethical code.

Doctors

It would be wrong to think that doctors are immune to misleading their patients when it comes to CAM.

One UK doctor – who shall remain unnamed – has widely (and irresponsibly in my view) promoted a herbal medicine as a cancer cure – saying that it made ‘tumours disappear' despite a thorough review of the evidence found that not a single available study shows the treatment is effective [3].

The popular media

If we key in 'alternative medicine' into Google, we currently obtain about 50 millions hits. The vast majority of the information provided there is less than reliable. We have investigated websites offering CAM advice for cancer [4], HIV/AIDS [5], diabetes [6], and depression [7]. Invariably, we found that much of it was promotional, factually incorrect and frequently even dangerous.

The popular print media hardly seem to be any better. We have repeatedly shown how unreliable CAM books for lay readers are [8]. The UK daily press have an almost insatiable appetite for CAM. Unfortunately much of this coverage is also overoptimistic, promotional and far from reliable [9].

Conclusions

The high quantity of readily available information on CAM is in stark contract with its very poor quality and misleading nature. This puts patients' health at risk. In view of this situation, GPs should consider their own position. One solution to the problem would be that GPs inform themselves about the essential evidence on CAM and advise their patients responsibly.

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

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