TCAM Flashcards
what is TCAM?
Traditional, Complementary & Alternative Medicine
This encompasses medical and health care therapies outside the territory of conventional medicines, some of which are yet to be validated using scientific methods
what are some traditional medicines?
- surgery
- pharmaceutical drugs
- herbal medicines
- nutritional medicines
- lifestyle and behaviour
- mind and body medicine
- energy medicine
- manipulative therapies
what does traditional medicine mean?
Traditional medicine has a long history. It is the sum total of the knowledge, skill, and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness
what are the most common TCAM in the UK
- chiropractic
- naturopathy
- herbal medicine
- osteopathy
- homeopathy
- acupuncture
what is chiropractic
Focuses on the relationship between the body’s structure – mainly the spine – and it’s functioning
Treat and prevent neuromusculoskeletal disorders e.g. back pains, neck pains and headaches
what is osteopathy
It works with joints, muscles and connective tissue to treat soft tissue imbalances and abnormalities in skeletal function
Treatment increases the mobility of joints, relieves muscles tension, promotes the blood and nerve supply to tissue and helps the body’s own healing mechanisms
Using a range of techniques e.g. joint manipulation, soft/deep tissue massage, soft tissue stretch
what is neuropathy
Uses a wide range of “natural” therapies, including homeopathy, herbalism, acupuncture, nutrition and lifestyle counselling.
what is acupuncture
Inserting ultra-fine sterile needles into specific acupuncture points, a traditional acupuncturist seeks to re-establish the free flow of qi to restore balance and trigger the bodies natural healing response.
what is acupuncture
Inserting ultra-fine sterile needles into specific acupuncture points, a traditional acupuncturist seeks to re-establish the free flow of qi to restore balance and trigger the bodies natural healing response.
what is homeopathy
It is based on the principle of “like cures like” – substance that causes certain symptoms can also help to remove those symptoms
It is believed that the more a substance is diluted, the greater its power to treat symptoms
NICE currently does not recommend that homeopathy should be used in the treatment
what is herbal medicine?
The use of plants for medicinal purposes
Including Traditional Chinese Medicine (TCM), Ayurveda, Kampo and Western herbal medicine
why do people use TCAM
Part of culture and identity
Personal experience of success
Dissatisfaction with conventional medicine
Perceived effectiveness
Non-invasive
Emphasis on the whole person (holistic approach)
Personal feeling of control over the treatment process
Belief in natural and green therapies, awareness of environmental issues and sustainability
Always use TCAM instead of Western Medicine
Use after Western medicine has failed
Occasional use, depending on suitability of treatment and severity of illness
In addition to, and concurrently with Western medicine, with or without the knowledge of their doctor
what are the criticism of TCAM
They are ‘non-scientific’ and not ‘evidence based’ – i.e. mostly unsupported by clinical trail evidence
Unregulated – anyone can ‘practice’ and there is a lack of accredited training of TCAM practitioners
Perception of TCAM as an unsafe practice
It is all down to the placebo effect
why is TCAM important to know about
TCAM is becoming more common
Herbal medicines are being sold in many community pharmacies
Acceptance by UK profession medical bodies has increased significantly
what is the pharmacists role in regards to TCAM?
Good awareness of TCAM products e.g. dietary supplements, herbal
medicines, homoeopathic remedies and aromatherapy oils
Providing information on the appropriate use of TCAM
Asking questions about use of TCAM during consultations
Being aware of potential adverse reactions and interactions with conventional medicines
what is the pharmacists responsibilities in regards to TCAM?
GPhC code of conduct standard 5: “Pharmacists must ensure that their knowledge, skills and performance are of high quality, up to date, evidence based and relevant to their field of practice at all stages of your professional working life”
To ensure that stocks of TCAM are obtained from a reputable source of supply
Not recommend any remedy where you have any reason to doubt its safety or quality
Only to offer advice on homeopathic or herbal medicines or other complementary therapies or medicines if you have undertaken suitable training or have specialist knowledge
Need to be aware that the majority of TCAMs are sold as food supplements – no assurance of their quality
Should stock and recommend only those products made by reputable pharmaceutical companies – in-house quality measures
Many TCAM practitioners are mostly unregulated. The British Register of Complementary Practitioners has a list of practitioners registered according to the different disciplines (www.icmedicine.co.uk) , and is currently the best overall guide to appropriately qualified practitioners
Be aware patients may be using TCAM in addition to, or instead of conventional treatments
Questions about TCAM use should form part of any medication review or response to symptoms
Patients are often wary of telling you that they are using TCAM
Be non-judgemental!!!!!!!
You need to inform patients that TCAM is often thought to be safer, but they are not risk free and risk of interactions
The yellow card scheme can be used for reporting adverse reactions of TCAM with complementary medicines
what were the regulations from the past?
UK herbal medicines were regulated under sections 12(1) and 12(2) of the medicines act 1968, which provided exemption from regulation for “unlicensed herbal remedies” either made up for individual patients (the “herbalist exemption”) or sold over the counter
MA68 Section 12(1) has been replaced by Regulation 3 of the human medicines regulations 2012
A review of herbal regulation at the EU level, prompted the review of UK legislations
what are the EU regulations for TCAM?
The Directive on Traditional Herbal Medicinal Products (Directive 2004/24/EC) came into effect on 30 Apr 2011
All manufactured herbal medicinal products are required to have either a full marketing authorisation or a traditional herbal registration
It creates a unified licensing system for traditional herbal medicinal products
what are the UK regulations for TCAM and the UK THR scheme * the same thing*
The EU directive is implemented in the UK by the Medicines (Traditional Herbal Medicinal Products for Human Use) Regulations 2005, which came into force on 30 Apr 2011
3 ways TCAM can continue to be sold in the UK:
Achieving traditional herbal medicines registration (THR) via assessment on application to the MHRA
Being licensed as a medicine under a marketing authorisation
Being prepared for a specific patient by a practitioner following a one to one consultation
eligibility for THRs
History of traditional use for at least 30 years (of which generally 15 years must have been in the EU)
Evidence of safety
Adherence to appropriate manufacturing standards
Provision of appropriate product information to users
Exemptions for THR – herbal practitioners do not need a licence to supply herbal medicines created on their premises to patients following one-to-one consultations
what are the risks of buying online
Risks of obtaining fake/contaminated/substandard/unlicensed TCAM are higher when buying online or by mail order
Unlicensed products manufactured outside the UK may not be subject to the same regulation and quality control
Herbal products sold online may also contained banned ingredients and toxic substances
Herbal slimming products are best avoided because they have been found to contain dangerous ingredients which aren’t stated on the label
