TCAM

Question 1

what is TCAM?

Answer 1

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

Question 2

what are some traditional medicines?

Answer 2

• surgery
• pharmaceutical drugs
• herbal medicines
• nutritional medicines
• lifestyle and behaviour
• mind and body medicine
• energy medicine
• manipulative therapies

Question 3

what does traditional medicine mean?

Answer 3

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

Question 4

what are the most common TCAM in the UK

Answer 4

• chiropractic
• naturopathy
• herbal medicine
• osteopathy
• homeopathy
• acupuncture

Question 5

what is chiropractic

Answer 5

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

Question 6

what is osteopathy

Answer 6

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

Question 7

what is neuropathy

Answer 7

Uses a wide range of “natural” therapies, including homeopathy, herbalism, acupuncture, nutrition and lifestyle counselling.

Question 8

what is acupuncture

Answer 8

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.

Question 8

what is acupuncture

Answer 8

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.

Question 9

what is homeopathy

Answer 9

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

Question 10

what is herbal medicine?

Answer 10

The use of plants for medicinal purposes

Including Traditional Chinese Medicine (TCM), Ayurveda, Kampo and Western herbal medicine

Question 11

why do people use TCAM

Answer 11

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

Question 12

what are the criticism of TCAM

Answer 12

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

Question 13

why is TCAM important to know about

Answer 13

TCAM is becoming more common

Herbal medicines are being sold in many community pharmacies

Acceptance by UK profession medical bodies has increased significantly

Question 14

what is the pharmacists role in regards to TCAM?

Answer 14

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

Question 15

what is the pharmacists responsibilities in regards to TCAM?

Answer 15

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

Question 16

what were the regulations from the past?

Answer 16

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

Question 17

what are the EU regulations for TCAM?

Answer 17

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

Question 18

what are the UK regulations for TCAM and the UK THR scheme * the same thing*

Answer 18

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

Question 19

eligibility for THRs

Answer 19

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

Question 20

what are the risks of buying online

Answer 20

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