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Homeopathy: pharmacists dispense with professional guidance

Homeopathy remedy

As soon as you talk about homeopathy, it divides opinion. But the debate raises wider issues when some pharmacists fail to explain there’s no clinical evidence that certain alternative remedies work, like homeopathy.

There are people who swear by homeopathic remedies, and everyone’s entitled to their opinion. However, if you ask your pharmacist whether a homeopathic remedy works you’d expect their response to be based on scientific evidence. This is the Royal Pharmaceutical Society’s (RPS) official advice:

‘The pharmacist should advise on the lack of evidence on the efficacy of homeopathic products… and provide advice relevant to the patient’s condition.’

Some pharmacists say homeopathy works

However, in our snapshot investigation, 13 out of the 20 pharmacies our trained mystery shoppers visited failed to follow this guidance. For example, one pharmacist said that homeopathy does work and another said it’s very good and will help. The RPS does not endorse homeopathy as a form of treatment. And even though membership of the RPS is voluntary, our expert panel was clear that any pharmacist who recommends a homeopathic remedy should make it clear it’s their personal opinion.

On visits rated satisfactory and good by our expert panel, pharmacists were very clear about the lack of evidence. One said, ‘it’s all anecdotal, you know, it’s homeopathy, so there’s no science behind it.’

Separate personal experiences from professional advice

There was also no excuse for pharmacists who did not give the correct advice when asked about homeopathic treatment for a cough that had lasted over a month. 17 of them failed to spot this potentially serious undiagnosed condition – only three advised us to see a GP when asked for a homeopathic remedy for this cough. And our visits actually took place during a nationwide NHS campaign urging people to see their GP if they’d had a cough for more than three weeks.

We have to be able to rely on pharmacists to give us clarity over what we buy. It may be difficult if they have personally had positive experiences with homeopathic treatment. But they need to clearly separate the anecdotal, and their own views, from the evidence base. That surely has to be the hallmark of professionalism.

Should pharmacists only recommend remedies backed by scientific evidence?

Yes - pharmacists should only recommend remedies backed by science (68%, 715 Votes)

Maybe - as long as pharmacists make clear it's just their personal opinion (17%, 179 Votes)

No - pharmacists should be free to recommend any remedy, including homeopathy (15%, 158 Votes)

Total Voters: 1,052

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Comments
Guest
Robin says:
30 May 2013

Chris, for the purpose of clarity let me explain. Your post accused someone of making up the term surgical oncologist, you made (or maybe just repeated?) incorrect assumptions about the origin of the name Orac, you later used the words ” you do love with coming up with these terms”. I interpreted that as suggesting Guy invented the term. I did say I was struggling to understand your meaning to hopefully put the reason for my question in context. Your reply has made it clear you didn’t mean to suggest Guy invented the term, and I hope you realise now why I read it that way. I am sure I don’t always make my points crystal clear, but it is important we strive to do so. Even when we understand each others points there is obviously still a gulf between our interpretation of the evidence – if we can minimise that gulf by clearer communication it can only be to the good.

Guest

Guy,
indeed quackery is a real and serious problem, but that depends on what you mean by quackery and to whom or what do you level that accusation.
Predictably, in short, and for you and people like you, it means anything that is not Mainstream. So in your opinion, and if you allow yourself to be honest with yourself, anything outside of Mainstream is therefore quackery, and despite the studies and scientific evidence to the contrary.
A very narrow-minded viewpoint.

WHICH conducted this survey of Pharmacists to assess the advice given out of Pharmacists, not to examine the efficacy or otherwise of Homeopathy. Any critique should therefore be centered around any Pharmacists and not the remedy.

WHICH have merely taken the stance as laid down by the RPS and no other source as if the RPS’s advice and recommendations are the only source of reliable and accurate information

This point…..
“There is nothing flippant or irresponsible about addressing quackery”: is absolutely true, and where I would endorse that recommendation, but this depends entirely on what exactly is construed as quackery. Thousands if not millions of believe that Homeopathy is not quackery and because of its use as a remedy in addressing their ailments, unless of course all of these users are prone to be gullible and allow the placebo effect to dominate: a condescending and patronizing viewpoint.

What you identify as “crank” websites do actually provide truthful information, although I must admit that some of them are prone to sensationalism, and if you had bothered to read/study any of them this would substantiate my point; but your mindset will not allow you to do so because you
have determine a priori what they are and how they operate and the information that they contain.
Not a very intelligent or impartial approach I must say.
I also understand why this is the case, because this would greatly undermine your “belief system” and challenge your preconceived notions and ideas about health and disease.

Splitting hairs again……………..
“And you keep asserting that crank websites provide truthful information. They don’t. As with the reports of the King case, the news reports say that NCAHF produced witnesses who lacked credibility, the crank websites say the court found Barrett lacked credibility, which is not what the court found”.

The end result was the same though Guy, and something you are in denial of: Barrett and his associate were found to be biased with no credibility by the Court, not least of which was the fact that Barrett had been out of medicine for so long, he did not know what he was talking about.
FACT: Barrett has lost almost ALL of the court cases he has brought against any alternative therapy because of this, and not because of the lack of efficacy of the therapy.

If there is no link between autism and the MMR vaccine, then that would be fine of course, but Caroline was reporting an association or possible link; the studies that have found there not be a causal association were slanted studies designed to fail, where there are at least 5 independent studies in 5 separate countries that have provided identical findings to that of Andrew Wakefield.
I refer to an earlier post of mine where there has been no studies to compare those who are vaccinated and those that were not, so pray tell how we can eliminate the possible causal effect unless any serious studies are conducted.
It is not in the interest of the vaccine manufacturers to discover any link, because this would make them liable to offer financial compensation in damages if proven, whilst having a devastating effect on their profits.
You haven’t learnt anything if you haven’t yet realised that money is the name of the game here. I f you really believe that vaccine manufacturers have the sole interests of humanity at heart, and that their income is only secondary to disease-prevention then you are deluded.

I would agree with you here………………
“There is no scientific evidence that vaccination causes autism”, but you omitted “as yet”.

Let me remind you, the anti-vaccination lobby exists because of the overwhelming and common experience and consensus of those who have experienced their children suffering from various kinds of damage shortly after vaccinations, when prior to this the children were of normal development.

It really is that simple. The purported link is partly the understandable application of the post-hoc fallacy (ignoring the fact that in most cases the autistic behaviour is actually identifiable pre-hoc), and partly a deliberate fabrication by the antivaccination lobby who will do anything to stop the march of vaccination.

Strange how the incidence of autism has grown incrementally with the increasing use of vaccines though isn’t it? Coincidental perhaps?
The main reason why anyone talks about vaccines and autism is that some parents have noticed changes in children shortly after the children were vaccinated. Their kids seemed to be developing normally, then suddenly stopped interacting with people and lost language abilities — a condition called “regressive” autism.
Scientists often hedge about saying whether their findings prove or disprove anything. That’s because the scientific method proceeds by constantly modifying theories rather than accumulating “proofs.”
“Until scientists can prove exactly what causes autism, it’s difficult to definitively disprove anything”…………….Lee Sanders, MD, MPH, associate professor of pediatrics at the University of Miami Miller School of Medicine,

Whatever else, autism rates continue to rise, and unless the medical community discover the actual cause, any correlation between vaccines and autism cannot and should be discounted.

Hoodwinked? who me? no…………………..just open-minded, which some here are most definitely not.

Guest

Chris, you are the polar opposite of open-minded, because you reject out of hand any claim made with the basis of credible scientific evidence but accept without question the claims of people with an obvious agenda, just because you are sympathetic towards the agenda.

In respect of vaccines, you have been had. The antivaxers pretend that every single VAERS report is a provable damaging effect of a vaccine, but they are wrong. And not accidentally wrong, since it is trivially easy to find out the truth. The HPV figures to 2009 demonstrate this perfectly. 44 fatality VAERS reports track to 29 actual deaths, not one of which was actually attributable to the vaccine.

VAERS is deliberately conservative, in a way you assert the medical establishment is not. It tracks any adverse health event which occurs after a vaccine is given. These are then analysed for patterns and where there is anything prompting concern the cases are investigated in detail. That’s how they know that the HPV vaccine doesn’t kill, though it may cause fainting.

HPV vaccine preventable cancers kill 15,000 women every year in the US alone. That’s a nasty, drawn out, painful death. Even if the worst case estimates were true, it would still be good odds. But the worst case estimates aren’t true because they are not honest.

Same applies to the “vaccine-autism link”. All the evidence points to it not being vaccines. The causes appear to be genetic, and onset appears to be well before the vaccine schedule. If some link is found at some point in the future, it will only account for a tiny handful of cases of diagnosed autism because almost all cases right now can be established before the vaccines. These vaccines prevent thousands of deaths of children every year. You are ignoring the benefit, ignoring the death toll from preventable disease before vaccines, in order to promote a hypothetical risk which is looking less and less likely with time.

Nor is the antivaccine story consistent, except in that it’s always the vaccines. They claimed it was thiomersal, but after thiomersal was removed there was no change in autism diagnosis rates. Another ad-hoc hypothesis was generated, and the chelation cranks carried on their trade regardless. It is hard to express how wrong it is to subject a child to chelation therapy when there is absolutely no credible evidence that their condition has any root in heavy metal toxicity. Provoked testing is an invalid and exploitative practice.

Yet people will do these bizarre and harmful things to their children based on the claims of people whose reputation rests on rejecting anything that can be scientifically proven, if it runs counter to their preconceived ideas. And scientists are supposedly the closed-minded ones. Go figure.

And your agenda is pretty obvious when one examines your defence of Wakefield. His work was fraudulent, clearly so, yet you still apparently believe it and disbelieve the scientific consensus.

There is nothing anybody can do to make you less angry about the application of the scientific consensus, if you refuse to accept it for what it is. There’s a lot of history in agenda-driven denial of scientific consensus: the tobacco industry, the chemical industry over CFCs, the power industry over acid rain and global climate change. They were all, like you, unshakeably convinced that they alone bore the truth, but they were all wrong, and increasingly obviously so.

The idea that because science can’t disprove something, it should be assumed to be true and action taken which brings easily quantifiable and significant risks, rather than action which introduces small and hypothetical risks, is simply not rational.

Guest

Guy,
I believe I am as open-minded as anyone, but you you are placing words in my mouth that I have never said or uttered. I absolutely do not reject out of hand any claim made with the basis of credible scientific evidence at all, in fact I do accept Mainstream (credible?) or any other evidence if as a result of that evidence a particular therapy or treatment modality is demonstrated to work.

I am dubious/skeptical of many mainstream scientific trials and studies, because of bias and to which Ben Goladacre has alluded to, such as “ghost writers” and only publishing those studies that are shown to be favorable to a drugs outcome whilst disregarding the rest which are not. When will you ever realize that profit is the name of the game and health comes in a not very close second.
Just one example is the use of Nutritional Medicine or Orthomolecular Medicine which has been proven to be effective against disease but discounted by Mainstream through bias. The therapeutic use of Nutraceuticals and Vitamin D3 would be a case in point.

The only agenda I have is: “does it work and is it effective”, although people do not generally suffer from a drug-deficiency over a nutritional deficiency.

No Guy, I am open-minded enough to realize a possible link between vaccination and autism: I have an open mind on the issue, as did Andrew Wakefield when he suggested a “possible link” requiring further investigation into the causes of “regressive autism” which occurred coincidentally after vaccinations.

You may believe what you wish, as I have the right to believe what I wish re’ any health modality, but what I object to quite strongly is the gradual erosion of my health-freedoms by vested interests, that do not agree with millions of people who wish to pursue that avenue of therapy.

You are clutching at straws now, so I would give up while you are still behind.

HPV vaccine may and probably is very effective against cancer, but you are missing the point: and that POINT is: the legacy for many who are damaged by vaccines; the forgotten minority in favor of the majority. This is not acceptable and never will be.

One more point though is that Vaccination is NOT Immunization, so I would advise you to read the book with the same title by Tim O’Shea (2013 edition) and supported by the relevant science.
There is only one kind of immunity and that is natural immunity which is achieved by battling the infectious diseases itself. Vaccination is merely the artificial triggering of temporary responses to manmade pathogens. Vaccines also do not provide long-term immunity: only temporary at best.

Have a nice day.

Guest

Chris: OK, so you only reject out of hand the scientific consensus view in respect of anything discussed here to date, where it conflicts with your ideology. I concede that does leave you agreeing with the science where convenient. So you reject the strong consensus that vaccines prevent serious and fatal disease, you reject the strong consensus that they do not cause autism, but you selectively accept the fact that immunity is not always permanent and that there can be rare side effects.

The result of course is even more biased than if you rejected all the science. And that, unfortunately, is a consequence of the undermining of science by vested interests in he last few decades, leading to a popular belief that science is just an opinion rather than the truth, which is that science represents the best way we have of understanding the universe.

Guest

Guy, you say……………..
“I only reject out of hand the scientific consensus view in respect of anything discussed here to date, where it conflicts with your ideology”.

I didn’t say that. You are just playing on words and meanings now which doesn’t amount to much.
I actually agree with the science if it is proven to work, and work effectively, and wherever it is sourced: remember, I mentioned: “According to the US government’s Office of Technology Assessment (US OTA) — only 10% to 20% of all procedures currently used in medical practice are supported by controlled clinical studies. That’s it — just 10-20 percent”!

So much of Medical practice is based on faith and hope. Take the case of SSRI’s, which are said to work on the theory of “correcting chemical imbalances”. The efficacy of SSRIs in mild or moderate cases of depression has been disputed.[3][4][5]………………………..
^ a b c Jay C. Fournier, MA; Robert J. DeRubeis, PhD; Steven D. Hollon, PhD; Sona Dimidjian, PhD; Jay D. Amsterdam, MD; Richard C. Shelton, MD; Jan Fawcett, MD (January 2010). “Antidepressant Drug Effects and Depression Severity”. The Journal of the American Medical Association 303 (1): 47–53. doi:10.1001/jama.2009.1943. PMID 20051569.
^ a b Kramer, Peter (7 Sept 2011). “In Defense of Antidepressants”. The New York Times. Retrieved 13 July 2011.
^ a b Ronald Pies, MD (April 2010). “Antidepressants Work, Sort of-Our System of Care Does Not”. Journal of Clinical Psychopharmacology 30 (2): 101–104. PMID 20520282. Text “doi:10.1097/JCP.0b013e3181d52dea” ignored (help)

A Duke University study recently discovered that exercise (yes exercise) is equally if not more effective at combating depression than Prozac. So why take a poison when you can exercise your way out of depression.

So all in all the scientific support for medical procedures is lacking in 80% of cases and procedures. So this is what you refer to as “science”?

Yes, the truth is that science is our best way forward in understanding the Universe, but unfortunately this is not the case with “Medical Science”.

Here’s another whopper……………
If Medicine relies on science then why the following?…………………………..

As the 5-year relative survival rate for cancer in Australia is now over 60%, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival. To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.

PMID: 15630849 [PubMed – indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/15630849?ordinalpos=1&itool=Entrez
System2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum