Home Pharmacy practice Despite a place on the shelves of pharmacies, homeopathy has no role in the care of patients

Despite a place on the shelves of pharmacies, homeopathy has no role in the care of patients

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The continued interest in homeopathic products has caused both confusion and frustration within the healthcare community. While physicians and pharmacists have overwhelmingly endorsed the practice of evidence-based medicine, homeopathic products continue to reach the hands of patients with considerable frequency.

Reports of pharmacist approvals of homeopathic products have received considerable attention. A recent CBC survey found that “pharmacists working in Canada’s top drugstores” recommended remedies that are “basically sugar water or sugar pills with no scientific evidence they can do what they claim.” . As a pharmacist, it is disappointing to see recommendations for such products; it does not reflect the profession as a whole. However, knowledge gaps about these products played a role in this error in judgment.

Unlike drugs subject to the drug approval process facilitated by Health Canada, homeopathic products do not need to provide scientific evidence of effectiveness in the conditions they are intended to treat. In addition, homeopathic products do not offer a testable mechanism of action. Instead, homeopathy advocates the consumption of substances that can cause symptoms similar to the disease it intends to treat. This is conceptually called “like cures”. (Arsenicum album, for example, a homeopathic product made with arsenic, has been shown to treat anxiety. And arsenic poisoning, in turn, can cause psychiatric problems like anxiety.)

And the more the product is diluted, the greater its perceived potency.

In contrast, drugs like insulin have been shown to lower blood sugar levels through its role in metabolism and molecular interactions with cells. This has been widely demonstrated both in the laboratory and in the treatment of patients.

Some may argue that even though they are not effective, homeopathic products do not cause harm. But it must be recognized that its expected effectiveness may steer patients away from evidence-based drugs.

Patients who believe homeopathy will cure their condition may decide that they will no longer need their usual medications, putting their health at risk. And for patients with complex drug regimens, adding homeopathic products can cause confusion and increase the burden of the pill. There is also a financial cost to purchasing homeopathic products. Consumers can find themselves spending money unnecessarily with no gain for their personal health.

For pharmacists, the fact that homeopathic products are in stock is in contradiction with their pharmacological expertise. After informing patients that the homeopathic product of interest is ineffective, they may naturally ask why the product is even kept in stock.

Unfortunately, the choice of products on the shelves is rarely controlled by the pharmacist. But at this time of responding to the patient’s request, one could imagine the discomfort and struggle to explain this inconsistency. For this reason, if pharmacies are truly dedicated to evidence-based care, they should commit to no longer stocking homeopathic products.

In the meantime, further training in patient communication strategies regarding homeopathy may be helpful so that pharmacists can empathetically clarify that these products have no place in the delivery of patient care.

Pierre Zhang, Pharm.D. is a hospital pharmacist and MBA candidate at the Rotman School of Management at the University of Toronto.