Pharmacists and the pharmacy profession must move with the times

pharmacy

It’s time for community pharmacy to stop selling quackery, argues pharmacist Anthony Cox:

Pharmacists have long been providing advice to prescribers based on evidence. Before EBM became widely used in the 1990s, pharmacists ran medicine information centres and answered complex drug queries using the best available evidence. Pharmacists were involved in the development of EBM and its propagation via drug and therapeutics committees, and more recently working with the National Institute for Health and Care Excellence (NICE).

By its very nature, pharmacy is an evidence-based profession in both primary care and hospital care and the industry is undergoing a period of change. Future models of community pharmacy practice that focus on management of long-term conditions will place an even greater reliance on EBM.

Well, that is the case with prescribed medicines. When it comes to OTC products, pharmacists’ approach to evidence seems to be forgotten, with a “what the public wants, the public gets” attitude taking precedence.

More here

Photo from flickr user jeepersmedia used under a CC licence.

The problem with “Integrative” Pharmacy

 

pharmacy window

Imagine a retail pharmacy where some of the medicines on the shelves have been replaced with similar-looking packages that contain no active ingredients at all. There is no easy way to distinguish between the real and the fake.

Another section of the store offers a number of remedies with fantastic claims, such as “boosting” the immune system, “detoxifying” the body, or “cleansing” you of microscopic Candida. They look sciencey, unless you realize that they treat imaginary medical conditions.

A corner of the store offers unpurified drugs supplied as tinctures and teas. The active ingredients aren’t known, and the batch-to-batch consistency of the product is unclear. The store will suggest products for you based on your symptoms.

Walk past the enormous wall of vitamins and other supplements and you’ll find a nutritionist who will tell you what products you should be taking. You’ll also find a weight loss section. From a science-based perspective, this shouldn’t even exist, given no product has been shown to offer any meaningful benefit. But there are dozens of products for sale.

At the back of the store you’ll finally find the pharmacist. A sign on the counter offers blood- and saliva-based tests for food “intolerance” and adrenal “fatigue”, claiming to test for medical conditions that actually don’t exist or lack an evidence base. The pharmacy also offers a large compounding practice, advertising what it calls “personalized” approaches to hormone replacement with “bioidentical” hormones.

Welcome to the “integrative” pharmacy.

You may not see all of this in your local pharmacy, but they’re coming: claims of a new “integrative” way to provide health care that is changing the face of retail pharmacy. Unfortunately, it’s harkening back to the era of patent medicines and snake oil. It’s not good for the pharmacists and the profession of pharmacy, and it’s even worse for the patients we serve. Continue reading

Does Target sell the most irresponsible homeopathic remedy ever?

I can’t think of anything more appalling than selling water to someone and telling them it will treat their asthma. This pic via Ryan Melyon on Twitter, was taken at a Target pharmacy in Chicago:

Fake asthma remedy

I’ve said it before but it’s worth repeating: Homeopathy is an elaborate placebo system where the “remedies” are inert. It’s reckless endangerment of life to sell a product for treating the acute symptoms of asthma when there is no medication in the bottle, even if there is a caution on the front of the box. And it should be obvious, but placebo has no meaningful effects in the treatment of asthma.  The sale of homeopathy in pharmacies is not only misleading to consumers, it is fundamentally unethical behavior from a health professional. Target and its pharmacists have a ethical and moral responsibility to pull this product off the shelf immediately.

January 16: Here’s an update on Target’s fake asthma “remedy”. And a petition has been started asking Target to stop selling this product.

Weekend Reading

An example of #badpharmacy

An example of #badpharmacy

The photo above is from a pharmacy in Toronto. Acid base nonsense? Check? Cancer quackery? Check. Endorsed by a pharmacist? Check. Send me your own pictures of ludicrous pseudoscience and quackery for sale in a pharmacy, and I may feature it in a future post.

Here’s today’s updates to engage, inspire and possibly infuriate you… Continue reading

The Ethical Implications of Rexall’s Dubious Homeopathic Offerings

Main ingredient in homeopathy

From ethicist Dr. Chris MacDonald, a column on Rexall’s recent advertisements promoting homeopathy:

The problem, of course, is there’s no reliable evidence that homeopathy works, nor any plausible reason to think that it even could work. In commercial contexts, that’s pretty bad. And it’s worse still when the company selling the stuff is a company people rely on for competent health advice, and when that company leverages the credibility of a licensed health profession to promote bogus wares.

And importantly:

The commercial world is full of scams, and all too often people with something to sell have unwarranted faith in their products. Greed and ignorance are nothing new, but that doesn’t mean they are excusable. Companies that claim not just to provide a product, but to educate and take care of consumers, ought to do better. They should do their best to sell only those products that they, and their customers, are justified in believing in.

More here.

I’ve written about the ethics of selling homeopathy before.  As XKCD said about pharmacies selling homeopathy,

 Telling someone who trusts you that you’re giving them medicine, when you know you’re not, because you want their money, isn’t just lying–it’s like an example you’d make up if you had to illustrate for a child why lying is wrong.