Pharmaceutical Society of Australia
The Pharmaceutical Society of Australia (PSA) is the peak national professional pharmacy organisation and represents Australia’s 30,000 pharmacists working in all sectors and locations. PSA’s core functions include: providing continuing professional development, education and practice support; developing and advocating standards and guidelines; and representing pharmacists’ role as frontline health professionals.
Do not recommend complementary medicines or therapies unless there is credible evidence of efficacy and the benefit of use outweighs the risk.
Complementary medicines may also be called 'traditional' or 'alternative' medicines and include items such as vitamins, minerals, herbal products, aromatherapy and homoeopathic products. Many of the products available in pharmacies, supermarkets or health food outlets have limited evidence of efficacy. There is some evidence of efficacy for some complementary medicines, however this may be formulation and dose dependent, and health practitioners are encouraged to seek this information before recommending such products.
- Pharmaceutical Society of Australia (2012). Australian pharmaceutical formulary and handbook: the everyday guide to pharmacy practice (22nd ed). Pharmaceutical Society of Australia, Deakin West, ACT
- Pharmacy Board Guidelines on Practice Specific Issues: 5. Complementary and alternative medicines. https://www.pharmacyboard.gov.au/codes-guidelines.aspx
- Cochrane collaboration – Systematic reviews. https://www.cochrane.org/ Some examples are:
- Abdelhamid AS, Brown TJ, Brainard JS, et al. Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD003177. DOI: 10.1002/14651858.CD003177.pub3.
- Flowers N, Hartley L, Todkill D, et al. Co‐enzyme Q10 supplementation for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD010405. DOI: 10.1002/14651858.CD010405.pub2.
- Geng J, Dong J, Ni H, et al. Ginseng for cognition. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD007769. DOI: 10.1002/14651858.CD007769.pub2.
- Braun LA, Tiralongo E, Wilkinson JM, et al. Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice. BMC Complement Altern Med. 2010 Jul 20;10(1):1-7
- Popattia AS, Winch S, Caze AL. Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review. International Journal of Pharmacy Practice. 2018 Apr 1;26(2):93-103
- Ung COL, Harnett J, Hu H. Community pharmacist’s responsibilities with regards to traditional medicine/complementary medicine products: A systematic literature review. Research in Social and Administrative Pharmacy. 2017 Jul 1;13(4):686-716
A working party of members of the Pharmaceutical Society of Australia (PSA) was established. Members of the State and Territory Branch Committees were invited to contribute suggested recommendations. Over 40 recommendations were submitted. The working party grouped the recommendations into themes, eliminated ones that were out of scope, reduced the list to twelve and refined the wording. All PSA members were sent an online survey to rank the proposed recommendations, indicate how likely they would be to implement the recommendations in practice, and suggest additional items for consideration.
Based on the survey responses, six recommendations were shortlisted and supporting evidence gathered. The final list was signed off by the PSA Board in November 2018.
Note: PSA uses Vancouver reference style. Where there are more than three authors, only the first three are listed followed by et al.
Do not initiate medications to treat symptoms, adverse events, or side effects (unless in an emergency) without determining if an existing therapy or lack of adherence is the cause, and whether a dosage reduction, discontinuation of a medication, or another treatment is warranted.
- 2 Do not promote or provide homeopathic products as there is no reliable evidence of efficacy. Where patients choose to access homeopathic treatments, health professionals should discuss the lack of benefit with patients.
- 3 Do not dispense a repeat prescription for an antibiotic without first clarifying clinical appropriateness.
Do not prescribe medications for patients on five or more medications, or continue medications indefinitely, without a comprehensive review of their existing medications, including over-the-counter medications and dietary supplements, to determine whether any of the medications or supplements should or can be reduced or discontinued.
- 5 Do not continue benzodiazepines, other sedative hypnotics or antipsychotics in older adults for insomnia, agitation or delirium for more than three months without review.
- 6 Do not recommend complementary medicines or therapies unless there is credible evidence of efficacy and the benefit of use outweighs the risk.