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CM education for
In 2015 The University of Sydney reorganised the way it teaches
complementary medicines (CM). Associate Professor Parisa Aslani and
Dr Joanna Harnett from U/Syd Faculty of Pharmacy outline the changes.
What is the status of CM in the
Pharmacy curriculum at the University
Before 2015, specific CM was taught in
various units of study in the Bachelor of
Pharmacy degree program, for example
as part of the case studies for students
in Year 4. Some herbal medicine topics
were also available in the third year of the
curriculum. The focus was on treatment
of conditions and herb-drug interactions.
A new approach was initiated for 2015
onwards; namely a systematic way of
integrating CM into the curriculum
throughout the four year degree.
You have increased your resources and
emphasis in this area. What drove this?
The Faculty of Pharmacy conducted a
needs analysis amongst community
pharmacists via qualitative research
(focus groups). The results pointed to
a desire for more education among
Pharmacists on complementary
medicines, particularly around
efficacy, safety, and interactions with
Pharmacists were more reactive in
supplying CMs rather than being proactive
in recommending CMs for treatment
or prevention. They had reservations
about recommending CMs which might
be safe but lacked evidence of efficacy.
Study participants reported having
difficulty finding information on CMs and
often resorted to searching on the internet
to answer questions from consumers.
They reported that most useful
resources were considered to be
textbooks detailing the active
ingredients used in CMs. The main
barriers to CM use were a lack of
knowledge and inadequate information
sources. These affected both the supply
of CMs and counselling about them.
However, consultations and information
provision to consumers would be
facilitated by: higher-quality information
resources and better access to these,
such as a mandatory textbook in the
pharmacy; educational programs and
working with a naturopath.
What changes have been made to the
More recently we have developed
a CM curriculum that is integrated
and aligned across the four years of
the Bachelor of Pharmacy degree.
We have placed a specific focus on the
evidence-base for certain CMs. The main
aim is to ensure the quality use of all
medicines including CMs. To ensure this
objective is met, students will engage
in learning a number of topics including
CM in our health care system, sourcing
reliable information, the efficacy and
safety of selected CMs in specific
conditions, and communication and
ethical considerations. We expect
our graduates to be able to both
initiate and respond to CMs inquiries
The CM curriculum grades the evidence
obtained from the primary literature
for efficacy and safety of selected CMs.
The same evidence grading system is
employed by the highest quality CM
databases. Students are informed about
the clinical utility of these databases in
preparation for their day to day practice
of sourcing information as a future
pharmacist. One of the challenges
with tertiary information resources
is maintaining currency. Given the
exponential growth of CM research in
the last two decades, keeping abreast
of the latest research and maintaining
these databases will require significant
What is the biggest challenge for
pharmacy students and pharmacists
when it comes to CMs?
For practising pharmacists, the
biggest challenges are around
gaining knowledge regarding safety,
interactions and efficacy on the myriad
of CMs that are available. Currently
there is no independent, single ‘go-to’
source for CM products, similar to MIMs
for S3 and S4 medicines. There are
CM resources for single ingredients.
For pharmacy students, the key
challenge is developing clinical
decision-making skills and applying
those to situations where the
information available is limited.
Patients will have often read about a
CM and may ask about the concomitant
use with a prescription medicine.
In some cases a patient may request
a CM alternative to their prescription
product. Pharmacists require skills
to navigate their way through these
potential scenarios to ensure they meet
their professional and legal obligations,
and ensure appropriate use of medicines
by their consumers.
What needs to happen in the future
Ultimately, the key will be educating
not only health care providers but also
consumers. Given an estimated 70% of
Australians are taking a CM product
or employ a CM service, it would seem
prudent to develop a government
supported database for Australian
consumers that provides non-biased,
up-to-date information on the available
evidence for efficacy and safety of
common CMs. A CM database directed
towards the consumer may also serve as
a vehicle to promote important public
health messages including the evidence
to support the role of diet and lifestyle in
the prevention of a number of Australia’s
chronic diseases such as diabetes,
heart disease and certain cancers.
Such a database may also incentivise
the CM industry to conduct
more independent high quality
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