Melbourne Holistic Health Group

Published in Clinic Information on 01 January 2010 by Melbourne Holistic Health Group

Complementary medicine (CM) in health care is becoming increasingly popular. A large number of health care funds now cover for the use of CM. A study in 2000 found that around 57 per cent of the Australian population used some form of complementary therapy, and that public spending on complementary medicines far exceeded total patient contribution for all pharmaceutical medicines (A2.3 billion). A follow up survey in 2004 reported that while spending had decreased on complementary medicines (A1.8 billion); visits to complementary therapists had increased by around 26 per cent. So it is clear that public use and spending on complementary medicines, and practitioners, is increasing and represents a significant proportion of health care.

In recent years there has been greater recognition by the Australian government of the need for research and regulation of CM. In 1999 the federal government established a regulatory framework for complementary medicine, with the ‘Office of Complementary Medicine’ within the Therapeutic Goods Administration (TGA). As a result there is now greater regulation over the control, safety and quality of manufactured complementary medicines. In late 2006 the Australian government pledged $5 million to the National Health and Medical Research Council (NHMRC) for ‘Special Initiative Research Grants’ for research into CM. In 2007 the government granted $4 million to establish a National Institute for Complementary Medicine (NICM) at the University of Western Sydney. This funding is in response to a statement by the Expert Committee on Complementary Medicines that the government has a social responsibility to fund CM research given the high community use of such medicines and services. Government support for CM research initiatives in Australia is consistent with international trends. The US government currently allocates approximately $120 (USD) million per annum for CM research through the National Centre for Complementary and Alternative Medicine (NCCAM), and $300M per year is committed for CM research across all National Institute of Health centres (NIH).

CM has become more widely accepted by the medical profession in Australia. The current position statement of the Australian Medical Association (AMA) ‘acknowledges the growing use of complementary medicines and therapies by the Australian population’ and states that ‘evidence based aspects of Complementary Medicine are part of the repertoire of patient care and may have a role in mainstream medical practice’. In 2005 the Royal Australian College of General Practitioners (RACGP) and the Australasian Integrative Medicine Association (AIMA) put forward a joint position paper on complementary medicine which further endorsed the AMA’s position statement.

Use of complementary medicines by GP’s also appears to be increasing and aspects of complementary medicine are now being taught in a number of medical undergraduate courses. Surveys have found that around 30-40 per cent of Australian GP’s practice some form of CM, while 75 per cent formally refer their patients to such therapies. However, a recent survey found that it was the non-medicinal and non-manipulative therapies such as acupuncture, hypnosis, meditation, massage and yoga that were considered to be the safest and most effective, whilst osteopathy, homoeopathy and herbal and nutritional medicines were seen as potentially more harmful than beneficial. Furthermore, GP’s saw the risks associated with CM to result from incorrect, inadequate or delayed diagnosis and the interactions between complementary medications and pharmaceuticals.

Obstacles to integration still remain and there is still a lack of understanding and clear communication between the orthodox and allied health professions. Of particular concern is the fact that while most people use complementary medicine as an adjunct to orthodox medicine, many are reluctant to inform their doctors that they are doing so. This is a significant concern. Awareness is growing as to the potentially dangerous interactions between a number of herbal and nutritional supplements and pharmaceutical medications. A recent survey of surgical patients in hospitals highlighted this issue. It was found that while 46 per cent of the patients had taken complementary medicine in the two weeks prior to surgery; only 58 per cent disclosed this to hospital staff. The most common reason cited for non-disclosure was that they were not asked (80 per cent). It is known that there are a number of nutritional supplements and herbal medicines, such as vitamin E, garlic, ginger and fish oils than can increase bleeding time. The fact that this is not paid due attention has the potential to result in medical negligence.

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