Consumers need easily accessible information about CAM. This information should be reliable, objective and, where possible, based on sound evidence. High-quality consumer information about CAM is necessary to ensure public safety and to enable people to make informed choices about their health care. [Correct, but there are very few reliable sources.]
If information about CAM is limited, unreliable or difficult to access, consumers may be unable to identify the therapies that are most likely to be safe, effective and appropriate to their needs.
No organisation currently has overall responsibility for providing consumer information about CAM. The Ministry of Health provides some information about herbal medicines via the Medsafe website. [Medsafe provides safety information about a few herbs.] Medsafe also produces guidelines for medicinal product manufacturers on the form and content of the consumer information they supply (Medsafe 2001).
The Consumers' Institute website, Consumer Online, has a section on alternative health. However, access is only available to Consumer Online subscribers and coverage is currently limited to medicinal plants. The New Zealand Charter of Health Practitioners produces a directory and a website that list practitioners and affiliated practitioner organisations. They also provide some basic information on consumer rights and complaints procedures. Many of the other voluntary registration and professional bodies also supply information about individual CAM modalities.
Other sources of information include:
It is generally agreed that consumers need better access to comprehensive, reliable and objective information about CAM. The Ministry of Health is therefore establishing a database of CAM research, which is expected to go live in the second half of 2003. The database will give New Zealand consumers a convenient and easy-to-use portal to existing worldwide research on the safety and efficacy of CAM. The database has been granted funding of $600,000 over four years.
Consumers in the UK have access to information about CAM through a variety of sources, including:
The House of Lords Select Committee on Science and Technology has recommended that the NHS takes responsibility for providing contact details of CAM organisations and information about NHS provision of CAM in each area. The Select Committee recommended that the NHS also offers guidance to help consumers evaluate different CAM therapies (House of Lords Select Committee 2000).
The NHS operates a Web-based health information service for consumers, NHS Direct Online. Coverage of CAM has been improved in response to the Select Committee's recommendations. Sections on CAM are now available on the NHS Direct Online website. [A few topics are covered. The articles on acupuncture, chiropractic support unscientific claims made by proponents of these methods.]
The UK Department of Health has also commissioned a leaflet to provide consumers with information on CAM.
The National Center for Complementary and Alternative Medicine (NCCAM) provides information for consumers and practitioners of CAM via its website.23 The information ranges from general descriptions of the modalities available in the US to summaries of research on specific treatments. As NCCAM's primary focus is research, information on CAMs that are easier to evaluate using quantitative techniques (eg, herbal remedies) tends to predominate. [As a matter of policy, NCCAM provides reports on research it has funded but does not advise consumers on what they mean.]
The US Food and Drug Administration (FDA) also provides consumer advice on dietary supplements via its website. It has published a guide to help consumers make informed choices about supplements (US FDA 2002).
In 2002 the White House Commission on Complementary and Alternative Medicine Policy (WHCCAMP) recommended that 'Federal government should make available accurate, useful, and easily accessible information on CAM practices and products, including information on safety and effectiveness'. The volume of CAM information provided by the US government may therefore increase in the future (WHCCAMP 2002). [No federal agency has done anything in response to this recommendation. The only real gaps in government CAM information are (a) the failure to identify which CAM methods are worthless and (b) the failure of NCCAM and other government agencies to refer people to information sources that are justifiably critical of CAM methods. Setting up more agencies with similar policies would worsen the situation rather than improve it.]
Consumers in the US also have access to a wide range of information from practitioner bodies, consumer organisations and special interest groups, much of it provided via the Internet.
Consumers in Canada currently have access to a variety of information on CAM. Until recently provision of information has been fragmented and the main sources have traditionally been CAM practitioners, practitioner and patient organisations, the media and the Internet. However, increasing demand for CAM has prompted Health Canada to provide information in a more co-ordinated and accessible manner. The Canadian Health Network, a national Internet-based health information service funded by Health Canada, now includes a section on CAM on its website. This gives information on different modalities and advice on choosing a practitioner, and offers links to other CAM resources on the Internet. [The information is skimpy and of low quality.]
Another useful Canadian resource is the Camline website, which was set up to provide health professionals and the public with evidence-based information on CAM. The Camline initiative is a collaboration between various CAM and biomedical organisations. [So far, there are only three articles, each of which is descriptive and not sufficiently critical.]
The Therapeutic Goods Administration provides information about CAM products on its website. The Complementary Healthcare Consultative Forum, established by the Australian Federal Government, is currently examining the provision of consumer information on CAM with a view to implementing formal policies. It has particular concerns about the claims made in product advertising and the marketing of remedies and supplements via the Internet. [So far, the focus is on regulations, with little useful advice for consumers.]
The Consumers' Health Forum of Australia has published a guide to complementary medicines (Consumers' Health Forum 1999). The Cochrane Collaboration Consumer Network, based in Australia, provides simplified summaries of Cochrane reviews via its website. These are designed to help consumers make informed decisions about health care. The summaries often include information about CAM therapies. It should be noted that although based in Australia, the Consumer Network is a worldwide initiative. It is part of the international Cochrane Collaboration and the information on the website is therefore international in scope. (Footnote: The Cochrane Collaboration is an international network of researchers who undertake 'systematic reviews' on the effectiveness of medical treatments. A systematic review pools and interprets the results of all existing research on the effectiveness of a particular treatment.) [The consumer summaries, which cover various herbs and six other categories, are well written. Most conclude that the claims that were reviewed were unsubstantiated.]
There are laws governing the labelling of, and information provided with, Chinese proprietary medicines. The Singapore Ministry of Health must approve these products prior to import or sale. Information on other CAM therapies and products is provided by practitioners and practitioner associations.
The advertising, labelling and information content of TCM products must comply with legislation on general drug advertising. The rules are described in the Anthology of Policies (SATCM 1997). The various provincial, regional and municipal health administrative departments are responsible for enforcing these laws within their jurisdictions. Generally speaking, drug advertisements are required to be truthful and accurate. Advertisements in the media must carry the warning 'Please follow your doctor's advice'