(2004; 109 pages)
1.4 Additional important aspects for the proper use of TM/CAM
Although these guidelines focus mainly on the development and content of reliable information for consumers, there is also a critical need to ensure that key health systems structures and processes are in place when promoting proper use of TM/CAM. For instance, the presence of structures governing TM/CAM education, information and/or research and the existence of professional TM/CAM organizations are all important for the development, implementation and dissemination of activities promoting proper use of TM/CAM (28). The following sections describe some of these key areas.
(a) Quality control of herbal medicines
Herbal medicines are the most popularly used form of TM/CAM medication therapy. However, in some countries animal, mineral, or other materials may also be used. Therefore, in these cases, regulations should be specifically tailored to address each country’s unique situation. Regulatory systems for the quality assurance and registration of herbal medicines will improve the quality of products and enable consumers to use high quality products (2). Quality control of herbal medicines involves complex issues, which have been described in a series of WHO documents such as Quality control methods for medicinal plant materials (29), WHO monographs on selected medicinal plants and General guidelines for the methodology on research and evaluation of traditional medicine (3, 25, 26, 29). It is important that regulations on the quality control of herbal medicines are developed and implemented appropriately so that small-scale manufacturers are able to comply and are not excluded from the market.
(b) Development of reliable treatment guidelines
The development of reliable information on the most commonly used TM/CAM therapies, based on results from clinical studies and other scientific studies, can offer clinically relevant information about these therapies to guide TM/CAM practitioners, conventional health care providers and the public. This will help prevent irrational use and improve the ability of consumers to make informed decisions on TM/CAM use.
(c) Training and qualified practice for TM/CAM practitioners
Adequate training and the licensing of TM/CAM practitioners will improve safety, promote the credibility of TM/CAM therapies and TM/CAM providers, and enhance consumer trust in their practitioners (30, 31). Guidelines for basic training and continuing education of TM/CAM practitioners have been developed by a number of organizations including WHO and a number of national governments and various professional organizations (32).
(d) Collaboration between conventional health care providers and TM/CAM practitioners
Since consumers often use both TM/CAM and conventional treatment simultaneously, it is necessary to improve collaboration between registered/licensed TM/CAM practitioners and conventional health care providers. Ideally, the training of conventional health care providers should include basic knowledge of commonly used TM/CAM. Likewise, the training of TM/CAM practitioners should include basic knowledge of relevant parts of conventional medicine, such as public health, hygiene, first aid and ethical issues. Moreover, TM/CAM practitioners should be encouraged to conduct research and submit reports to medical journals, in order to initiate information sharing between conventional and traditional medicine.
(e) Communication between TM/CAM consumers and their conventional health care providers and TM/CAM practitioners
Since conventional health care practitioners are sometimes sceptical about TM/CAM treatment, there is often a communication barrier between the consumers and doctors. Improved communication between TM/CAM consumers and their different health care providers, may promote greater trust between patient and providers and reduce the risks of adverse events and interactions in patients using TM/CAM medication therapies or using procedure-based therapies in conjunction with conventional treatment (30, 31).
(f) Organization of TM/CAM practitioners
Efforts to strengthen the organization of TM/CAM practitioners will help ensure better structures for self-regulated control mechanisms and contribute to increased professionalism (30, 33). There is a need to develop local organizations of TM/CAM practitioners which can become the backbone of future national organizations. The development of a professional code of ethics can further contribute to consumer trust and safety. Official recognition of relevant TM/CAM practitioners (e.g. through legal frameworks) should also take place.