Legal Status and Regulation of Complementary and Alternative Medicine in Europe

Wiesener, Solveig; Falkenberg, Torkel; Hegyi, Gabriella; Hök, Johanna; Sarsina, Paolo Roberti di; Fønnebø, Vinjar

doi:10.1159/000343125

Cited by 78 publications

(63 citation statements)

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“…In contrast to some other EU countries, costs for CAM therapies are not covered by standard health insurance in the Netherlands [36]. Dutch citizens have the possibility to pay for additional insurance that (partly) covers some CAM therapies, however, health insurers are not obliged to accept people that apply for additional insurance.…”

Section: Discussionmentioning

confidence: 99%

Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain

Jong¹,

Busch²

2016

Primary Health Care

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Section: Discussionmentioning

confidence: 99%

Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain

Jong¹,

Busch²

2016

Primary Health Care

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“…As a result of insufficient herbal product regulations, some ADR may 21 be attributable to a lack of standardization, contamination, adulteration, plant misidentification/substitution, improper use of herbal medicines including their inappropriate labeling rather than pharmacological/toxicology effects of herbals [5][6][7]31]. Also, implementation of innovative preparation methods of traditionally used herbal remedies may alter pharmacological/toxicological properties of herbs and lead to their toxicity rather than therapeutic use.…”

Section: Suspect Herbalsmentioning

confidence: 99%

“…The public often considers herbal products as safe since they are natural and is unaware that Complementary and Alternative Medicines (CAM) are not tested by regulatory agencies for their safety and efficacy [4]. In most countries, herbal medicines are defined as dietary supplements and as such do not have to meet pre-and postmarketing drug policy regulations [5]. However, use of herbal medicines can be associated with development of severe adverse reactions as a result of complex chemistry of herbals as well as their inappropriate use and a lack of quality control [6,7].…”

Section: Introductionmentioning

confidence: 99%

Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase®

et al. 2016

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INTRODUCTION Herbal medicines are used worldwide and with an increasing popularity in Western countries. Although often perceived as 'naturally safe', herbals may cause severe adverse drug reactions (ADRs), with immediate allergic reactions being particularly life threatening. OBJECTIVES The aim of this study was to analyse immediate allergy-like ADRs to herbals documented in VigiBase(®), the WHO international pharmacovigilance database. METHODS The documentation of all suspected ADRs in association with herbal exposure reported to VigiBase(®) from 1969 to August 2014 was retrieved. Among all reports in which WHO-ART reaction terms were indicative of acute allergic reactions, those classified as 'suspect' with a documented causality assessment and latency time of 1 day were selected. For the most frequent specific herbal-ADR combinations, the information component (IC) as a measure of disproportionality based on Bayesian statistics was calculated. RESULTS We identified 757 reports out of 1039 ADRs. Products with mixed herbals (36.0 %) as well as those administered orally (63.2 %) were predominant. The most frequent reactions were urticaria and rash (49.2 %). Anaphylactic reactions accounted for 9.5 %. Disproportionally frequent reporting of mouth edema (IC = 1.81) and anaphylactic reactions (IC = 1.24) to Phleum pretense were noted. CONCLUSION Our findings indicate that herbal medicines for oral use carry a risk of causing immediate allergy-like ADRs. Studies using the Vigibase(®) database can identify specific combinations of particular herbs and adverse reactions. Healthcare professionals and patients should be aware of these risks and report any serious adverse experiences. Results:We identified 757 reports with 1,039 ADR. Products with mixed herbals (36.0%) and oral administration (63.2%) were predominant. The most frequent reactions were urticaria and rash (49.2%).Anaphylactic reactions accounted for 9.5%. We found disproportionally frequent reporting of mouth oedema (IC=1.81) and anaphylactic reactions (IC=1.24) with Phleum pratense. Conclusion:Our findings indicate that herbal medicines for oral use carry a risk for allergy-like immediate ADR.Studies using the Vigibase ® database can identify specific combinations of particular herbs and adverse reactions. Health care professionals and patients should be aware of these risks and report any serious adverse experiences.

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“…It thus widens the possible options for individuals in resolving symptoms, coping with ill-health and promoting health and well-being. here is also a highly varied legal context for CAM across countries and diversity in the regulation of CAM practice [24,25]. In the UK, a 'right to practice' is enshrined in English common law and some CAM modalities are taking part in voluntary regulation with the Complementary and Natural Healthcare Council (http://www.cnhc.org.uk/).…”

Section: What Is Cam?mentioning

confidence: 99%

Complementary and Alternative Medicine (CAM) and the Public Health: an Innovative Healthcare Practice in Supporting and Sustaining Health and Well-Being

Long¹

2014

Epidemiol

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IntroductionPublic health is commonly deined as 'the science and art of preventing disease, prolonging life and promoting health through the organised eforts of society' [1]. It centres on promoting and protecting the health of communities, individual citizens and the wider population. Epidemiology with its focus on exploring and identifying the determinants of ill-health and why and how some stay healthy [2], and by extension health inequalities [3] is a core contributory discipline generating evidence on inluences, causes and potential ways to break the causal chain, thus enhancing health.In a European context where a cross-country average of 3% is spent on prevention [4] one must question why a greater proportion of healthcare expenditure is not targeted and invested 'upstream' with a view to addressing the root socio-economic and cultural causes of ill-health and health inequalities, thus, intervening with whom or whatever is 'pushing them into the river'. he diicult of such a funding and policy action is compounded by population ageing and increased survival, accompanied by an increasing burden of chronic illness and associated co-morbidity [4] all to be addressed within tight resource constraints. here remains the urgent imperative to treat and care for those 'downstream', 'pulling them out of the river'.With the publication of Health 2020 [5] and its approval by the 53 countries within the European health region at a session of the WHO Regional Committee for Europe in September 2012, a higher priority for a shit in focus and resurgence of public health arises. his policy framework aims to 'signiicantly improve the health and well-being of populations, reduce health inequalities, strengthen public health and ensure people-centred health systems. ' (ibid, p1). It identiies four priority areas for policy action, throughout emphasising 'developing assets and resilience within communities, empowerment and creating supportive environments. ' (ibid, pvi). Public health is identiied as the third priority area, drawing attention to the importance of investing in health through the life-course, in order to empower and create resilience in supportive environments. As Dr Zsuzsanna Jakab, WHO Regional Director for Europe, argued at the fourth annual conference of the [6] European Public Health Alliance (2013), 'today's health emphasis is on non-communicable diseases and mental health problems. Also important is health-related behaviour, including tobacco and alcohol use, diet and physical activity: behaviour, which is itself socially determined and oten relects the stresses and disadvantages in people's lives.' he challenge of converting this political/policy level rhetoric into implementation and practical action remains to be realised.Public health and Health 2020 (WHO 2013) draw explicit attention both to the social determinants of ill-health and the role of individuals and communities in enabling health. Associated notions include health promotion, empowerment and health literacy, all potentially aimed and taken f...

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Legal Status and Regulation of Complementary and Alternative Medicine in Europe

Cited by 78 publications

References 1 publication

Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain

Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain

Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase®

Complementary and Alternative Medicine (CAM) and the Public Health: an Innovative Healthcare Practice in Supporting and Sustaining Health and Well-Being

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