Overview of Complementary Medicines

Over the past few years, it has been clear that the increased popularity of complementary and alternative medicines (CAM) has created the need for the public to receive accurate information from their healthcare professionals (HCP). Reviews of published research studies which consider the knowledge, use and attitudes of doctors to CAM suggest increased HCP interest in CAM. Moreover, similar reviews have also raised a number of concerns including inadequate knowledge of HCP in addition to other concerns such as CAM efficacy and safety. ^[3] According to the Global Report on Traditional and Complementary Medicine 2019 ^[4], complementary medicine (CM) and its related therapies are important and underestimated health resources, with regard to their potential application in the prevention and management of lifestyle-related chronic diseases and in addressing the health needs of ageing populations. Such an increase in the popularity of CAM has motivated EMGuidance to provide information for HCP and their patients related to CAM available in South Africa in order to ensure that our healthcare system can receive accurate information and to bridge the gap between between CAM providers and HCP for better experience, aiming to maximise the benefits and minimise the risk associated with the use of CAM as health-related and lifestyle-related therapies. EMGuidance will continue providing additional information across a range of CAM once made available.

As per the South African General Regulations made in terms of the Medicines and Related Substances Act, 1965 (Act 101 of 1965): ^[1-2]

HEALTH SUPPLEMENT (HS) (also knowns as Alternative Medicine) means any substance, extract or mixture of substances as determined by the authority, sold in dosage forms used or purported for use in restoring, correcting, or modifying any physical or mental state by: complementing health; or supplementing the diet; or  a nutritional effect.

The term Health Supplement excludes injectable preparations, medicines (both prescription and ‘Over-The-Counter’), or substances listed as Schedule 1 medicine or higher.

COMPLEMENTARY MEDICINE (CM) means any substance or mixture of substances that:

1. originates from plants, fungi, algae, seaweeds, lichens, minerals, animals or other similar group of substance, and

2. is used or purporting to be suitable for use or manufactured or sold for use:

   • in maintaining, complementing, or assisting the innate healing power or physical or mental state, or

   •  to diagnose, treat, mitigate, modify, alleviate or prevent disease or illness or the symptoms or signs thereof or abnormal physical or mental state, of a human being or animal, and

   •  is used as a health supplement, or in accordance with those disciplines as declared by Act to be a complementary medicine.

COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) product means a single product that contains:

1. a mixture of substances of different discipline-specific origins or philosophies;

2. a mixture of at least one substance of discipline-specific origin and one or more health supplements; or

3. a mixture of at least one substance of discipline-specific origin and one or more of its isolated constituents.

REFERENCES:

1. SAHPRA - COMPLEMENTARY MEDICINES - DISCIPLINE-SPECIFIC AND EFFICACY. [7.01_CMs_SE_DS_Jan2020_v3_1.doc]. January 2020.

2. SAHPRA - COMPLEMENTARY MEDICINES - HEALTH SUPPLEMENTS SAFETY AND EFFICACY. [7.04_CM_SE_Health_Supplements_June20_v4]. June 2020

3. Botting DA, Cook R. Complementary medicine: knowledge, use and attitudes of doctors. Complement Ther Nurs Midwifery. 2000;6(1):41-47

4. van Rensburg R, RazlogR, Pellow J. Knowledge and attitudes towards complementary medicine by nursing students at a University in South Africa. Health SA. 2020;25:1436. Published 2020 Dec 9