ACCP White Paper: Guidance on Natural Products

In 2000, the American College of Clinical Pharmacy (ACCP) published a white paper on herbal products. Since then, growth in the global market for natural products has continued. Statisticians project that consumers will spend more than $115 billion by 2020 and an estimated 40 million adults indicate they have used a natural product in the last 12 months. Despite the fact that consumers embrace the natural products market, these products continue to remain largely unregulated, be supported by little to no clinical evidence, and create vast safety concerns.

ACCP has updated its white paper on natural products, and published it recently in the journal Pharmacotherapy. The current white paper discusses regulatory issues, efficacy, and safety evidence, and reviews contemporary natural product resources. It also provides recommendations for clinical pharmacists about incorporating information about natural products into medication histories and reconciliation, transitions of care, and discharge planning.

Many online databases and websites are available for both patients and clinicians that provide evidence-based information on using natural products. The article includes a comprehensive table of these databases and websites with descriptions of the sources, cost, referencing, and how often information is updated.

When recommending online resources, clinical pharmacists should encourage patients to evaluate the quality of the information effectively. The National Library of Medicine has a tutorial on MedlinePlus that patients can use to evaluate the health information found online.

In addition, the white paper recommends a patient-centered process for clinical pharmacists with respect to educating patients on the use of natural products. The standards recommend that pharmacists assess the patient’s medication-related needs by:

• Reviewing the medical record using a problem-oriented framework to determine the patient’s clinical status.
• Meeting with patient/caregivers to obtain and document a complete history to identify all of the patient’s current medications, medication-taking behaviors, adherence, allergies, and experience with therapies.
• Obtaining, organizing, and interpreting patient data
• Prioritizing patient problems and medication-related needs

Pharmacists' main goal in this setting is to use of objective information, clinical guidance and a non-judgmental approach to help patients make informed health decisions about herbal supplements.

Reference

Gabay M, Smith JA, Chavez ML, et al. White paper on natural products. Pharmacotherapy. 2017;37(1):e1—e15.