Health Beliefs and Behavior & Quackery

Transcription

1 Health Beliefs and Behavior & Quackery Matthew M. Murawski, R.Ph., Ph.D. Associate Professor of Pharmacy Administration Purdue University 1

2 Consumers and Health Behavior Consumer myths and misconceptions Alternative systems Alternatives to prescription and OTC drug therapy 2

3 Consumer myths and misconceptions Unusual or unproven health beliefs and practice that decrease the likelihood of engaging in health behaviors. USA national Study of Health Practices & Opinions 73% Extra vitamins give more pep and energy 20% Cancer and Arthritis are caused by vitamin deficiencies 10% Organic or natural foods prevent diseases 12% Have self-diagnosed a major disease 3

4 What s the harm? already doing something (vitamins/organic foods) why do more? not susceptible (vitamins) why worry? self diagnosed already, so why try & treat or go to Dr? 4

5 People want to do something easy for their health. benefit/barrier equation drugs one of easiest health behaviors - a pill for every ill easier to take a diet pill then diet and exercise explains popularity of vitamins 5

6 What is "true" changes over time. Past Medical practices now considered quackery (Bleeding pts, calamol (strong laxative), leeches) smallpox vaccine from cow ulcers? Penicillin from bread mold? Not so long ago, no one knew a aspirin a day would reduce heart attacks Or that peptic ulcers caused by a slow infection Keep an open mind- BUT - need to recognize your role as authority; things outside mainstream may have some validity, but we need to stick with the best scientific evidence available. Don t believe the first few studies- wait for the body of evidence 6

7 Alternative systems Right? Wrong? -just not accepted 1/3 of Americans use some form of alternative medicine 34% use incorrect therapy You WILL come in contact with pts who use, practitioners as well. pts use without MD s advice or knowledge 72% don t tell MD about alternative therapy 7

8 Chiropractic Started with Daniel Palmer, a grocer in Iowa, in 1895 diseases caused by dislocations in spinal column, effecting nervous system & controlling health (SUBLUXATIONS) Licensed in 50 states, very strong in Mid-west, legally legitimate, but stigmatized politically active, in constant fights with AMA (who call them impostors, charlatans and quacks) 10,000,000 visits to 20,000 practitioners each year, workman s comp/medicaid/ covered Straights (just manipulation) and Mixers (massage, diet, vitamins & minerals) 8

9 Chiropractic vs D.O.s Doctors of Osteopathy also do manipulation, but NOT stigmatized- has been called the greatest tribute to applied public relations and marketing in the world patients are VERY loyal, places premium on a caring attitude 16 schools, 4 yr course with 2 yrs of college 9

10 Naturopathy <19% of population natural things- sunlight, heat, water, cold, ultrasound, natural drugs, herbal medications only one college in U.S., but many people claim to be trained in it Big in California 10

11 Homeopathy versus allopathy (MD s and D.O. s) <1% of population Law of Similars - like cures like if you have diarrhea, give a small amount of something that causes diarrhea if you have a headache, a small dose of something that causes a headache Law of Infinitesimals - the smaller the dose the greater the effect Minute (1/millon, 1/200 million) doses 11

12 Homeopathy(cont) a 10,000,000,000,000,000,000,000,000,000 to 1 shot (consumer reports discussing Yeastgard, Vaginex & Vagisil) Process of potentizing (dynamizing) shaking makes it stronger Humphrey s Remedies (#9, #114, etc) Big in Europe, few physicians left in U.S., legal prescribing status, homeopathic formulary remains an official compendium, because a powerful member of Congress was a homeopathic physician (1938) FDA pressured to remove, but low priority- no harm, no foul 12

13 Still Out there.why? Some insurance companies will pay for homeopathic remedies- Why? Providing Coverage is cheap Pts want it People who investigate and desire alternative coverage (and so buy your insurance) tend to be younger, healthier, and less likely to get sick, lowering your costs as an insurer Abuse possible - one HMO admitted sending AIDS pts to naturopathy clinic- cheaper than AZT and they die sooner, reducing costs Products are basically water and labeling. High profit margins 13

14 Faith healing any number of different religions, lots of variations Will refuse mainstream treatment, we hear about this when children die Christian Science is a major model, with a recognized system of healers 14

15 Acupuncture steel or copper needles at points in the body Sometimes with electrical stimulation added especially used for pain relief, anesthesia, drug withdrawal becoming integrated with medical practice 15

16 Alternatives to prescription and OTC drug therapy 16

17 Organic foods and drugs/herbal products St. John s Wort for depression All foods chemically organic, supposedly free of fertilizers/additives a molecule doesn t know its parents, test tube or plant Unless you actually eat the crude plant, no drug or vitamin is actually natural 17

18 Mega vitamin therapy/alternative vitamin uses times the normal dose use to think water soluble vitamins (Bs, C, Folic Acid) weren t a problem, but it has been shown B6 can lead to nerve disorder C leads to kidney stones Fat Soluble vitamins (A &D) collect in system Polar Bear Liver - lethal dose of Vitamin A 18

19 Folk medicines Most do no harm, but may delay real treatment butter on burns coca cola/whiskey for wounds sulfur/molasses to thin blood 19

20 Quackery Health quackery involves products that are worthless or people who cannot deliver a result or cure that they promise. Fine line between quackery and alternative medicine- and many consider most alternatives quackery Person may believe in product they sell- in fact, most do, but it is quackery if they can t deliver what was promised 20

21 Much quackery focuses on chronic disease conditions that hurt, that have no real cure- arthritis, cancer, chronic headaches, lower back pain grasp at straws Harm? toxic side effects, chemical impurities, unrecognized adverse effects Direct cost, as well as cost diverted from legitimate research DELAY IN TREATMENT - especially tragic Overall cancer cure rate >50% with early treatment 21

22 Ten tip-offs to quackery Exclusive cures promised Secret formula or device Testimonials and case histories Tabloid ads and mail order Quick and Simple solutions Cleanse body, especially using Natural Methods Drugs and Surgery condemned Lack of Scientific Proof Special diet or nutritional program Medical establishment conspiracy 22

23 Major types of quackery Food Devices Drugs Blender Queen baldness gizmos weight loss belts magnetized bracelets, belts and headbands muscle toners various and sundry machines with bells, whistles & buzzers weight loss hair growth alcoholism cures alternative cancer treatments bust enhancers 23

24 Something About Quackery In general, states don t have the resources to pursue quacks This is what the Feds do But unless the device crosses state lines, the federal authorities don t have the legal support needed to act So one additional sign of quackery is that it is always an in-state address 24

25 QUESTIONS? 25