Evolution of a policy disallowing the use of alternative therapies in a health system

The evolution of a policy disallowing patients' use of alternative therapie s in a health system is described. The pharmacy and therapeutics (P&T) committee at Childrens Hospital of Mich igan part of the Detroit Medical Center (DMC), was asked to review the appr opriateness of allowing inpatients to bring in and use alternative therapy products during their hospitalization. Recognizing the interest of consumer s in alternative medicines and patients' growing involvement in their own c are, the committee drafted a :policy that allowed patients to continue taki ng dietary supplements after being admitted to the hospital. If the physici an had no concerns about potential toxicities or drug interactions for a pa rticular product, he or she would write a medication order allowing it to b e used. Purchasing and administering the products were deemed the responsib ility of the patient or the family. However, many issues concerning supplem ents remained unresolved, including questions about safety, efficacy, dosin g, drug interactions, ethical conflicts, and liability. Ultimately, the P&T committee decided that the potential risks associated with alternative the rapies outweighed potential benefits and adopted a policy disallowing the u se of alternative therapies by hospitalized patients. The policy was eventu ally implemented at all eight DMC hospitals. A health system responded to patients' desire to continue their use of alte rnative therapies during hospitalization by drafting a policy allowing such use. However, concerns related to safety, efficacy, ethics, and liability led to the abandonment of the liberal policy and implementation of a highly restrictive one.