Module 7: Managing side effects and optimising treatment strategies - section 3

In this document:

Complementary and alternative interventions

Activity: Presentation and large group work
Section Time: Approximately 20 minutes

The purpose of this section is to help develop an understanding of the potential for complementary and alternative interventions to be used in the treatment of HCV.

Initiate large group discussion by showing Slide 7.8 (Group work) and asking participants the questions:


Facilitate discussion around responses by:

  • Reflecting back answers to group to encourage further definitions
  • Asking how effectiveness is determined
  • Asking participants to identify any known CAM
  • Referring to any local examples where CAM have been used
  • Asking what risks might there be in using CAM

Show Slide 7.9 (Defining complementary and alternative therapies - CAM) and use to build on understanding from previous discussion as needed:


Introduce Slide 7.10 (Herbal supplements for hepatitis C) :


Facilitate brief discussion:

  • Establish with participants whether some or all are familiar
  • Ask if there are other local remedies that are used by those with HCV
  • There is limited evidence of effectiveness of herbal remedies
  • Some growing evidence for use milk thistle in some cases although it still largely unproven
  • Recent Austrian study suggests that intravenous formulation of a milk thistle extract—silymarin has potent anti-HCV activity in some people. Much work remains to be done to confirm and extend these findings.
  • It is worth noting that Milk thistle has been used in Europe as a treatment for liver disease and jaundice since the 16th century

Show Slide 7.11 (CAM: Key points) and summarise key points on explaining:

  • Although evidence for CAM effectiveness is limited they are used extensively and particularly in the US and to a lesser degree in UK and Western Europe.
  • Use in other regions might be less extensive
  • Users do report benefits
  • Important that healthcare professionals aware of alternatives being used
 
Supporting content:

Complementary medicines are considered to have both benefits and drawbacks. Many elements of CAM provide a holistic response to hepatitis C infection and can assist in emotional and physical well-being. Having the ability to make decisions around complementary medicine can give people some sense of control over their hepatitis C infection. Herbal remedies have been used for centuries to treat liver disease, but they cannot cure hepatitis C and some may actually cause damage. However many people use them because conventional treatment has not worked for them, others because of concerns about the side effects of HCV therapy.

Healthcare providers should be involved in the decision to start herbal medicines in order to ensure safe, coordinated care, especially because many herbal remedies are not regulated for consistency or quality and some may cause an additional burden on liver function.

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