Phytotherapeutic medicinal products: reality or myth?
In recent decades, the interest of medical professionals in the use and knowledge of herbal medicines, and phytotherapeutics, has increased.
This increased interest may be due to the possible risks of the irrational use of allopathic medicines, in addition to their high cost.
Since the Declaration of Alma-Ata (1978), the World Health Organization has recognized that approximately 85% of the population of the developing world uses plants or herbal products for health purposes.
Therefore, this approach must be respected and valued. Phytotherapy is recognized as a therapeutic procedure promoted by national health authorities, but not as a medical specialty.
There is no such decision by the Federal Council for Medicine.
The Ceará Regional Council recommends careful government oversight of its use as a treatment by doctors. It should be noted that in its general concept it is considered a complementary treatment like acupuncture and homeopathy.
In this regard, the misinformation on the subject is clear, since the procedure for registering phytotherapeutic medicinal products follows the same principles and rules as for all synthetic medicinal products.
To avoid confusion on this issue, a law came into force in 2012 classifying three categories of herbal products: herbal medicine (for teas); Phytotherapeutic (finished product of living pharmacies) and phytotherapeutic medicine.
Looking at the date of publication, we can see that until that date there was a lot of confusion around the concept of phytotherapeutic medicine, then defined as a product obtained exclusively from plant raw materials on the basis of constant quality and reproducibility; as well as the knowledge of its risks and effectiveness, shaped by ethnopharmacological studies, technical-scientific documentation in publications or clinical studies.
They also follow the same Anvisa rules for synthetic drugs. It is necessary to highlight the differences between countries in terms of legislation on phytotherapy.
Agency, the strict FDA. However, in Brazil, herbal medicines can be considered medicines and are subject to strict legislation under Anvisa, although the definition of herbal medicines includes any product used as a therapeutic that is exclusive of plant origin.
therefore includes teas and artisanal or homemade preparations.
In a study aimed at assessing the opinions of healthcare professionals on the use of herbal medicines in public health care in primary care units, 60% said they only had information from popular culture. Only 20% have acquired knowledge from magazines.
This offers insight into the enormous risk of misinformation or inappropriate or even wrong conclusions. Respondents added that the government program was implemented without consulting or training the professionals involved.
When approached to doctors at the Family Health Program in the city of Canoas (RS), a city that has virtually no rural area, 27 of the 31 practicing doctors agreed to be interviewed.
The vast majority were up to 30 years old, indicating that they were recent graduates.
Almost all indicated that they not only use plants for personal hygiene but also recommend them to patients (avoiding the term “prescribing”), but also showed that their knowledge on the subject comes from their relatives or even from the patients themselves came from.
The almost unanimous report that “there is no knowledge based on evidence-based medicine”, clearly shows the ignorance of professionals about the content of the numerous studies published in national or international journals, as well as the ignorance received in theirs could become academic programs.
So although the pharmacological action has been recognized herbal products can in many cases (although the word was not mentioned) be considered a placebo effect due to patient trust and trust.
This ignorance is unique to Brazil.
In fact, a study conducted in Switzerland showed the growing interest in the use of alternative practices such as herbal medicine, homeopathy, and acupuncture, but these subjects have not been included in the country’s academic curricula either.
The aim of the study was to precisely record the interest of physicians and medical students in this inclusion.
The conclusion was that there is a desire and that there should be informative programs so that students know the actual effectiveness, interactions, side effects, and safety of these methods.
Regarding medical education in herbal medicine, a study presented in Congress underscores the need for a stronger approach to the subject in medical schools, and that much of what the medical class knows comes from pharmaceutical industry propaganda, rather than from university education, although there is a national program that encourages the use of complementary and inclusive practices.
A doctoral thesis dealt with the inclusion of phytotherapy in the curricula of Brazilian public universities. He analyzed the teaching of phytotherapy in 59 public universities: in the medical schools there were 42 references to the teaching of phytotherapy; in pharmaceutical faculties, 36; and in nutrition programs, 40. However, when the compulsory nature of the subject was analyzed, only one (the Federal University of Mato Grosso do Sul) addressed the topic in medical courses, and in 36 pharmacy programs, it was part of the curriculum.
It should be noted that students and professionals have shown an interest in its use and knowledge as long as it is scientifically well-documented.
Another important point is the misconception that herbal products are safe and can be consumed indiscriminately.
It should be noted that plant derivatives, like any other drug, have adverse and toxic effects. In addition, the long-term effects of many of them are unknown and therefore require education, research and appropriate use.
It is recommended to do this under medical supervision. In addition, there is often the advantage of significantly lower costs than other s. p>
Therapeutics. In a national study, the author reports data on herbal medicine training initiatives in different locations.
Among other things, he mentions the “Uso de Plantas Medicinais e Fitoterapicos” [Use of Medicinal Plants and Phytotherapeutics] program for community health agents of the Avasus unit of the Ministry of Health, active since 2010.
We have had the opportunity to access it and we have found that its main objective is to inform the public and have a better understanding of the use of plants in the communities, but not, particularly as a phytotherapeutic.
The study also mentions the Phytotherapy Program for Doctors, sponsored by the Ministry of Health but not awarded to 300 participants until 2003.
And the “Aim of Studies” course promoted by the Municipality of São Paulo for health professionals with several doctorates since 2010, including those of 2014 and 2015, with a total of 165 participants. Of these, however, only 27 were doctors.
In the interviews conducted as part of this study, participants reported difficulties in obtaining scientific knowledge on the subject and some confusion between scientific data and common knowledge.
The widespread opinion that there is no scientific evidence regarding products of plant origin is confirmed. be wrong by running a simple check.
For example, on the US National Health Service’s international reference website, PubMed, a search for Glycine max (soy) found 25,127 references. Using the word “therapy” as a filter returned 2,942 studies.
After searching, we found 3991 or 2017 posts respectively. 2625 or 931 articles were found for (Balm Mint). For (mint), 931 or 143 studies. For (passion fruit) 645 or 171 jobs. They are obviously well-studied plant extracts, and others not so mentioned.
This data shows that there are numerous researchers around the world interested in the topic. Not to mention the ability to access other available search sources.
On the other hand, the idea of prescribing phytotherapeutic medicines does not mean replacing traditional medicines, but rather expanding the therapeutic possibilities, since they are medicines and as such are authorized by Anvisa.
Brazil has a program sponsored by the Ministry of Health – the National Plan for Complementary and Integrative Therapies (PNPIC) – which includes the recommendation for the use by the Health System “SUS” of various therapeutic procedures, such as acupuncture, homeopathy, and others, including phytotherapy.
What we have observed, however, is that despite the fact that 12 plants have been approved for medicinal use, SUS experts do not usually provide detailed information about the scientific knowledge of these plants and their popular uses, including common ones. have in the area of the SUS unit and the “living pharmacies”, i.e. the use of cultivated medicinal plants, are consistently favored and widely used.
We cannot fail to notice that in some cities the programs were very well developed, with very insightful collaborators, among whom Vitória and Curitiba stand out.
Therefore, we consider it quite clear that phytotherapeutics can be very useful as a complete or complementary therapy for many pathologies, but it is necessary to provide more information to the medical institution (especially the actual inclusion of the subject in courses academics ) as well as the public so that they can trust such a powerful tool.
Phytotherapeutic medicines should be understood as available medicine, an additional option that is not a placebo!