Page 31 - HA Convention 2016 [Abstracts (Day 2)]

Special Topics HOSPITAL AUTHORITY CONVENTION 2016

T16.3 Integrative Chinese-Western Medicine 13:15 Room 423 & 424

How to Develop Evidence-based Practice in Chinese Medicine?
Wu J
Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong

Evidence-based medicine (EBM) is the cornerstone of modern healthcare practice. Conventionally, the hallmark of EBM refers
to rigorously designed clinical trials with robust clinical outcome measures. Owing to the individualised nature of Chinese
medicine, it is exceedingly difficult to fit Chinese medicine in the conceptual framework of EBM. This presentation will discuss
the challenges and future directions of developing EBM in Chinese medicine.

T16.4 Integrative Chinese-Western Medicine 13:15 Room 423 & 424

Chinese Medicine Safety — from Scientific Evidence to Clinical Practice Wednesday, 4 May
Yung T
Chief Pharmacist’s Office, Hospital Authority, Hong Kong

The safe use of Chinese medicines (CM) is one of the major areas of concern, especially when western medicines are
concurrently used in the development of integrative medicine. It is of particular importance in inpatient setting, where patients
may present with severe clinical conditions or under treatment with complex drug regimens. Although there are numerous
references or tools relating to herb-drug interactions (HDI), healthcare professionals have to pay tremendous effort and face
various challenges in interpretation of such information, in which pertinent scientific evidence for application in local practice
is often lacking.

To address these issues, the HA has recently developed a novel and evidence-based approach to review and assess
literature on CM toxicity and HDI for application in local inpatient settings. Primary data on human evidence such as
randomised controlled trials (RCT), non-RCT and case reports were obtained and the intrinsic toxicities of CM on important
organ systems and potential HDI were reviewed. Risk assessment on safe use of CM was conducted through a risk
stratification matrix by an expert panel comprising clinicians of various specialties, as well as pharmacists and CM experts.
As a result, risk ratings on the potential HDI and recommendations for safe use of medications, where appropriate, were
made to facilitate decision making in clinical management.

Many of the CM contain biologically active components and are known to possess some pharmacological effects similar
to western medicines. However, their impacts on different organ systems are often unpredictable owing to the diversity
of components and the complexity of mechanism of actions. Therefore, a pragmatic approach focusing on the clinical
significance in local inpatient settings was adopted, in which many of the potential HDI were concluded based on findings
extrapolated from well-established drug-drug interactions or interactions involving the principal components of the CM. In
this presentation, examples of potential HDI observed in some commonly used CM which may potentiate or counteract the
effects of western medicines through pharmacodynamic or pharmacokinetic mechanisms will be discussed.

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