What Responsibility Do Physicians Have in Confronting Pseudomedicine?

The prevalence of pseudomedicine products for dementia and cognitive performance, including those found in dietary supplements and detox products, has risen in recent years, targeting vulnerable patients and their caregivers with products manufactured or heralded by individuals with self-interest.

Often, these pseudomedicine interventions typically have little scientific backing, yet continue to gain popularity for their supposed benefits in improving brain health. Fortunately, steps can be taken in the healthcare industry to combat pseudoscience in dementia care, according to a paper published in JAMA.

Sophisticated health-related products, interventions, and technologies are developed and promoted on an almost daily basis, ranging from weight loss aides to “neuro-enhancers.” These products are accompanied by clever marketing campaigns that appear to communicate scientific and rational mechanisms for their efficacy, but they typically offer very little value for patients. A number of dietary supplements, which do not undergo safety or efficacy by the US Food and Drug Administration, have even inserted themselves in the cognition market, with some products insinuating they may have an effect on preventing or reversing dementia.

Some dietary supplements may have a beneficial effect on brain health; however, the data are not clear as to whether their benefit can delay, prevent, or treat neurodegenerative diseases. The responsibility is on healthcare practitioners to become familiar with these products and interventions, including being aware of any unbiased clinical trial data on these approaches that may exist.

Practitioners should also try to understand any motivations by the patient and/or their caregiver in seeking these products and demonstrate empathy for their needs and wishes. In a compassionate environment, clinicians can speak with the patient and discuss any scientific information, or the lack thereof, regarding a requested alternative therapy. Clinicians should label pseudomedicine interventions as such.

“Physicians have an ethical mandate to protect patients who may be vulnerable to promotion by” companies and practitioners motivated to sell these therapies, the authors wrote. “While unethical forces promote the existence of pseudomedicine, an educated community of physicians and patients is the starting point to counteract these practices.”

Reference

Hellmuth J, Rabinovici GD, Miller BL. The rise of pseudomedicine for dementia and brain health. JAMA. 2019;321(6):543-544.

This article originally appeared on Medical Bag