Carole Repchinsky, Christine LeBlanc, editors
Ottawa: Canadian Pharmacists Association; 2002. 896 pp. $125 ISBN 1-894402-03-0
Rating: ***
Audience: Pharmacists, physicians, nurses
Content: In general practice, I'm often most able (and willing) to help those patients who are both able and willing to help themselves. However, empowering patients to problem-solve safely and effectively remains a major challenge, and I'm always on the lookout for tools that will help. This book caught my attention with its theme of teaching patient self-care, and I wasn't too disappointed. Written almost exclusively by pharmacists and pitched mostly at front-line health care providers (particularly other pharmacists), its 65 chapters serve as brief but solid overviews on many unglamorous ailments (e.g., canker sores, infant colic, corns, calluses and bunions, periodontal disease) as well as some more serious concerns (depression, headache, menopause). The chapters, which are generally well referenced, feature many tables and some illustrations and follow a set template: pathophysiology of the condition, common goals of therapy, advice on assessing patients with the problem, and nonpharmacologic and pharmacologic therapies (including herbal and other alternative therapies). A wide breadth of topics relevant to primary care is covered, with nicely done chapters on traveller's health, infant nutrition and infections such as scabies, lice and pinworms. The numerous patient handouts are useful, but an absence of illustrations makes them visually drab.
Limitations: This book presents only sparse evidence for many of the treatments that are recommended, particularly the complementary and alternative therapies. When evidence is cited, the level of evidence is absent. Information on the adverse effects of therapies is also scant. Given these limitations, I wonder whether this book would really enable me to have truly meaningful discussions about informed consent with patients. I was also baffled at times as to why some treatments were discussed in the first place, if they were not being recommended by the authors. For example, the chapter on diabetes states that “current evidence does not support the use of herbal remedies in diabetes.” However, the next paragraph goes on to describe how one could use chromium, Gymnema sylvestre, ginseng and konjac-mannan to lower blood sugar levels. Despite its non-evidence-based approach and some truly odd parts (like the section on effective patient interactions, which recommends using the term “bum” instead of “rectum”), overall, I do recommend this book. Its selection of down-to-earth topics and its practical tone make it a useful tool for physicians helping patients to help themselves.
Eric Wooltorton Associate Editor CMAJ and Family Physician Kemptville, Ont.
This book is available through your local book retailer or through the publisher at www.pharmacists.ca/function/shopper/Index.cfm?RptCategPassed=Web&RptCodePassed=Pub. It is also available through the Canadian Medical Association at www.cma.ca
Footnotes
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Items reviewed are rated on a 4 star scale (4 = excellent)