Book Review
Herbs & Natural Supplements. An Evidence-Based Guide (2nd edn)
Lesley Braun and Marc Cohen
ISBN: 978-0-7295379-6-4; 2007; xvi+792 pages; Churchill Livingstone;
Matthew Leach
Lecturer in Natropathy, School of Health Sciences, University of South Australia, City East Campus, Adelaide SA
Over the past decade, increasing use of complementary and alternative medicine (CAM), and its integration into mainstream health care, has raised questions about the level of evidence for the safety and efficacy of these interventions. This text is one of an emerging number about evidence-based CAM, and is claimed by the authors to provide readers with a ‘one stop shop' on some of the main CAM interventions in Australia. The book contains three sections and targets practitioners and consumers of CAM.
The first part of the book provides an overview of CAM, and an introduction to several complementary modalities, such as herbal medicine, nutrition and aromatherapy. The second section of the text discusses a number of CAM clinical practice issues, including integrative medicine, safety, preoperative care and cancer. These first two sections introduce CAM and integrative health care for nurses and other health practitioners. The final section of the book presents abridged monographs of 120 CAM products, including nutritional supplements, herbs, essential oils and medicinal foods. Each of these monographs includes details about the history, chemistry, actions, clinical evidence, dosage, and safety of the intervention, as well relevant practice points and frequently asked questions. The appendices are on a CD and include a detailed list of herb-nutrient-drug interactions that is a useful desktop reference for healthcare practitioners.
This second edition of this text has expanded significantly, including new chapters and the addition of more than 25 new monographs. The main strength of this text is that it reflects current Australian practice. The book is also easy to navigate, providing a logical and systematic format for each monograph, with evidence that is well referenced and summarized in a clear and concise manner.
Despite a brief overview of evidence-based CAM in the introduction, there is a paucity of detail in the monographs regarding the quality and strength of the evidence, including adequate details about study design, statistical precision and size of effect. Without these details, it may be difficult for practitioners to make an informed decision about applying the intervention to clinical practice. The text may also benefit from presenting the research findings in order of evidence quality, such as the level of research quality reported by the National Health and Medical Research Council. Lastly, the inclusion of toxicity data, as well as data about use during lactation, would ensure readers are better informed about the safety of the intervention. This book is a suitable introductory text and a useful desktop reference for practitioners and consumers of CAM. However, the paucity of detail in some areas highlights that this is not a comprehensive stand-alone text, and that in order for readers to make informed decisions, they need to use this book in consultation with other texts.
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