Should medications always be our first choice?

As a pharmacy student, a large proportion of the pharmacy course revolves around drugs and their mechanisms of action and thus there is a great focus on pharmacological interventions in the improvement of health. Pharmacological interventions involve treating a condition with the use of medications. The guidelines that we consult however, give us details not only on these pharmacological interventions but also non-pharmacological interventions.

There are certain conditions where pharmacological interventions are not always the first choice and non-pharmacological interventions are used. The high risk to benefit ratios of certain medications, mean that the drug has a more chance of causing harm than benefit. Cost can be another factor influencing the choice of intervention. Sometimes pharmacological interventions are not necessary and minimising the use of drugs would in turn reduce the associated side-effects.

In this instance, non-pharmacological interventions may initially be used. As an example, mental health disorders such as depression and anxiety use psychological interventions such as Cognitive Behavioural Therapy (CBT) before initiating drug treatment. Non-pharmacological interventions can also be used in combination with pharmacological interventions. One example is the recommendation of fibre-rich foods in patients suffering from constipation.

Aside from psychotherapy and diet, other non-pharmacological interventions may include surgery and complementary and alternative medicine (CAM). Recommendation of the latter non-pharmacological intervention is highly controversial and deserves a topic of its own.

As a pharmacy student and a future pharmacist, I feel it's important to understand these non-pharmacological interventions and their role in the management of conditions and diseases regardless of what opinions may exist in their effectiveness over pharmacological interventions.