Promoting evidence-based non-drug interventions: time for a non-pharmacopoeia?

Paul P Glasziou
Med J Aust 2009; 191 (2): . || doi: 10.5694/j.1326-5377.2009.tb02686.x
Published online: 20 July 2009

A compilation of effective non-drug treatments could help increase their uptake in clinical practice

In 2004, the Journal published a randomised controlled trial of graded exercise for chronic fatigue syndrome (CFS).1 As with several similar trials, this trial found that graded exercise was an effective intervention. But what is graded exercise? In response to numerous emails from both doctors and CFS patients who wanted further details of the exercise program, the authors of the study published a second article that provided the additional “how to” details and addressed different scenarios.2 I now keep the pdf file of this second article on my general practice computer to give to, and discuss with, CFS patients. The difficulties in accessing information on this simple, non-drug intervention are in stark contrast to the helpful tools available for prescribing pharmaceuticals: formularies, prescription pads, and pharmacies.

  • Centre for Evidence-Based Medicine, Oxford University, Oxford, UK.

  • 1. Wallman KE, Morton AR, Goodman C, et al. Randomised controlled trial of graded exercise in chronic fatigue syndrome. Med J Aust 2004; 180: 444-448. <MJA full text>
  • 2. Wallman KE, Morton AR, Goodman C, Grove R. Exercise prescription for individuals with chronic fatigue syndrome. Med J Aust 2005; 183: 142-143. <MJA full text>
  • 3. Glasziou P, Meats E, Heneghan C, Shepperd S. What is missing from descriptions of treatment in trials and reviews? BMJ 2008; 336: 1472-1474.
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  • 7. Anderson L, Lewis G, Araya R, et al. Self-help books for depression: how can practitioners and patients make the right choice? Br J Gen Pract 2005; 55: 387-392.
  • 8. Robinson A, Lee V, Kennedy A, et al. A randomised controlled trial of self-help interventions in patients with a primary care diagnosis of irritable bowel syndrome. Gut 2006; 55: 643-648.
  • 9. Glasziou P, Chalmers I, Rawlins M, McCulloch P. When are randomised trials unnecessary? Picking signal from noise. BMJ 2007; 334: 349-351.


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