Views and opinions: 20 February 2019

IV vitamin therapy outside our scope

Pip White urges physios to be aware of regulatory guidance on the use of intravenous (IV) vitamin therapy in non-healthcare gyms and clinics.

The CSP was recently contacted by a member exploring the potential to offer IV vitamin therapy to people attending their private practice in a gym.

Following advice sought from the Medicines and Healthcare Products Regulatory Agency (MHRA), the CSP does not support physiotherapists using these products in their work. Members should think very carefully about the consequences of using these products and be aware such use would not be covered by the terms and conditions of the CSP PLI scheme, as we consider their use to be outside the scope of physiotherapy practice.

As this advice is restricted to a very specific set of circumstances, we believe it is helpful to clarify to members how they may use other vitamin products in their physiotherapy work.

Vitamins are usually regulated as food supplements. This means that physiotherapists may advise and/or use them in their work within their own scope of practice. For example, vitamin supplements may be recommended as part of a comprehensive management programme in a range of physiotherapy settings.

Vitamin products are regulated as medicines when they are used to treat diagnosed health and medical conditions. These products will hold a valid UK Marketing Authorisation (MA). They are classified as prescription-only medicines (POM) when the route of administration is IV. Physiotherapists may only use medicines within their own scope of practice and in accordance with the appropriate medicines supply/administration or prescribing framework.  For example, medicinal vitamin prescription may be a valid part of physiotherapy practice in public health or long term condition management settings.

In unclear ‘borderline’ cases, the MHRA makes a case-by-case decision about whether a product, and the claims made about it, make it a medicine or not. The MHRA is clear that where any medical claim is made about an IV vitamin product, it must have a valid UK MA (also known as a licence) in place. Where the IV vitamin product is intended for non-medicinal purposes and does not hold a valid MA, this must be made clear to people. Any advertising must comply with the Advertising Standards Authority CAP code of conduct. The MHRA will take enforcement action against clinics not complying with the law.

CSP members are reminded that both The British National Formulary (BNF) and the British Nutrition Foundation (BNF) state non-licensed IV vitamin products currently have no proven health benefits and may be dangerous. We therefore do not endorse their use by our members.

Pip Whiteis a CSP professional adviser

Presenting your dissertation at Physio UK

Nathan Augeard and Sean Paul Carroll were part of a group of newly graduated physiotherapists presenting at the annual conference. They share their experience here.

Last October, six graduates (Nathan Augeard, Alan Bartholomew, Sean Paul Carroll, Jaime Donnachie, Fiona Gassner and Jacob Tennant) from the BSc(Hons) programme at Glasgow Caledonian University attended the Physiotherapy UK Conference in Birmingham to deliver an assortment of presentations and posters.

The research presented ranged from primary data collection on pain-related attitudes and beliefs to electrical stimulation on ischaemic experimental pain, and we had systematic reviews on neurally adjusted ventilatory assist and inspiratory muscle training.

We started by submitting our abstracts, which involved précising a few thousand words and striking the balance between academic and appealing, as well as preparing for any questions and rehearsing the presentation with the slides, aiming to be both engaging and entertaining. Although it was outside our comfort zone, we all found that rewording our research into posters and presentations gave us the tool to develop an “elevator pitch” of our studies, as well as developing a deeper understanding of our findings and, perhaps more importantly, sharing the results meaningfully with a wider audience.

We had great support, advice and encouragement from our supervisors, Dr Chris Seenan and Kathryn Simms. The reassurance and vote of confidence from experienced researchers helped us to submit the best synopsis of our work.

As this was the first time any of us had presented at a conference, we kept in touch on social media, and arranged transport and accommodation together. Our advice to other cohorts considering submitting an abstract is:

• link in with each other, so you can ask for feedback on content
• rehearse your speaking, and further develop your own presentation with the aid of peer review
• On the day, get to the room early to get used to it and practice.
• Remember – try to stay calm.

In summary, we were grateful to be selected and would encourage more graduates to get involved.