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„Haben Sie ein Mittel gegen Makuladegeneration?“

Eine Feldstudie in 60 deutschen Apotheken über die Beratung zu Nahrungsergänzungsmitteln

“Do you have a remedy for macular degeneration?”

A field study about the advice given on dietary supplementation in 60 German pharmacies

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Zusammenfassung

Hintergrund

Die AREDS-Studie hat erstmals Hinweise auf einen positiven Effekt der Substitution mit hochdosierten Vitaminen und Spurenelementen für einzelne Verlaufsformen der altersabhängigen Makuladegeneration (AMD) gegeben. Ziel dieser Untersuchung sollte die Feststellung sein, welche Präparate mit welchen Argumenten und Hinweisen in deutschen Apotheken für die AMD empfohlen werden.

Methode

In 60 Apotheken wurde ein einfach verblindetes Beratungsgespräch nach einem standardisierten Ablaufprotokoll geführt.

Ergebnisse

In 36 Apotheken wurden konkrete Produkte zur Nahrungsergänzung empfohlen, wobei die Dosierung nie der AREDS-Studie entsprach. Die Möglichkeit oder Notwendigkeit einer augenärztlichen Beratung oder Untersuchung wurde von 24 Apotheken nicht erwähnt. Nahezu alle Apotheken schlossen mögliche Interaktionen zu anderen Medikamenten oder Nebenwirkungen ausdrücklich aus.

Schlussfolgerung

Mögliche, wenn auch seltene Risiken der Einnahme von Nahrungsergänzungsmitteln werden unterschätzt. Das medizinische Wissen um die häufigste Erblindungsursache der westlichen Welt war lückenhaft. Eine klarere Formulierung von Empfehlungen nach evidenzbasierten Kriterien ist anzustreben.

Abstract

Purpose

Since completion of the AREDS study, evidence has accumulated to suggest that some form of dietary supplementation may be of value in special individuals who are at risk of progressive age-related macular degeneration (ARMD). We wanted to find out which of the many supplements available are recommended in practice and which instructions, promises, and purchasing arguments are used by German pharmacies.

Methods

A blinded consultation following a standardized protocol was carried out in 60 pharmacies.

Results

In 36 pharmacies specific products for dietary supplementation were recommended, but the dosage never complied with the AREDS study, and in 24 pharmacies, the necessity for a medical examination or consultation with an ophthalmologist was not mentioned. Possible interactions with other drugs or side effects were generally excluded.

Conclusions

Potential risks of supplement intake were underestimated. Medical knowledge of the most frequent cause of blindness in the Western world was insufficient. A clear policy of recommendations according to evidence-based criteria is needed.

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Authors and Affiliations

  1. Abteilung I, Augenklinik, Eberhard-Karls-Universität Tübingen, Germany

    F. Ziemssen, M. Warga & K. U. Bartz-Schmidt

  2. Abteilung II, Augenklinik, Eberhard-Karls-Universität Tübingen, Germany

    H. Wilhelm

  3. Abteilung I, Augenklinik, Eberhard-Karls-Universität, Schleichstraße 12, 72076, Tübingen, Germany

    F. Ziemssen

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  1. F. Ziemssen
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  2. M. Warga
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Correspondence to F. Ziemssen.

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Ziemssen, F., Warga, M., Bartz-Schmidt, K.U. et al. „Haben Sie ein Mittel gegen Makuladegeneration?“. Ophthalmologe 102, 715–725 (2005). https://doi.org/10.1007/s00347-005-1231-5

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