e-HANDI: Promoting Effective Non-Drug Treatments in Primary Care

Non-drug treatments, in the broadest sense, refer to any intervention that would not normally appear in a pharmacopoeia including exercise, physical therapies, diets, herbal treatments, behavioural, and psychological therapies.

What is the HANDI project?

HANDI is an online formulary of non-drug interventions in health care, which have solid evidence of their effectiveness.

Based on the idea of modern pharmacopoeias, each HANDI entry includes indications, contraindications and ‘dosing’. The aim is to make ‘prescribing’ a non-drug therapy almost as easy as writing a prescription for a drug.

HANDI enables clinicians to offer a greater choice of interventions to a patient, who may wish to avoid pharmacotherapy and the risks and life style changes often associated with drug treatment regimes.

Advances in non-drug treatments in the past few decades have been substantial and diverse: exercise for heart failure and COPD, the Epley manoeuvre for benign paroxysmal positional vertigo, knee taping for osteoarthritis, cognitive therapy for depression, ‘bibliotherapy’ (specific guided self-help books for some conditions), to name just a few.
Nearly half the thousands of clinical trials conducted each year are for non-drug treatments. However, the effective non-drug methods are less well known, less well promoted, and less well used than their pharmaceutical cousins.

Scope

The HANDI team (the Committee) only consider the assessment of non-drug treatments that are relevant to primary care which might be classed as:

  1. Interventions performed by a GP or other primary care clinician ( The Epley manoeuvre)
  2. Interventions performed by the patient under the GP/primary care clinician’s guidance or (wet combing)
  3. Interventions usually performed by the GP/primary care clinician that can be taught to patients under special circumstances (knee taping for OA)
  4. Interventions that require referral after initial assessment from GP/primary care clinician (IBS referral for FODMAP, or psychologist referral for CBT or depression).

Class 4 is only considered for assessment under the following conditions:

  • the intervention is not widely known by GPs/primary care clinicians
  • the non-drug intervention would not be the routine therapy for that condition (FODMAP diet for IBS)

Meet the e-HANDI team

The e-HANDI team includes researchers and clinicians from the Australian primary healthcare sector.

Professor Paul Glasziou

e-HANDI Chair

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Dr Loai Albarqouni

Assistant Professor and NHMRC Emerging Leader

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Dr Ali Davidson

Postdoctoral Research Fellow

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Hannah Greenwood

PhD Candidate

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