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Key principles on avoiding ingredients in medicines

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Topics: ExcipientsFormulation

Spiritual, religious, cultural, and lifestyle factors can affect preferences for excipients and active ingredients in medicines. We cover key principles.

Contents
  1. Key considerations
  2. Key principles
    1. Patient centred approach
    2. Education and information
    3. Shared decision making
  4. Exploring options
  5. Managing with limited alternatives

Key considerations

The General Medical Council (GMC) professional standards guidance recognises that personal beliefs and cultural practices are central to the lives of medical professionals and patients.

Where possible, healthcare professionals should support patients to receive care that meets the requirements of their beliefs and values.

To provide respectful and effective care, seek to understand:

  • the person’s specific request
  • options available
  • impact on the patient
  • impact to the NHS

Address concerns sensitively and proactively. Healthcare professionals can support patients in managing their health whilst respecting the patient’s beliefs and preferences.

Key principles

Use the following principles in consultation with patients to understand and address preferences.

Patient centred approach

Engage the patient in an open discussion to understand their beliefs and preferences. This helps ensure treatment plans align with patient values.

It is appropriate to ask patients about their beliefs, but healthcare professionals must never pressure them to discuss, justify, or explain their beliefs or lack thereof.

Be mindful of your words and actions. Do not imply judgement of the patient or their beliefs and values.

Consider patients individually as cultural beliefs and lifestyle choices can vary significantly within populations.

Additional resources

If you would like to know more about patient centred care there are many resources available. Two of which include:

Guidance on person-centred care from NHS England, Workforce, training and education.

An article on making patient-centred care a reality from the King’s Fund.

Education and information

If patients seek advice, consider offering information about the ingredients, formulations, alternative treatment options, and potential implications of declining a specific therapy.

Healthcare professionals should provide clear information and stress the importance of treatment adherence.

Shared decision making

Patients should be active partners in the decision-making process with their views and preferences recognised throughout discussions regarding their care and treatment.

Patients wishing to avoid certain products may seek information on active ingredients or excipient origins to make fully informed treatment decisions.

Exploring options

SPS have a number of articles to support decision making on this topic. We advise you to review our articles and recommended resources. However, it is sometimes necessary to contact the manufacturer directly to determine the source of an excipient.

Discuss available and appropriate options with the patient as part of a collaborative effort to find a suitable treatment and discuss relevant risks and benefits. 

Managing with limited alternatives

Sourcing a suitable product may not always be possible.

Some supportive guidance is available for when an appropriate alternative is not available.

For example, The Vegan Society encourage vegans to recognise that it is not always possible or practicable to avoid animal-derived ingredients or products.

For Muslim patients, non-halal medication may be acceptable if no suitable alternatives exist in life-threatening situations and when their life or well-being is at serious risk.

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