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Sneezes and sniffles

Like many poor people who wish they could get more enjoyment out of the summer, I suffer from hay fever. As a child I was constantly sneezing and had tissues permanently stuffed up my cardigan sleeve. It was a rather miserable experience not helped by endless family mockery; friends I don't remember being a problem. Seriously my family are a questionable bunch. 

At some point when the symptoms were particularly bad my mother and I visited Boots and looked for an potential (affordable) solution; my family didn't tend to have much money to spare. We also didn't know much about medicine, and so when we found on the shelves a small fairly inexpensive bottle of pills for the treatment of hay fever we purchased them. This was before generic hay fever tablets could be bought 14 for a £1. The pills we bought were homeopathic; I think we thought that meant they were a herbal remedy. I took them for a while, I think more than one season, so I clearly thought they were working but eventually lost faith with them and moved onto more dependable drugs. 

As an adult, having read Ben Goldacres discussions of homeopathy and the indisputable (to scientists, medics and those of us that generally trust them) evidence that these are nothing but sugar pills that offer only a placebo effect at best, I have frequently had cause to reflect back on this. I'm mildly embarrassed that I ever thought they were effective, but more than that i'm irritated that it was possible for me and my mother to be so easily fooled. How is it that Boots were/are allowed to sell Homeopathy pills as medicine? Now I know there are people out there who believe it is, and i'm not the right person to have that debate with as I have no medical/scientific background, but I do accept the evidence now that it is no better than placebo. However that's information you have to know to know that homeopathy isn't medicine, so in fact if it is presented as medicine and sold by a pharmacy, or prescribed on the NHS, why wouldn't most people believe that it has value?

Now this blog isn't really about homeopathy, it's about that last sentence. How much should we really expect most people to know about the over-the-counter remedies they're presented with? I think the answer, based on absolutely no research, is not very much, Most of us read what something is supposed to cure, we might read about potential side effects, but then we will take this information presented at face value. I think 'not very much' is a fairly reasonable guess.

Towards the end of  2017 I had an awful cold in addition to my usual allergies. As is my habit I was wasting time on Youtube, watching a collection of random videos from channels I subscribe to. SciShow had a recent video out entitled  “How does cold medicine work?”SciShow is an American YouTube channel that produces 3-10 minute videos on Scientific topics of interest, particularly relating to current research or as a response to a question provided by their Patreon sponsors. It's pop science and in a slightly assaulting fast-paced style, but interesting. 

Just over 2 minutes in I was provided with a rather unsettling piece of information.

Phenylephrine, a decongestant in the form of Phenylephrine Hydrochloride I use fairly regularly for colds and allergies, may not be any more effective than a placebo.

I'm sorry SciShow but I do beg your pardon? Your saying the drug I take to easy my sneezy suffering may be no better than sugar pills? The drug that can be found in pharmacies and supermarkets all over the UK declared as a decongestent, including in Beechams cold and flu and Lemsip?

Their videos are referenced so I decided to follow some of them up with references found through Scholar:
Neither of these documents is a systematic review so I searched a bit further before I gave up on my drug:
This systematic review paper is over 10 YEARS OLD and declares that there is no evidence for the efficacy of Phenylephrine as an oral decongestant.

So the question has to be, why are we still being sold this as decongestant medicine? And this isn't homeopathy or herbs, this is an often not cheap drug. How is it that medical companies are still able to sell this as a decongestant? Seriously, if you are professional able to explain this to me i'd really like to understand it. But for now i'm just going to have to stick to Olbas oil (This definitely works, evidence be damned!!). 

What on earth has this to do with Libraries and open access you might well ask? It’s a very good question and I have an answer, but it's only mine so feel free to disagree with it. 

Currently the public are being failed in two ways. Firstly the information they need to make informed decisions is hidden behind paywalls. Hopefully one day OA will mean that it isn't but for now much of it is and so what people who do read rely on is that information which is available to them and certainly when it comes to basic medical choices that shouldn't be the case. Secondly, this information, one it has reached a point of 'we are 99% certain of this' should be bloody easy to find and I wonder if Librarian's might have a part to play in making that so. No one should have to actively search to find out if their drug is a placebo, it should be clearly labelled as such, but if someone wants to find that information from systematic reviews we should be make it easier for them to find and understand it. The future of Libraries isn't in subscriptions and access management, I hope it is in information exploitation for all.

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