The HANDI Project
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 (and almost everything else!), ‘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.
There are well-established drugs/medications formularies such as the Australian Medicines Handbook. However, until now, no such formulary or resource for non-drug treatments (interventions) exists.
The HANDI project is a commitment by the RACGP National Standing Committee for Quality Care to promote effective non-drug treatments, making them visible and easy to use. 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.
HANDI development process
The HANDI Project Team chooses candidate treatments; a team member then reads and presents the evidence; the whole team then votes on whether the evidence about benefits and harms is sufficient to warrant an entry.
If deemed sufficient, a detailed HANDI entry is drafted. The HANDI entry goes through a process of drafting. This includes testing through a network of GP and GP registrars and consultation with subject matter experts where possible. The final draft is approved by the project team.
HANDI development considerations
- Each entry focuses on the intervention, not the diagnosis.
- All entries must be must be supported by at least 2 trials or 1 trial and supportive evidence.
- Where available, interventions are supported by external resources such as videos, websites and illustrations and instructions.
- It is preferred that these resources are freely available.
- There is a maximum of only 2 or 3 references for each entry
- As HANDI is not a guideline, there are no recommendations only levels of evidence.
The RACGP gratefully acknowledge funding received from the Jack Brockhoff Foundation and BUPA Foundation to develop the HANDI project.