The establishment of Integrated Chinese-Western Medicine Treatment Safety Centre (ICWM-TSC) under Hong Kong Poison Control Centre represents a major milestone in the development of ICWM. Over the past years, Hospital Authority (HA) Toxicology Service played a crucial role in the surveillance of drug and herb adverse reactions. One of the major concerns in ICWM development related to drug and herb safety. The co-use of Chinese medicine (CM) and western medicine (WM) treatment, such as herbs and western medications, is a common and well-accepted practice in Hong Kong. While this practice offers additional patient benefit comparing with either CM or WM use, it also carries inherent risks such as intrinsic herb toxicity and herb-drug interactions. The need to ensure ICWM co-use safety was well-aware by HA since the implementation of ICWM Pilot Programme in 2014. Over the past decade, HA has progressively expanded its ICWM services. Many patients with specific conditions (e.g. stroke, cancer palliative care) have received treatment by both CM practitioners and WM doctors using an integrative approach.

During the development of ICWM Pilot Programme, an objective and systemic approach was developed to assess the risk and guide the co-use of drug and herb. An expert panel (EP) comprising of clinical and CM pharmacologists, toxicologists, pharmacists, clinical leaders of the projects in CM and WM fields, as well as CM experts from universities, was formed to address the safety concern. The EP applied risk assessment algorithm that evaluated each herb and herb-drug pair based on the likelihood of adverse reactions and the overall strength of supporting scientific evidence. Risk levels of each herb and herb-drug pair in causing adverse effects were established and guidance was provided to support ICWM practice.

To further promulgate the ICWM herb and drug safety beyond the HA Pilot Programme, ICWM-TSC will adopt the EP model and function as a surveillance and advisory body dedicated to resolve ICWM safety issues. It will serve as a hub in HA to collaborate internal and external experts under Hong Kong Poison Control Centre to monitor, investigate, provide guidance and research on the clinical safety of Chinese medicine and western drugs co-use.