consumer health complementary and alternative medicine (cam)
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Consumer HealthComplementary and Alternative Medicine (CAM)
Prayer
I got behind and forgot to tell people about what happened with him......the morning after the 'global prayer circle' (for lack of a better name for it) he improved dramatically! In fact the doctors decided against the surgery they were planning (and dreading as he has so much 'scar tissue' inside) and sent him home! He's doing amazingly well - went out and bought a Christmas tree and decorated it! Thanks for asking and Happy New Year to you! J
BMJ VOLUME 324 13 APRIL 2002 bmj.com
Prayer
I got behind and forgot to tell people about what happened with him......the morning after the 'global prayer circle' (for lack of a better name for it) he improved dramatically! In fact the doctors decided against the surgery they were planning (and dreading as he has so much 'scar tissue' inside) and sent him home! He's doing amazingly well - went out and bought a Christmas tree and decorated it! Thanks for asking and Happy New Year to you! J
Complementary and Alternative Medicine
Defining CAM History of CAM Major Domains of CAM Extent of Use Organizations, Certification, Training Selecting Practitioner
Defining CAM
Original Definition
National Library of Medicine Unrelated group of non-orthodox
therapeutic practicesOften with explanations not following
conventional biomedical explanationsNo satisfactory scientific explanation
for effectiveness Another old definition
Medical interventions not taught in US
Defining CAM
New Definition
National Library of Medicine Complementary Medicine
Alternative Therapeutic practices not considered
an integral part of conventional allopathic medical practiceMay lack biomedical explanationCould become accepted or not
Defining CAM
Complementary MedicineTherapies used in addition to
conventional treatments Alternative
Therapies used instead of conventional treatment
Defining CAM
Differences in Emphasis
Conventional High Tech Pharmacological Surgical and other technological
approaches Prevention and
wellness underemphasized
CAM Low Tech Prevention Treating the whole
person Promoting self-care Recognizing a
spiritual nature of each individual
Individualized treatment
Major Domains of CAM
Alternative Health Care Systems Ayurvedic Medicine Chiropractic Homeopathic Medicine Native American Medicine Naturopathic Medicine Traditional Chinese Medicine
Major Domains of CAM
Mind-Body Interventions
Meditation Hypnosis Guided Imagery Dance Therapy Music Therapy Art Therapy Prayer and Mental Healing
Major Domains of CAM
Biological Based Therapies
Herbal Therapies Special Diets Orthomolecular Medicine
Major Domains of CAM
Therapeutic Massage, Body Work and Somatic Therapies Massage Feldenkrais Alexander Method
Major Domains of CAM
Two Additional Domains
Energy TherapiesQigongReikiTherapeutic Touch
BioelectromagneticMagnet Therapy
History of CAM
Mid-19th CenturyBotanical healers, midwives,
chiropractors, homeopaths 1892
The Principles and Practice of Medicine
1910Flexner Report
History of CAM
Early 20th CenturyDrugs and antibiotics introducedCAM: “unscientific relics of the past”
Mid-20th CenturyChronic, degenerative diseasesSignificantly longer livesHealth care costs (See next slide)
History of CAM
Mid-20th CenturyChronic, degenerative diseasesSignificantly longer livesHealth care costs
1965 $ 41,000,000,000
1975 $ 130,000,000,000
2000 $ 1,200,000,000,000
2010 $ 2,600,000,000,000
History of CAM
1950s – 1970sMedical pluralism reemergesWhole foods and dietary supplement
movementsExposure to traditional health care
systemsCounterculture movementHolistic health care movementNurses and family physicians
History of CAM
1970s – 1980sSelf-care movements
• For individual and family to increase wellness
• Diet and exercise to reduce risk of onset of illness
• Personal fitness• Increased use of yoga, tai chi, massage
Consumer Use of CAM
43% of US population Due to chronic conditions
Most frequent users• Cancer, chronic pain, HIV• Ethnic populations
Dietary Supplements158 million users$17,000,000
Reasons for Using CAM
Characteristics of usersInterest in spirituality and personal
growthCommitment to environmentalismFeminismInternal locus of controlTransformational experiences
Reasons for Using CAM
Perception of conventional medicine is ineffective
Believe it will work Recommendations from friends Desire to avoid side effects of
conventional treatments Failure of conventional treatment
Reasons for Using CAM
Perceived poor health status Perceived poor emotional functioning Musculoskeletal disorder
Back pain
CAMs Used
Chiropractic: 35% Herbal Remedies and supplements:
27% Massage Therapy: 17%
Cancer and CAM
At least one CAM approach: 63% to 75% Women more than men More use for surgery, chemotherapy or both than
neither Most frequent approaches
Nutritional: 63%, Massage: 53%, Herbs: 44% Spiritual approaches, relaxation, imagery, exercise,
lifestyle, diet, nutritional supplementation therapies Reasons for use
“stimulate an immune response:” 73% Outcomes
QAL, coping, decrease discomforts, sense of control
HIV and CAM
Frequent Substances Vitamin C: 63%, Multiple vitamin
supplements: 53%, Garlic: 53% Frequent practitioners
Massage: 49%, acupuncturists: 45%, nutritionists: 37%
Frequent activities Aerobic exercise: 63%, prayer: 58%,
massage: 53%, meditation: 46%
Ethnic Differences in Use of CAM
Mexican-American and Hispanic, and Native AmericansAt least once in last year: ~50%Herbal medicine, spiritual healing,
traditional healers
Conventional Medicine Use of CAM Give referrals to:
Acupuncture: 43%Chiropractic: 40%Massage: 21%
Practiced by them:Chiropractic: 19%Massage: 19%Homeopathy: 9%
Conventional Medicine Belief in Efficacy of CAM
Believe in efficacy of:Acupuncture: 51%Chiropractic: 53%Massage: 48%
OthersHomeopathy: 25%Herbal approaches: 13%
Conventional Medicine Use of CAM
Insurance Companies Medical Schools Hospitals
Organizations
American Holistic Nurses Association http://ahna.org
National Certification Commission for Acupuncture and Oriental Medicine www.nccaom.org
Complementary and Alternative Medical Association http://www.camaweb.org
British Complementary Medicine Association http://www.bcma.co.uk
CAM Certification and Education Council of Colleges of Acupuncture and Oriental
Medicine www.ccaom.org
American Association of Naturopathic Physicians www.naturopathic.org
Tai Sophia Institute www.tai.edu
East West Institute of Healing Arts www.eastwestqi.com
American Academy of Acupuncture and Oriental Medicine www.aaaom.org
Selecting Practitioners
Speak with primary provider Make a list of CAM providers and check
Training Licenses and certifications Costs
Check insurance coverage List questions to ask at visit At visit answer questions about MX Assess visit for comfort and reasonableness
Research
NCCAM and NIH nccam.nih.gov/research/priorities/index.htm
Cochrane Collaboration www.cochrane.org
AltHealthWatch• www.epnet.com/TitleLists/html/aw_h1.htm
AMED• www.bl.uk/services/information/amed.html
eBMJ http://bmj.bmjjournals.com/cgi/collection/complementary_medicine
Major Domains of CAM
Alternative Health Care Systems Ayurvedic Medicine Chiropractic Homeopathic Medicine Native American Medicine Naturopathic Medicine Traditional Chinese Medicine
Major Domains of CAM
Mind-Body Interventions
Meditation Hypnosis Guided Imagery Dance Therapy Music Therapy Art Therapy Prayer and Mental Healing
Major Domains of CAM
Biological Based Therapies
Herbal Therapies Special Diets Orthomolecular Medicine
Major Domains of CAM
Therapeutic Massage, Body Work and Somatic Therapies Massage Feldenkrais Alexander Method
Major Domains of CAM
Two Additional Domains
Energy TherapiesQigongReikiTherapeutic Touch
BioelectromagneticMagnet Therapy
Future Prospects for CAM
Depends on evidence-base for safety and efficacy
Conventional and CAM may merge Collaborative Independent
Challenges Communication Certification and training Insurance reimbursement
Summary
Defining CAM History of CAM Major Domains of CAM Extent of Use Organizations, Certification, Training Selecting Practitioner
Types of CAM
Acupuncture and Chinese Medicine
Reflexology Chiropractic Naturopathy Natural Hygiene Iridology Homeopathy
Psychic Healing Occult Practices Astrology Biorhythms Meditation Yoga Therapy Visual Training Guided Imagery
Types of CAM
Alexander Technique
Aromatherapy Feldenkrais
Method Magnet Therapy Polarity Therapy
Radionics and Radiesthesia
Reiki Rolfing Clinical Ecology Chelation Therapy Holistic Medicine