Complementary and Alternative Medicine (CAM) – Flashcards
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National Center for Complementary and Alternative Medicine
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NCCAM stands for:
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A group of diverse medical and healthcare systems, practices, and products that are not generally considered to be part of conventional medicine
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What is the definition of CAM?
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Also called Western or allopathic medicine Medicine as practiced by folder of MD (medical doctor) and DO (doctor of osteopathic medicine) degrees and by allied health professionals, such as physical therapists, psychologists, and registered nurses
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What is conventional medicine?
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Complementary medicine is used TOGETHER WITH conventional medicine Alternative medicine is used IN PLACE OF conventional medicine
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What is the difference between complementary medicine and alternative medicine?
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When conventional medicine interventions are used in combination with CAM therapies that have been scientifically proven to be safe and effective
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What is integrative medicine?
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True
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T/F CAM use among adults has remained relatively steady from 2002 to 2007.
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30-69 50-59
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CAM use is the greatest among those aged ____. Which age group is the highest?
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American Indian/Alaska Native White Asian Black Hispanic
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CAM use is greatest among with race/ethnicity? Give in order of greatest to least use.
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Nonvitamin, nonmineral natural products (natural products) Deep breathing Meditation
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What was the most commonly used CAM therapy among adults in 2007? What are the next two?
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Fish oils/omega 3
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What are the most popular natural products?
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Back pain Neck pain Joint pain Arthritis
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What are the four most common reasons (in order from greatest to least) for CAM use?
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Dissatisfaction with aspects of conventional medicine Total rejection of conventional medicine due to an anti-science or anti-establishment Desperation
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*What are the push factors according to Ernst? (i..e, those that push toward CAM)
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Hope for increased well-being and other positive outcomes Philosophical congruence (i.e., with the "spiritual dimension" of alternative medicine, its emphasis on holism, or the more active role patients play) Personal control over treatment Good relationship with therapist (i.e., interaction on equal terms, time for discussion, emotional factors allowed for) Accessibility
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*What are the pull factors according to Ernst? (i.e., pull of CAM)
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Failure to yield cures Adverse effects of orthodox regimens Dissatisfaction with the technical approach Fragmentation of care by specialists Lack of practitioner time
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What are push factors according to NCCAM?
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Media reports of dramatic results Belief that CAM treatments are natural Patient empowerment Focus on spiritual and emotional well-being Therapist providing "touch, talk, time"
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What are pull factors according to NCCAM?
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Two fold - there is so much of it and there's the tub, evidence
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What is the problem with CAM practice?
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Well designed clinical trials for many CAM therapies are often lacking, therefore the safety and effectiveness of many CAM therapies are uncertain
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Is CAM safe and effective?
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The approach will either disappear or become integrated with conventional practice
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What happens once effectiveness of CAM therapy or lack thereof is established through scientific research?
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Codeine for pain Digitalis for heart failure Quinine for malaria Aspirin for fever Behavioral therapy for headache Hypnosis for smoking cessation Exercises for diabetes Support groups for breast cancer Low fat, low cholesterol diets
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Give examples of CAM therapies that have found their place in conventional medical practice.
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Disciplines such as physiotherapy and chiropody are also not taught in medical schools Some medical schools have a complementary medicine component as part of the curriculum
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Elaborate on the assumption that CAM is "unconventional-not taught in medical schools."
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Good conventional medicine also involves rehabilitation with, say, rest, exercise, or diet; there are "natural" interventions" Complementary medicine may also involve unnatural practices such as injecting mistletoe or inserting needles into the skin There is a growing body of evidence that certain complementary therapies are effective in certain clinical conditions Many conventional healthcare practices are not supported by the results of controlled clinical trials
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Elaborate on the assumption that CAM is "natural."
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Scientific research is starting to uncover the mechanisms of some complementary therapies, such as acupuncture and hypnosis
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Elaborate on the assumption that CAM is "irrational with no scientific basis."
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There are reports of serious adverse effects associated with using complementary medicine
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Elaborate on the assumption that CAM is "harmless."
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Advocates contend that there have been recently published research studies that support the effectiveness of specific therapies, and that a PubMed search of research studies classified as CAM has yielded over 370,000 entries in Medline-recognized journals since 1996
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Explain the argument for efficacy of CAM.
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Advocates believe that danger is reduced when CAM therapies are used in concert with conventional medicine. Data from the CDC reveal that the majority of individuals in the US (54.9%) used CAM in conjunction with conventional medicine.
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Explain the argument for complementary instead of alternative use of CAM therapies.
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Advocates believe that the "placebo effect" demonstrates the effectiveness of alternative therapies, although skeptics contend that such as claim is tantamount to the ineffectiveness of the treatment being defended
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Explain the argument for the placebo effect.
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Occurs when the patient's symptoms are alleviated by a treatment because the patient believes that the treatment will work
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What is a placebo effect?
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Critics point to the lack of proper testing using randomized controlled trials, and argue that the placebo effect is equivalent to an admission of the therapy's ineffectiveness
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Explain the critique of the efficacy of CAM.
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Critics contend that therapies which have not been proven effective comprise patient safety, and that the use of these therapies only delays patients in seeking conventional medical treatment. Critics also argue that CAM practitioners sometimes misdiagnose patients and that CAM practice itself is not regulated.
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Explain the critique of the safety of CAM.
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Critics contend that research studies surrounding CAM therapies utilize poor research design that do not yield high quality research evidence
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Explain the critique of the testing with CAM.
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Folklore Anecdotal information Small studies
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Information on safety and effectiveness of CAM utilization is based largely on what three sources?
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Return on research investment (the treatment products have been used for thousands of years and CAM therapies, such as herbs can be grown in the backyard without having to yield exclusive ownership rights to the drug company) Individualized CAM treatments (CAM practitioners provide different therapies for the same condition, therefore, it's hard to draw overall conclusions from these therapies)
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What are the two reasons the Mayo Clinic provides for the absence of scientific studies on CAM?
