Difference between revisions of "Complementary Alternative Medicine"

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Complementary and Alternative Medicine

Introduction

Complementary and Alternative Medicine (CAM) and its new iteration of Integrative Medicine (IM), refer to therapies and treatment modalities that are outside of conventional Western medicine. They have less scientific evidence than Western medicine but have a long tradition of treatment in different cultures and societies. There has been a growing popularity of CAM therapies amongst patients, who often seek them out when they feel Western medicine hasn’t fully addressed their needs. They are often used for chronic illnesses or to alleviate the adverse effect of mainstream treatments. The usage of CAM is growing; the latest survey by the National Center Complementary and Integrative Medicine showed almost 34% of adults and about 12% of children used some form of CAM therapy.^[1] CAM therapies also represent a growing marketshare; CAM therapies represent 1.1% of total health care expenditures, and 9.2% of all out-of-pocket spending.^[2] About 59 million Americans spend $30.2 billion a year for CAM treatments.^[2]

Lately there has also been a growing acceptance of CAM therapies by Western medicine. Long dismissed because of inconsistent evidence on efficacy, CAM began to see an expanding acceptance by mainstream providers in the late 1990s. Western physicians view CAM therapies as ways to reduce the need for medications, and alleviate some of the side effects of conventional treatment. They feel they can reduce the disease burden and provide more comprehensive coverage. There has also been a gradual shift in medicine away from treating just diseases and focusing more on treating the patient as a whole. Better health outcomes and higher quality care result when the emotional, physical, and mental needs of the patient are addressed in conjunction with the disease process. There has also been an acceptance by mainstream medicine that there are some disease processes such as chronic pain, which aren’t treated very effectively by conventional care that CAM can help mitigate. CAM therapies have begun to be viewed as another tool to be used in treating a patient’s total disease burden. Many hospitals offer CAM therapies as another consult service that can be used by the patient. 80% of hospitals and healthcare services now offer some sort of Integrative medicine services. ^[3] In this modern era of EHRs and better communication, the growing popularity of CAM represents an important need that must be addressed. Inpatient CAM services have the benefit of using an enterprise-wide EHR, but face problems in standardized documentation since there are limited EHR modules that address their needs while still being understandable to providers. Outpatient CAM services have an even more difficult task. There is less of a requirement for CAM services to upgrade to EHRs and achieve Meaningful Use, so many CAM providers write manual notes that use their own specialized language. Coordination of care amongst different therapies plans then become entirely dependent on the patient. This is further complicated if the patient acquires herbal supplements on their own without even consulting a CAM provider. There is a potential for severe adverse effects due to limited communication and coordination between outside CAM providers and the patient’s principal conventional provider. Although some CAM practices are relatively benign and low risk, proper documentation is essential for any high quality care plan. Integrating CAM practices into the greater framework of mainstream medicine will allow for evidence gathering, and generate a best practice treatment guide on which therapies are most effective for which diseases. There is thus an integral need for more appropriate, standardized documentation of CAM therapies for all patient care.

CAM Definitions

Complementary and alternative medicine is an umbrella term for various health care practices which are considered to be outside of traditional “Western” allopathic medicine. There are several definitions of CAM. “Complementary and alternative medicine (CAM) is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period”^[4] “CAM includes complex and longstanding fields of study, such as acupuncture, Ayruvedic medicine, and homoeopathy, but can also be as straightforward as taking a specific dietary supplement to lower blood pressure or blood lipid concentrations”^[5] If and when a treatment method previously considered "unproven therapy" is proven to be safe and effective, it may be adopted into conventional health care and may cease to be viewed as "alternative". The term CAM is being largely replaced with Integrative medicine, which focuses on integrating CAM practices into a greater framework within mainstream medicine. Complementary Occurs when therapy is used in addition to mainstream medicine Alternative Occurs when therapy is used in place of mainstream medicine Integrative Medicine Refers to the use of complementary and alternative medicine practices for which there is some high-quality scientific evidence of safety and effectiveness used in conjunction with mainstream medicine

“Integrative medicine makes use of appropriate therapies, both conventional and alternative…that takes account of the individual as a   
unique and whole person, taking into account body mind and spirit”.[6]

References

1. ↑ Clarke, TC. Et al. Trends in the use of complementary health approaches in adults: United States, 2002-2012. National health statistics reports; no 79. Hyattsville, MD: National Center for Healthcare statistics, 2015. https://nccih.nih.gov/research/statistics/NHIS/2012
2. ↑ ^{2.0 2.1} “National Health Care Expenditures Data for US, 2007”. US Department of Health and Human Services. CMS website. Accessed on Oct. 22 2016 << https://www.cms.gov/Research-Statistics-Data-and-systems/Statistics-Trends-and-reports/NationalHealthExpendData/index.html>>
3. ↑ SIMUS Survey, State of Integrative Medicine in the U.S. CIMex Health, 2009. <www.nccam.nih.gov>
4. ↑ O’Connor BB, Calabrese C, Cardeña E, Eisenberg D, Fincher J, Hufford DJ, Jonas WB, Kaptchuk T, Martin SC, Scott AW, Zhang X (Panel on Definition and Description, CAM Research Methodology Conference, April 1995). (1997). "Defining and describing complementary and alternative medicine.". Alternative Therapies. 3 (2): 49–57.
5. ↑ Kamerow D. (2007). "Wham, bam, thank you CAM.". Brit Med J. 335: 647. doi:10.1136/bmj.39349.437442.43
6. ↑ Lemley, Brad. “What is Integrative Medicine?" DrWeil News. Accessed 10-20-2016 << http://www.drweil.com/health-wellness/balanced-living/meet-dr-weil/what-is-integrative-medicine/>>