HE101 Complementary + Alternative Medicine

complementary and alternative medicine (CAM)

term for medical products and practices that are not part of standard medical care

• Flexner report and medical care act differentiate complementary medicine and alterative medicine

standard medical care

the treatment thats accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals

types of medicine

1. conventional

2. alternative

3. complementary

4. functional

5. integrative

conventional medicine

• a system in which health professionals who hold an M.D. or D.O. degree treat symptoms and diseases using drugs, radiation, or surgery

• practiced by other health professionals; nurses, pharmacists, physician assistants, therapists

• symptoms management = acute care

alternative medicine

• any non-mainstream practice used to replace conventional care

  • in place of conventional medicine

• holistic approach with a focus on treating whole body and mind

• changes as some CAM practices become more mainstream

• DEBATE on what is considered alternative because once you give scientific evidence, it becomes complementary

complementary medicine

• combines conventional and alternative therapies

  aka. allopathy, western, mainstream, orthodox, biomedicine

functional medicine

• advertises functional imbalances underlying illness

• promotes optimal health and function

Integrative

• focuses on healing the individual as a whole

• uses the best evidence based therapies available

• combines mainstream therapies and CAM therapy for which there is some high quality scientific evidence of safety and effectiveness

• once you have scientific data, you move to integrative then to conventional

why care about CAM

• majority of countries accept the use of CAM

• insurance won’t cover without scientific evidence to back up products, therefore, patients back out

  • financial backing lacking

• side effects are risky because no scientific evidence, and no regulation

• 40-70% of CAM users don’t disclose their use to their physician

Characteristics of CAM

• body believed to have inherent balance or ability to heal itself

• whole person is treated; physical, mental, emotional, spiritual

• each person is unique, so treatment individualized

• many practices use complex combo of interventions → this involves medication at same time with

CAM Therapies

has inert mechanism of action, but still produces a subjective effects

1. light base therapy

2. magnetic field therapy → uses magnets to maintain therapy, can; relive pains, and improve function in patients with various muscoskeletal pain conditions

3. quantum healing/therapy → create high frequency of life-force energy then use energy to place this field at high energy around areas of pain, stress, inflammation, disease

disease/conditions in use of CAM

• use of CAM is supported by the idea that pain is subjective

• CAM has best effect of pain

• CAM is best approach for mental issues/trauma

conventional CAM medicine

• natural products have been used/identified as having anticancer properties undergo conventional drug developmental process

• in 2020, 100 unaltered natural products and their analogues were in oncology based trials

examples of natural products in clinical trials

• combretastatins

• curcumin = active ingredient in tumeric

• indirubin

• ingenol mebutate

• paclitaxel = was a natural products that prevented cancer, and is now a conventional “gold star” product of chemo cancer therapy

Influences on health care choices

1. Insurance = without insurance chronic health conditions are less well controlled due to prohibitive costs

   • determined when problems are diagnosed, and what/when preventative actions are taken

   • Affordable care act of 2020 = young adults can stay on parents health insurance up to age 20

2. Media = dissemination of health info

   • popularized diets, products, treatments, attitudes

3. Direct-To-Consumer Advertising = marketing of products directly to consumers instead of to health care providers

challenges for CAM

• non-standard therapies/therapist

• person centered/individualized treatment to treat the same condition

• finding methadologies that produce robusr evidence

• blinding/replicating/protocols

• Fidelity → what acctually delivered and said to be delivered

• Quality → ex. herbal products and devices

Randomized controlled trials issues for CAM

• double blinding (bias)

• protocolised interventions

• comparison groups

• crochrane grade criteria and quality appraisal checklist

mind body therapies

• medical practices based on the premise that the mind influences the body in ways that promote/detract from well-being

• engaging brain as a whole organ and engage in its body

• brain change must lead to physiological change

example mind body therapies

• meditation → steady state engagement of brain, and can be prescribed and is now conventional (used to be considered alternative

  • yoga

  • deep breathing

  • prayer

  • progressive relation

  • visualization

  • biofeedback

  • hypnotherapy

energy therapies

• based on the idea that a disruption/imbalance of energy is at the root of illness and that restoration restores health

  1. acupressure

  2. magnetic field therapies

  3. therapeutic touch and reiki

  4. light-based therapies

acupressure

use of Japanese shiatsu massage at acupuncture points to improve the flow of energy

magnetic field therapies

used to ease chronic pain/brain function was considered an alternative, but now complementary

• pain relief via the peripheral nervous system

  • static magnetic fields do not change and are generated by permanent magnets or passing an electric current through a coil

  • these magnetic fields are employed for pain relief as they target the peripheral nervous system

therapeutic touch and reiki

use of practitioners hands to channel and direct energy

light based therapies

the exposure to direct sunlight/artificial light at uncontrolled wavelengths in order to treat disorder

ex. Hailey-Hailey disease (HHD) is an autosomal dominant genetic disorder characterized by skin abnormalities

• involving dysfunctional Ca2+ ATPase an enzyme important for maintaining calcium balance within cells

• 55 yo patient who had HHD, 37 years of conventional treatments didn’t help