Integration Of Complementary Alternative Medicine Research Articles

Complementary alternative medicine practices and beliefs in spinal cord injury and non-spinal cord injured individuals

Context/Objective: To compare the beliefs and practices of individuals with spinal cord injury (SCI), their friends and family members (F&F SCI), and healthcare professionals (HCP) regarding complementary alternative medicine (CAM).Design: A questionnaire regarding CAM practices and beliefs was administered to participants on paper or online.Setting: An academic rehabilitation hospital.Participants: Ninety-six individuals voluntarily participated in the study. Participants included 28 patients with SCI, 36 F&F SCI, and 32 HCP.Interventions: Not applicableOutcome Measures: The questionnaire assessed participants’ prior or current use of 14 CAM modalities, their willingness to use CAM in the future or recommend its use, and their beliefs and opinions of CAM.Results: Participants with SCI and their family and friends, were more likely than HCP to have used CAM (P ≤ 0.01 and P ≤ 0.03, respectively) and recommend its use (P ≤ 0.04 and P ≤ 0.03, respectively). All three groups showed statistical significance in their willingness to ever use certain CAM modalities (P ≤ 0.03 for SCI, P ≤ 0.04 for F&F SCI, and P ≤ 0.02 for HCP). SCI, F&F SCI, and HCP groups had similar beliefs and opinions regarding CAM.Conclusion: Patients with SCI as well as their friends and family, have significantly more experience with CAM and are more likely to recommend its use than HCP, suggesting that they are interested and find benefit in alternative healthcare. This warrants further investigation of the integration of CAM into general health practices for those with SCI.

An approach for integrating complementary-alternative medicine into primary care.

Despite family practitioners frequently being requested to assist their patients with advice on or referrals to complementary-alternative medicine (CAM), there is an absence both of evidence about the efficacy of nearly all specific treatments or modalities and of guidelines to assist with the integration of conventional and CAM therapies. The aim of this article is to suggest a comprehensive and rational, best-evidence strategy for integrating CAM by primary care practitioners into primary care, within the context of the limitations of the current knowledge base and the local milieu. The suggested approach was developed by a combination of literature review, key informant interviews, focus groups, educational presentations for family practice residents and practitioners, and field testing. An iterative model was utilized whereby more refined drafts of the suggested approach were subjected to later discussants and groups, as well as further field testing. Drafts of the strategy were utilized in consultations of patients requesting advice on alternative medicine in a primary care setting and in a CAM clinic. Both family physicians and CAM practitioners provided useful comments and recommendations throughout the process. These can be categorized in terms of knowledge, attitudes and skills. Our strategy suggests that patients requesting advice on the use and integration of CAM modalities as part of their health care should be evaluated initially by their primary care physician. The physician's responsibilities are to evaluate the appropriateness of that use, and to maintain contact, monitoring outcomes. Advice on referrals should be based on the safety of the method in question, current knowledge on indications and contraindications of that modality, and familiarity and an open dialogue with the specific therapist. Given patients' demands and utilization of CAM therapies, despite the lack of evidence, there is an increasing need to address how CAM therapies can be integrated into conventional medical systems. These suggestions should respond to patient's expectations and needs, but at the same time maintain accepted standards of medical and scientific principles of practice.