Complementary and Alternative Medicine

1
Complementary and Alternative Medicine an
overview

• Dr Kevin Hickey
• Shipley Health Centre

2
Complementary and Alternative Medicine

• 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 systems of a
  particular society or culture in a given
  historical period!!

3
Complementary and Alternative Medicine

• Perceptions Positive
• Treat anything
• More time given to patients
• Growing body of evidence
• More holistic approach
• Can succeed where conventional methods fail
• Hope for the hopeless

4
Complementary and Alternative Medicine

• Perceptions Negative
• Strange smelling herbs and needles
• Strange words chakras / meridians/ energies/ chi
• Unnecessary pain
• Limited evidence
• Unknown mechanisms of action
• Placebo effect
• Unregulated
• Private sector

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Complementary and Alternative Medicine

• Evidence improving
• Mechanisms more understood
• More regulation
• Full explanations before treatment
• Significant numbers of therapists working within
  the NHS
• Primary and secondary care
• Private, voluntary and NHS funding

6
House of Lords ReportNovember 2000

• CAM therapies grouped by organisational
  characteristics, diagnostic capabilities,
  apparent effectiveness and training

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Group 1

• Acupuncture
• Chiropractic
• Herbal medicine
• Homeopathy
• Osteopathy

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Group 2

• Aromatherapy
• Bach flower remedies
• Bodywork therapies including massage
• Counselling stress therapy
• Healing
• Hypnotherapy

• Maharishi ayurvedic medicine
• Meditation
• Nutritional medicines
• Reflexology
• Shiatsu
• Yoga

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Group 3a

• Anthroposophical medicine
• Ayurvedic medicine
• Chinese herbal medicine
• Eastern medicine (tibb)
• Naturopathy
• Traditional chinese medicine

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Group 3b

• Crystal therapy
• Dowsing
• Iridology
• Kinesiology
• Radionics

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CAM As Last Resort?

• Mainly provided in the private sector for people
  with poorly met needs
• Chronic painful and stress related conditions,
  frequent consulters
• Specific conditions e.g. Irritable bowel
  syndrome, migraine, back and neck pain, eczema,
  rhinitis, hay fever, insomnia
• Side effects from conventional therapies

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CAM As First Resort?

• Improve patient choice
• Improve practitioner choice
• Improvement of public well being
• Improvement of public health
• Freely available on NHS?

13
What about the Placebo Effect?

• 20-40 improvement accounted for by placebo
  effect
• People feel better
• Symptoms resolve
• Long tradition of using placebos in primary care
• Less use of resources
• (Mostly) harmless
• Better than doing nothing?