Falling for CAM

Recent studies indicate the growing popularity of Complementary and Alternative Medicine (CAM), as both the general public and healthcare sector fall for new integrative possibilities.

A review conducted by researchers at the Universities of Exeter and Plymouth in the United Kingdom expressed concern over the need for more clinical, scientific evidence and trials in CAM journals.

The authors explained that previous research suggested that CAM journals publish few clinical trials, systematic reviews and meta-analyses and a high proportion of positive articles.

The study described the content of major CAM journals in 2005 and compared key findings with secondary data from previous years.

The study found that there is an apparent shift away from effectiveness research in CAM journals. The authors suggested that further investigation is needed as well as comparisons with other journals. The large proportion of positive articles published in CAM journals appears to not adequately reflect the best available evidence on the effectiveness of these therapies. This has implications for those using CAM journals as their main source of information in this area.

Another study conducted by scientists at the Université de Sherbrooke in Canada explained that the use of complementary and alternative medical therapies is common and increasing, particularly for children with chronic disease.

Researchers explained that the purpose of their study was to describe the use of CAM by children and to identify factors that may influence the use of CAM.

The cross-sectional descriptive study included children who were visiting a pediatric outpatient clinic. Parent's satisfaction about primary care was evaluated with the Parent's Perceptions of Pediatric Primary Care Quality questionnaire.

The study found that 54 percent of children used at least one type of CAM in the previous year. No sociodemographic characteristic difference was found between user and nonuser groups. Children most often used CAM to treat musculoskeletal problems (27 percent), psychological problems (24percent) or infections (20 percent).

Factors that influenced CAM use were "word of mouth" (36 percent), "reference by a physician" (28 percent), "personal experience by parents" (28 percent) and "no adequate resources in 'traditional' medicine" (21 percent).

Forty-seven percent of CAM users used prescribed medications simultaneously. Most users (75 percent) believed that CAM had no potential adverse effects or interactions with prescribed medication. Only 44 percent of CAM users were known as such by their physician. The primary care satisfaction was significantly lower in CAM users versus nonusers. Parents of CAM users were less satisfied in the areas of accessibility, knowledge of the patient and communication.

The study authors concluded that it is important that physicians systematically elicit families' expectations of treatment and be aware of the range of therapies used by children.

Finally, researchers at Oregon Health & Science University School of Medicine in Portland, Oregon conducted a survey containing a variety of assessments of attitudes toward CAM and the personality traits of adventurousness and tolerance to ambiguity among students entering four Portland, Oregon doctoral-level health professional schools and an allopathic medical school in the Upper Midwest (University of Nebraska College of Medicine) during the 2004-2005 academic year.

Students of naturopathy (63 students) and Oriental Medicine (71 students) were the most "CAM positive," adventurous and tolerant of ambiguity, and Midwestern allopathic medical students (58 students) the least. In general, chiropractic students (89 students) and allopathic medical students from the Pacific Northwest (95 students) were intermediate in CAM attitudes between these two groups. Female students were more "CAM positive" in all schools compared to male students.

The study authors concluded that students have high levels of interest in CAM upon entrance to their schools. Health professional discipline, geographic location, personality qualities and gender appear to influence CAM attitudes in entering students.

Natural Standard is an international research collaboration that aggregates and synthesizes data on complementary and alternative therapies. Using a comprehensive methodology and reproducible grading scales, information is created that is evidence-based, consensus-based and peer-reviewed, tapping into the collective expertise of a multidisciplinary Editorial Board. The mission of this collaboration is to provide objective, reliable information that aids clinicians, patients and healthcare institutions in making more informed and safer therapeutic decisions. Natural Standard is widely recognized as one of the world's premier sources of information in this area. For more information, please contact us.

Comments

[femi]

I am urgently seeking herbal help for sarcoidosis. If anyone has any knowledge, please e-mail me back.

Thanks.

[Emily P.]

I think it's wonderful that so many people are looking into integrative and natural medicines to improve their health. There are so many viable alternative options to standard medications that have less side effects and are potentially cheaper and more accessible. The only concern I have is that people put too much trust in the word 'natural' and do not always think about the potential interactions their CAM therapies may have with standardized drugs or other supplements. Natural medicines are also less regulated than conventional therapies and may contain ingredients not listed on the bottle or may contain inconsistent amounts. This can be a serious health threat. While I encourage this interest in CAM, I just hope people still conduct the proper research on what they're taking. Resources such as Natural Standard are very important in this area.

[Sasha]

I agree with Emily. I think it is great people are looking into other options, but people also need to be aware and educated about the CAM therapies. It is easy to get access to and buy many of these natural products, but I have noticed that most of the time it is difficult to understand what is on the label, or there might not be much information on the label at all. Just because it wasn't chemically manufactured doesn't mean that it is automatically safe to take without looking into it.

[dalz]

It's awesome that a CAM resource like Natural Standard is out there to provide unbiased reviews and information for a growing interest in complimentary and alternative medical options!!

[Benson]

I found it interesting that the study reported that CAM users were less satisfied with primary care than non-users. I had always always focused on the word "alternative" when thinking of herbal therapies and alternative modalities, but I have found that their use is really becoming more integrated. I'm all for using all the resources we have. Hopefully in the future, the attitude that "anything that is natural must me safe" will subside and people will inform their physicians of alternative therapies they are using.

[Tomlin]

I don't think that Americans are using more CAM for more health problems because of the amount of research being done. I think the spreading popularity of CAM has led people to consider it as a real option, and more research is being done because more patients are using it.

[D Martin]

Am I the only one who is alarmed by the fact that 47% of people used CAM in children along with prescription medications and that nearly half did so without informing their physicians? As a nurse, this really concerns me! As Emily P pointed out, natural does not always equal safe! Many "natural" herbs and supplements can have serious interactions with drugs, some can cause serious cross allergic reactions, and some are potentially toxic in and of themselves. CAM has its value, but it should be used and mixed with conventional medicine carefully and under the supervision of a knowledgeable physician or naturopath!!

[Richard]

I wonder if integrative therapies are gaining popularity because so many people do not have health insurance and are trying to treat themselves. Think about it. There are so many Web sites out there that are aimed at helping individuals diagnose their own medical conditions. Individuals can just type in their symptoms, diagnose themselves, and buy whatever herbal supplement claims to work.

[Janelle]

I COMPLETELY agree, Tomlin. Natural does not mean safe, and I cannot emphasize that enough to people who talk to me about taking something "natural," which in their minds, means safe. Unfortunately, too, people mistake that the popularity of CAM is related to effectiveness.

[Sandro]

I totally agree with Richard. Don't get me wrong, I think it's great that patients are able to take a more active role in their health, but I also think they need to be cautious about the treatments they choose. As everyone else has already mentioned, natural does not mean safe.

[Maria]

I think it's great that people are more willing to try integrative therapies. People haven't always been so accepting of alternative medicine. Many people used to think it was just a bunch of bologna, but now it is finally starting to become more mainstream.

However, I do agree with what everyone else is saying. If you start treating yourself, without talking to a doctor or pharmacist first, you could suffer from some serious adverse effects. For some reason, many people don't seem to realize this.

My aunt is adamant about treating her high blood pressure with a combination of several different herbs. She treats herself, without talking to her doctor, and I can't seem to convince her that it is dangerous. Most drugs are developed based on properties found in herbs. Therefore, they can interact with other herbs, supplements or drugs.

[Anon]

Most people in my life are willing to try a therapy if it has worked for someone they know. It is how everybody I know got into alternative medicine.

[Cindy]

You all seem to presume that patients get more than five minutes with the doctor, or that people go to doctors at all. Doctors are intimidating and usually don't listen. Why volunteer information when they are too busy to listen? Most people don't have serious side effects from herbs and supplements. And besides, people have all sorts of weird side effects with normal medicines, too. Most people manage to live without talking about those to the doctor.

[Misha]

Cindy,

If that's your experience with your doctor, perhaps you should switch PCPs. You should never feel like your doctor des not have time to listen because that's their job. I have seen several doctors, including dermatologists, orthopedics, ophthalmologists, and obstetricians/gynecologists, and I have never had a bad experience.

It helps to research doctors before choosing one. For instance, I did a Google search before I choose which orthopedic to see this summer, and there were tons of Web sites where patients rated their experiences. I ended up choosing the one with the best reputation, and i lucked out.

I would never hold back information, especially regarding herbs and supplements, because they can cause serious side effects.

[Justin A.]

I understand that it is difficult and sometimes intimidating to speak to a doctor, but I feel that by no means should that stop you from discussing what you are taking. I disagree with Cindy and think that people should talk to their doctors because you can have serious side effects from herbs. I do not think your health is something you should be taking chances with.

[Sari]

As a student in the health profession, I find it discouraging that not many of my professors are abreast of CAM modalities. Out in the community, I find that many health professionals steer clear of recommending any CAM because of fear, stemming from lack of knowledge. It is increasingly important that we educate the up-and-coming healthcare professionals in both conventional and complementary/alternative medicine, because, as we've seen, the majority of patients are using both.

[Kevin]

I think it's awesome that there is a call for more research. I think that in general, people underestimate the wealth of options in alternative medicinal practices, and they are really limiting their possibilities of treatment. More evidence and information would definitely help to increase awareness, and also safety.

[Aspen]

I know that CAM therapies in children are really popular when the child is diagnosed with autism.

I think that lots of parents with autistic children try alternative therapies out of desperation. Autism is difficult to treat, and it is understandable that parents would want to help their children.

[Sam]

What are integrative therapies? Can I get a snake oil infusion along with a heart transplant?

[Dave]

We certainly need more clinical trials that investigate the different types of alternative medications. We need more studies in humans and more information on dosing.

An increasing number of people are using CAM therapies every day. I do believe that different forms of CAM therapies can be greatly beneficial to the public, however, they can be equally as harmful if not used correctly. We simply need more information and better designed studies to deliver this information.

[Tina]

Aspen, do you happen to know which CAM therapies are used for children with autism? I used to work in a school for children with autism, and I know how difficult it is for both the students and families to find suitable treatments and medications. I am curious as to what exactly is used for autism.

[George]

I was talking to a pharmacist, and he told me that his training never once mentioned anything about alternative therapies or integrative medicine. He said when he started working, he was surprised about the number of questions patients asked him about supplements and herbs and he was even more surprised that they hadn't provided any education about this at school.

I agree with Sari and feel CAM therapies need to become a focus in the education of healthcare professionals. I think it is great that there are resources like Natural Standard available for healthcare professionals. Patients need to know that their questions can be answered, and professionals should be prepared to help patients, especially since the usage of CAM therapies is on the rise.