1. CHAPTER 8
Global Use of Complementary and Alternative Medicine (CAM) and Treatments

2. CAM Defined: Complementary and Alternative or Traditional?
Refers to a set of medical and healthcare systems, practices, and products that are not part of that country’s tradition and are not integrated into the dominant healthcare system

3. CAM Defined: Complementary and Alternative or Traditional?
WHO defines traditional medicine as the “knowledge skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness”

4. Alternative Medicine
Complementary Medicine
Traditional Medicine
CAM in the United States
Allopathic Medicine
2005 Institute of Medicine’s Report on Complementary and Alternative Medicine in the United States

5. CAM use by category, in order of prevalence:
Biologically based (19.9%).
Mind–body (19.2%).
Manipulative and body-based therapies (15.2%).
Alternative medical systems:
Acupuncture, Ayurveda, homeopathic treatment, naturopathy, and traditional healers (3.4%).
Energy healing therapies (0.5%).
(Barnes, Bloom, & Nahin, 2008)

7. People who are more likely to use CAM:
Women
People with higher household income
Older adults
Ethnic minorities & low-income individuals
People with lower emotional role functioning and perceived general health
People who had been hospitalized in the last year
People with a holistic orientation to health
People with certain health problems

8. Reasons that people were most likely to use CAM
They believe CAM therapies integrated with conventional therapies yield better results
They thought trying CAM therapies would be interesting
They were recommended by a medical professional

9. Reasons that people were most likely to use CAM
They felt allopathic therapies were not effective
They felt CAM therapies would be more cost- effective
They believe CAM therapies can boost the immune system, treat cancer, and help them live longer

10. Mind-Body therapies, including prayer
Megavitamin Therapy
Biologically based therapies
Manipulative Therapies
Alternative Medical Systems
Energy Therapies

11. Nonvitamin, Nonmineral, Natural products
Deep Breathing Exercises
Participating in prayer
Meditation
Chiropractic care
Yoga
Massage
Diet-based therapies

12. CAM IN THE WORLD Global Use of CAM China
Ghana, Mali, Nigeria and Zambia
African countries
Europe
North America
Canada
Germany
United Kingdom

13. MAJOR FORMS OF CAM Alternative Medical Systems Ayurvedic Medicine
Homeopathic Medicine
Naturopathic Medicine
Traditional Chinese Medicine

14. MAJOR FORMS OF CAM designated by NCCAM
Natural products
Mind-Body Medicine
Meditation
Yoga
Manipulative and Body-Based Methods
Chiropractic Medicine & Massage Therapy
Energy Fields
Reiki, Therapeutic Touch, Qi Gong

15. RESEARCH AND TECHNOLOGY
Research Areas of Special Interest
Anxiety and depression
Cardiovascular diseases
Ethnomedicine
Immune modulation or enhancement
Inflammatory bowel disease
Irritable bowel syndrome
Insomnia
Liver
Obesity and metabolic syndrome
Respiratory diseases

16. Scientific evidence from randomized clinical trials is strong for:
many uses of acupuncture
some herbal medicines
some of the manipulative therapies (such as chiropractic and massage therapy)
Robinson & Zhang, 2011

17. NCCAM future research priorities in CAM (NCCAM, 2011b):
Advance research on mind and body interventions, practices, and disciplines
Advance research on CAM natural products
Increase understanding of “real-world” patterns and outcomes of CAM use and its integration into health care and health promotion
Improve the capacity of the field to carry out rigorous research
Develop and disseminate objective, evidence-based information on CAM interventions

18. LEGAL AND ETHICAL ISSUES
Development and implementation of regulations for:
Traditional medicine
Complementary medicine
Alternative medicine
Herbal medicine

19. LEGAL AND ETHICAL ISSUES
These challenges are related to the:
Regulatory status
Assessment of safety and efficacy
Quality control
Safety monitoring
Lack of knowledge by national drug regulatory authorities

20. Dietary Supplement Health and Education Act of 1994 (DSHEA)
FDA does require homeopathic remedies to meet certain legal standard for:
Strength
Quality
Purity
Packaging
Dietary Supplement Health and Education Act of 1994 (DSHEA)
Ethical Responsibility

23. Ethical Issues Surrounding CAM Treatment and Research
Influences of Politics, Economics, Culture, and Religion
Politics – The Role of Government
The influence of politics and government is significant in the United States

24. The use of CAM worldwide makes it important for governments to:
Formulate national policy and regulation for the proper use
Establish regulatory mechanisms to control the safety and quality of products
Create awareness about safe and effective traditional medicine
Cultivate and conserve medicinal plants

25. Economics Culture and Religion Developing and Developed Societies
Cultural beliefs significantly predict the use of traditional medicine practices
Developing and Developed Societies
The industrialized world uses traditional medicine and CAM as a choice
Well-educated
Well-informed