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Complementary and Alternative Medicine – an overview

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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

5 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 Report November 2000
CAM therapies grouped by organisational characteristics, diagnostic capabilities, apparent effectiveness and training

7 Group 1 Acupuncture Chiropractic Herbal medicine Homeopathy Osteopathy
Professionally organised disciplines, with their own diagnostic approach. They have some scientific evidence of effectiveness and recognised systems of training for practitioners

8 Group 2 Aromatherapy Bach flower remedies
Bodywork therapies including massage Counselling stress therapy Healing Hypnotherapy Maharishi ayurvedic medicine Meditation Nutritional medicines Reflexology Shiatsu Yoga Complementary therapies which lack a firm scientific basis and are not regulated to protect the public, but which give help and comfort to many people

9 Group 3a Anthroposophical medicine Ayurvedic medicine
Chinese herbal medicine Eastern medicine (tibb) Naturopathy Traditional chinese medicine Alternative disciplines which offer diagnostic information as well as treatment but for which the Committee did not find convincing evidence of efficacy. 3a are long established and traditional disciplines with very specific philosophies

10 Group 3b Crystal therapy Dowsing Iridology Kinesiology Radionics
As 3a but classed as “Other alternative disciplines”.

11 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

12 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?

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