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MD4001 - Public Health etc. > Complementary and Alternative Medicine (CAM) > Flashcards

Complementary and Alternative Medicine (CAM) Flashcards

1
Q

What are complementary Alternative Medicines?

A

Treatments that fall outside of mainstream healthcare

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2
Q

What is complementary medicine?

A

Use of CAM together with conventional medicine

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3
Q

What is integrative medicine?

A

Blends use of conventional and complementary approaches

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4
Q

What is alternative medicine?

A

Use of CAM in place of conventional medicine

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5
Q

What is allopathy?

A

Medical treatment by convential means

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6
Q

What is naturopathy?

A

Complimentary alternative medicine “natural healing”

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7
Q

Name different classifications of CAM?

A
  • Alternative medical systems (broad set of beliefs brought into one theory)
  • Mind-body interventions
  • Biologically based therapies
  • Manipulative and body-based methods
  • Energy therapies
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8
Q

What are examples of alternative medical systems?

A
  • Traditional Chinese Medicine
  • Ayurvedic Medicine
  • Homeopathy
  • Naturopathy
  • Indigenous healing systems
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9
Q

What are examples of mind-body interventions?

A
  • Meditation
  • Yoga
  • Deep-breathing exercises
  • Qi gong
  • Tai chi
  • Guided imagery
  • Biofeedback
  • Dream therapy
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10
Q

What are examples of biologically based therapies?

A
  • Herbal medicine
  • Bach flower remedies
  • Bee venom therapy
  • Chelation therapy
  • Vegetable juice therapy
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11
Q

What are examples of manipulative and body-based methods of CAM?

A
  • Osteopathy
  • Chiropractic
  • Caniosacral therapy
  • Alexander technique (body posture)
  • Acupuncture
  • Rolfing
  • Kinesiology (broad bands on athletes)
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12
Q

What are examples of energy therapies?

A
  • Therapeutic touch
  • Healing touch
  • Reiki
  • Magnet therapy
  • Light therapy
  • Crystal therapy
  • Qi gong
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13
Q

What alternative medical system does acupuncture derive from?

A

Traditional Chinese Medicine

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14
Q

What is the average one year prevelance of CAM?

A

26.3%

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15
Q

What is the average lifetime prevelance of CAM?

A

44%

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16
Q

What are the most popular CAM modalities?

A
  1. Herbal medicine
  2. Homeopathy
  3. Aromatherapy
  4. Massage
  5. Reflexology
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17
Q

What are the most popular CAM modalities with practitionars?

A
  1. Massage practitionar
  2. Osteopath
  3. Acupuncturist
  4. Chiropractor
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18
Q

What does the history of homeopathy come from?

A

Samual Hahnemann in 1796

  • Similia similibus curentur
  • Like cures like
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19
Q

Describe what is eant by “like cures like”?

A

Causes of disease were miasms and homeopathic treatments could remedy these

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20
Q

How are homeopathic treatments made?

A
  • Principle of similars
  • Preperation undergoes potentisation in between dilutions
  • Mother tincture is dilluted multiple times
  • 2c or 2x dilution (diluted by 10 or 100 each time)
  • More diluted means more potent in terms of homeopathy
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21
Q

What are the harms/risks of receiving homeopathic treatments?

A
  • No direct risk of interactions with ‘high potency’ medicines
  • Indirect harm of delay in receiving appropriate treatment and practitioner’s attitudes may be problematic
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22
Q

What are the regulatory bodies for heomeopaths in the UK?

A 
No legal regulation in UK 
- Society of Homeopaths 
- Faculty of Homeopaths 
- British Homeopathic Association 
Products regulated by EU directive
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23
Q

Is homeopathy available on the NHS?

A

No - used to be to some degree

24
Q

What does St John’s Wort (hypericum) have efficacy in treating?

A

Major depression (cochrane review proved this with 29 studies of 5489 patients)

25
Q

What is a major risk of herbal medications?

A

Many ingerdiants many may often be unkown - difficult to know side-effects and interactions with other drugs . Quality control (batch to batch variation)
- May also delay patient appropriate treatment

26
Q

What drugs is St John’s Wort (Hypericum) thought to interact with

A
  • Hormonal contraceptives
  • Anti-depressants
  • Anti-coagulants
  • Anti-epileptics
  • Heart mediccations
  • Anti-cancer agents
  • Anti-virals for HIV
  • Possibly others
27
Q

What body regulates herbal medicines in the UK market?

A

MHRA

28
Q

What are the 3 levels of herbal medicine regulation in the UK?

A
  • Marketing Authorisation (MA)
  • Traditional Herbal Medicines Registrations (THR)
  • Regulation 3 of the human medicines regulations 2012 (the “herbalist exemption”)
29
Q

What does the Marketing Authorisation (MA) ensure for herbal medicines?

A

Safety quality and efficacy as per any regular medicine

30
Q

What does the Traditional Herbal Medicines Registration (THR) ensure for herbal medicine?

A

Safety and quality (not efficacy)

- Based on traditional usage

31
Q

What does the herbalist exemption allow for?

A

Do not need to prove efficacy, safety or quality to prescribe a herbal medicine

32
Q

What is the difference between straight and mixed chiropacticors?

A 
Straight = believe 95% of all diseases are caused by displaced vertebrae 
Mixer = More specific
33
Q

What are subluxations?

A
  • Partially displaced vertebrae which block the flow of innate intelligence down the spinal cord
34
Q

What is a major feature of chiropractic therapy and not osteopathy?

A

Spinal manipulations (adjustments)

  • Fix / release subluxations
  • Including high-velocity, low-amplitude thrusts (audible ‘crack’)
35
Q

What are direct harms associated with chiropractic and osteopathic care?

A
  • 50% of chiropractic patients suffer an adverse reaction
  • Tearing of artery wall leading to stroke
  • Injury to the spinal cord
  • Chiropractix X-rays
36
Q

What are the only 2 CA modalities under statutory regulation?

A
  • General Chiropractic Council

- General Osteopathic Council (GOsC)

37
Q

What is acupuncture based on?

A

Ch’i (qi, “ch-ee”) as a ‘vital energy’

  • Flows through ‘meridians’
  • Meridians associated with major organs
  • Illness due to disrupted flow of Ch’i
38
Q

How are needles placed in acupuncture?

A
  • Insertion of needles along meridians
  • Restores flow of Ch’i
  • 1 - 10 cm in depth, with/without rotation
  • Left in place for seconds to hours
39
Q

What are the direct risks of acupuncture?

A
  • Infections

- Pneumothorax

40
Q

How are acupuncture practitionars regulated?

A
  • Voluntary regulation (e.g British acupuncture council)

- Premises and practitioners must be licensed via local athority (much like tatoo parlors or piercings)

41
Q

What is reflexology?

A

A type of massage that involves applying different amounts of pressure to the feet, hands, and ears. It’s based on a theory that these body parts are connected to certain organs and body systems

42
Q

What is an example of a drug which originally was not fully understood in how it worked or what it targetted but was used anyways?

A

Paracetamol - same principle can be applied for certain herbal / CAM therapies

43
Q

What are factors which are thought to underlie the placebo effect?

A
  • Endogenous opiates (proven through naloxone based studies)
  • Conditioning (e.g Pavlov’s dog)
  • Expectancy (wine and placebo alcohol, dopamine and money)
  • Motivation (a more compliant patient)
44
Q

What does anthroposophic medicine mix together?

A

Herbal and homeopathic medicine

45
Q

Are homeopathic medications any more effect than placebos?

A

NO

46
Q

Why is it difficult to compare a acupuncture and a placebo?

A

Difficult to blind patient and/or doctor

  • Sham acupuncture locations may hit meridians by chance
  • Difficult to make sham acupuncture needles
47
Q

What are some orthodox explanations of acupuncture?

A
  • Gate control theory of pain
  • Opioid release
  • Placebo effect
48
Q

Has there been shown a difference between sham and real acupuncture?

A

Yes - although only 10 point improvement on 100 point pain scale
- Suggest there must be a mechanism other than placebo at play

49
Q

What did the cochrane review find for acupunture treating osteoarthritis?

A

Showed sham controlled trials do not show enough benefit

- Acupuncture showed statistically significant and clinically relevant benefits

50
Q

What did the cochrane review find for chiropractic interventions treating lower back pain?

A

Combined chiropractic interventions slightly improved disability in the short term and pain in the medium term for acute and subacute LBP
- No evidence to suggest their is a clinically meaningful difference for pain or disability when compared with other interventions

51
Q

Why may people choose to use CAM?

A
  • Health promotion (e.g general wellbeing)
  • Believe will be more effective than conventional treatment
  • Exhaustive conventional options
  • Conventional options associated with side effects / risks
  • No conventional therapy available
  • Conventional approach emotionally / spiritually bereft
  • Feeling more in control
52
Q

What is medical pluralism?

A

Adoption of more than one medical system (beliefs/behaviours/treatments)
- E.g migrants trust in doctors/systmes back home, UK system may be confusing, pragmatism, speed of access

53
Q

How much more likely were healthcare proffessionals who use CAM themselves to recommend CAM to patients? (pregnant women)

A

8 times

54
Q

What percentage of pregnant women are recommended CAM?

A

1/3 (33%)

55
Q

What are some natural impediments to making valid inferences?

A
  • Placebo effect
  • Natural history of disease (usually receive when disease at worst)
  • Regression to the mean
  • Reluctance to admit when wrong (i.e cognitive dissonance)
  • Simple optimism (internal locus of control)
  • Respect for authority

MD4001 - Public Health etc. (6 decks)

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