Complementary therapies Flashcards
Terms
- Alternative therapy- Any therapy that is not accepted by the majority of mainstream doctors
- Complementary therapy- complementary to mainstream medicine (basically the same as alternative)
- Complementary and alternative medicine (CAM)- compounds used that is different to conventional medicine
Complementary and alternative medicine
-Other than those intrinsic to the politically deminent health system of a particular society or culture in a given historical period is known as a CAM
NB- this is not fixed medicines can interchange e.g. digoxin came from herbal medicine (CAM) but it worked and was synthesised became a conventional medicine
Alternative therapies- More common
- Acupuncture (chi lines)
- Homeopathy
- Chiropractic (not just back pain but treating things like asthma from back manipulation)
- Osteopathy (cure medicine from bone manipulation)
- Herbal medicine
Alternative therapy- less common
- Crystal therapy (placing crystals on the body to cure illness)
- Cupping (Brusing of the skin using suction from a hot cup)
- Leech therapy
- Reflexology (touch feet in certain places which will cure certain areas of the body)
- Spiritual healing (Channel energy through the body and pass it to the patient)
Do the public use CAM
-In many countries over half the population use alternative therapies
+USA 32-34%
+UK-20-28%
-In both US and UK, use is more likely in higher income groups
-Estimated annual expenditure on CAM in UK estimated at £1.6 billion
-A survey has shown that 52% of CAM users do not inform their GP of their use- this can lead to interactions with conventional medicine
Why do people use CAM: push factors
- People are dis-satisfied
- Rejection of conventional medicine due to anti-science or anti-establishment attitude
- Desperation, especially with a patient who has been given a life-threatening diagnosis
Why do people use CAM: pull factors
- Hope for increased well-being and other positive outcomes
- Philosophical congruence e.g. with spiritual dimension of CAM, it’s emphasis on holism or the more active role patients play
- Personal control over treatment- NHS is guideline driven, not alot of time with GP
- Good relationship with practitioner e.g. interaction on equal terms, time for discusion, emotional factors allowed for
- Accessibility and seeing the same practitioner over the course of treatment
Hierarchy of evidence
1) Systematic reviews (Team of stick together many randomised controlled trials to generate a causality)
2)Randomised controlled trials
3)Cohort studies
4)Case-control studies (observational lots of people but it is not random therefore is bias e,g, one group has more elderly people which will effect result; correlation not causation)
5)Case series, Case report (Case of 10 people, not enough people)
6)Editorial expert opion (Just because someone is a leader in a Field doesn’t mean there right)
NB- 1 is the best because this establishes causality, then progressively worse
-Anything lower than randomised controlled trials must have further tests to prove causality
Aromatherapy
- Based on healing properties of essential plant oils
- The oils are diluted in a carrier oil and are usually massaged into the body
- They can also be inhaled, used in a bath or cold compress next to the skin
- The basisof action is similar to modern pharmacology with active principlkes entering the biochemical pathways, albeit in much smaller doses. It is thought to work at psychological, physiological and cellular levels via olfactory stimulation and dermal action (works by smelling and absorb through skin)
Aromatherapy- evidence base
- Clamied to help a number of conditions including eczema, digestive problems and muscular aches and pains
- No evidence that aromatherapy can treat specific diseases
- There is some evidence (poor quality) that it reduces anxiety scores (probably the massage itself as opposed to the oil effecting the patient), in the short term, in settings, which include intensive care, cardiac surgery and palliative care
Bach flower recipes
- Bach believed that he could ascertain (Make sure) the properties of healing flowers by waving his hands over them
- He then attempted to develop the mental and physical symptoms corresponding to a plants properties and would be drawn to particular flower, which would ease those symptoms
- He was able to relate this to certain emotions and believed that he had been led divinely towards a new method of healing
Bach flower recipes- Preparation
- For flowers that bloom during late spring and summer, when the sun is at its strongest, the sun method is used to prepare mother tinctures
- Starting at around 9AM on a calm day, at the place where the plant material had been gathered
- Fifty parts of pure spring water are added to a glsas container until the level reaches just below the brim
- One part of the flow heads is floated on the water; this is left in the sunshine for 3 hours
- The flower heads are then removed; the remaining solution is strained into a glass bottle and mixed with equal quantity grape brandy. This is shaken and cooled
Evidence
- There are numerous anecdotal report that flower remedies are beneficial, but there is no rigorous clinical trial evidence that they are assoviated with effects beyond a placebo reponse
- Bach flower remedies mechasnism of action is highly implausible, with highly dilute solutions meanin that no pharmacological action is conceivable. They are therefore suggested to work by subtle energies, which are neither measurable nor definable
- This is a placebo response
Herbal medicine
- Herbal medicine is the use of plant remedies in the treatment of disease
- Many currently used conventional medicines have their origins in herbal products and plant materials (Aspirin form willow bark)
- Increasingly common (Market worth- £10 billion worldwide)
- Very little evidence to support the use of the vast majority of herbal remedies
Problems associated with herbal medicine
- Herbs can have potent pharmacological effects and toxicity
- Black Cohosh- used to treat ssymptoms of menopause- causes liver failure and need transplant
