What does CAM stand for?
Complimentary and alternative medicine
What is CAM?
CAM = alternative medicine, broad set of health care practices that are not part of the countries own tradition and not integrated into the dominant health care system
What % of UK population use CAM?
80%
What are some issues with CAM?
- Lack of scientific valid safety and efficacy data
- Reporting of ADRs
- Evidence of harm
- Questionable cost-effectiveness
What are some examples of CAM?
- Herbal medicine
- Homeopathy
- Chinese medicines
- Vitamins and minerals
- Acupuncture
- Hypnosis
- Meditation
- Osteopathy
- Yoga
Why do people use CAM?
- Desire to control own health
- Dissatisfied with conventional treatment
- Perception that conventional medicine lacks/disregards holistic approach
- Concerns about side effects of conventional medicine
What is the most popular CAM in the UK?
Herbal medicine
What does herbal medicine contain?
Contains active ingredients parts of plants or other plant materials
What are some concerns for herbal medicine?
- No safety or efficacy data
- In pregnant woman
- Teratogenesis
- Fetogenesis
- Drug-herb interactions
What is homeopathy?
Toxin diluted and ingested, remedies being produced by repeated dilution and succession of the substance:
- Potency increases with number of dilutions and successions
- Typical homeopathic dilution is 30X, where X represents 10
- One part toxin mixed with 10 part water or alcohol, repeated 30x
What evidence supports homeopathy?
There is no evidence this works
What is acupuncture?
Based on traditional Chinese medicine:
- Vital force called “Qi” which circulates along channels called meridians
- Balance of yin and yang
What happens during an acupuncture session?
- 4-10 needles inserted in session
- Left in place for 10-30 minutes
- Needles can be stimulated by twirling of electric current
Explain the efficacy and safety of acupuncture?
Efficacy:
- Could work due to release of natural endorphins
- Stimulates pain fibres entering dorsal horn of spinal cord, causing inhibition of pain impulses
Safety:
- Incidence of adverse effects is thought to be 10%
What is amotherapy?
Uses concentrated essential oils extracted from herbs, flowers and other plants to treat disease:
- Commonly administered into skin
- Or inhalation
- Or in diffuser
- Hot or cold compresses
- Soaking baths
What are possible side effects of amotherapy?
- Skin irritation
- Photosensitivity
- Headache and fatigues
- Bronchospasm
Is there any evidence for the efficacy of aromatherapy?
- Massage is pleasant but no evidence of clinical indication of prescription, no lasting benefit
Describe the UK regulation of CAM?
- Homeopathy
- Registered under National Rules Scheme 2006
- If you want to claim efficacy need evidence
- Herbals
- Regulated by European Traditional Herbal Medicinal Products Directive (THMPD)
Summarise what doctors need to know about CAM?
- Be aware of what’s available via complementary practitioners, on-line and OTC
- Ask patients about CAM use
- Be aware of potential for harm with CAM use
- How to evaluate evidence of safety and efficacy
- Appropriate use in NHS
What are some reasons that people believe in CAM?
- Magic believers
- Works in a way science cannot explain
- Pseudoscience believers
- Can be explained by untested theories
- Anecdotal believers
- Experienced its positive effects
- “Seeing is believing”
