Complimentary Medicine

Question 1

What does CAM stand for?

Answer 1

Complimentary and alternative medicine

Question 2

What is CAM?

Answer 2

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

Question 3

What % of UK population use CAM?

Answer 3

80%

Question 4

What are some issues with CAM?

Answer 4

• Lack of scientific valid safety and efficacy data
• Reporting of ADRs
• Evidence of harm
• Questionable cost-effectiveness

Question 5

What are some examples of CAM?

Answer 5

• Herbal medicine
• Homeopathy
• Chinese medicines
• Vitamins and minerals
• Acupuncture
• Hypnosis
• Meditation
• Osteopathy
• Yoga

Question 6

Why do people use CAM?

Answer 6

• Desire to control own health
• Dissatisfied with conventional treatment
• Perception that conventional medicine lacks/disregards holistic approach
• Concerns about side effects of conventional medicine

Question 7

What is the most popular CAM in the UK?

Answer 7

Herbal medicine

Question 8

What does herbal medicine contain?

Answer 8

Contains active ingredients parts of plants or other plant materials

Question 9

What are some concerns for herbal medicine?

Answer 9

• No safety or efficacy data
• In pregnant woman
  
  • Teratogenesis
  • Fetogenesis
• Drug-herb interactions

Question 10

What is homeopathy?

Answer 10

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

Question 11

What evidence supports homeopathy?

Answer 11

There is no evidence this works

Question 12

What is acupuncture?

Answer 12

Based on traditional Chinese medicine:

• Vital force called “Qi” which circulates along channels called meridians
• Balance of yin and yang

Question 13

What happens during an acupuncture session?

Answer 13

• 4-10 needles inserted in session
• Left in place for 10-30 minutes
• Needles can be stimulated by twirling of electric current

Question 14

Explain the efficacy and safety of acupuncture?

Answer 14

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%

Question 15

What is amotherapy?

Answer 15

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

Question 16

What are possible side effects of amotherapy?

Answer 16

• Skin irritation
• Photosensitivity
• Headache and fatigues
• Bronchospasm

Question 17

Is there any evidence for the efficacy of aromatherapy?

Answer 17

• Massage is pleasant but no evidence of clinical indication of prescription, no lasting benefit

Question 18

Describe the UK regulation of CAM?

Answer 18

• 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)

Question 19

Summarise what doctors need to know about CAM?

Answer 19

• 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

Question 20

What are some reasons that people believe in CAM?

Answer 20

• 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”