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AIII-Natural Health Products > L1-Integrative Medicine > Flashcards

L1-Integrative Medicine Flashcards

1
Q

Hx of American Medicine - describe 4 key time points.

A
  1. early 1800s: heroic v alternative Drs
  2. 1840s: licensing laws repealed
    - medical practising act: initially v restrictive to just the heroic method & you were fined if you were not licensed but eventually all the laws were repealed
  3. 1847: American Medical Association (AMA) strong movement toward sic/biomedical research-based medical schools
    - to deal w/ lack of STDs
  4. 1900s: pivotal discoveries enabled more effective med Tx
    - –> birth specialization –> disease-oriented or organ-oriented model of medicine –> huge impact on acute diseases v limited impact on chronic disease
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2
Q

Heroic & alternate medicine were both used in the early 1800s. Compare/contrast them.

A

Heroic: believed illness was caused by a systemic imbalance wherein the body was over-/under-stimulated
-Harsh practices involved bleeding, sweating, etc. the patient. Patient often died in the process but they were willing to take the chance b/c it looked like something was being done.
Alternative: included herbalists & homeopathies
- Included nut, exercise, minimal drug - worked b/c it did not kill the pt.

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3
Q

What is CAM?

A

National Centre for Complementary and Integrative Health (NCCIH):
“CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.”

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4
Q

What are the five disciplines of CAM? Provide examples.

A
  1. Alternative medicine system: Chinese, Indian Ayurvedic, natural path, chiropath
  2. Biologically-based prods: herbal tx, bee pollen, sharp collegen?
  3. Mind-body: mediation, hypnosis
  4. Manipulative & body-based practices: massage
  5. Energy med: therapeutic touch, Reiki
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5
Q

What are the two qualifiers of CAM?

A
  1. Not much well studied thru well-designed experiments. Questions still need to be asked as to whether these therapies are safe or efficacious.
  2. List of what is considered to be CAM changes continually, as the therapies proven to be safe and effective become apart of conventional health care
    - becoming more accepted - e.g. chiro is covered by drug insurance plans
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6
Q

What is difference between complementary and alternative medicines?

A

1) Complementary med: used together w/ conventional medicine
2) Alternative med: used in place of conventional medicine
- very few people use alternative, most use complementary

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7
Q

Describe “complementary and alternative health care” (CAHC).

A
  • Dx, Tx &/or Px that complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by conventional approaches, or by diversifying the conceptual framework of medicine.
  • while CAM is the term most often used internationally, CAHC recognizes the diversity of practice areas, including medicine, and is the term most commonly used by HC in policy context
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8
Q

T/F: NHP are included in CAHC.

A

FALSE - in Canada, it does not include NHP, NHP has its our category! This is because they passed regulation in 2004 with their own rules and regulations.

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9
Q

What are the 4 commonalities of CAM?

A
  1. Focus on improving health
  2. Work in conjunction w/ the body’s own self-healing mechanisms
  3. Holistic approach to treatment
  4. Involve the patient as an active participant
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10
Q
  1. Focus on improving health

What is the biomedical or conventional model of health?

A

AKA reductionist
- absence of illness?
- emphasis on curing a disease rather than Px
- treat (chemically or surgically) the cause or merely symptoms of the
disease
- treatment is validated based on proven outcomes of sustained
scientific enquiry

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11
Q
  1. Focus on improving health

Describe the CAM model of health.

A

AKA holistic (thing the own person v just their “illness”)

  • state of complete (physical, social, mental) well-being, and not merely the absence of disease
  • state of balance, a dynamic process with a focus on well-being regardless of a condition
  • sense of well-being differs between individuals, cultures, etc.
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12
Q
  1. Focus on improving health

What are the different perspectives on health?

A
  1. Biomedical or conventional model (reductionist)

2. CAM model of health (holistic)

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13
Q
  1. Focus on improving health

What are the 4 paradigms of CAHC?

A
  1. Mind
  2. Body
  3. NRG
  4. Spirit
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14
Q
  1. Focus on improving health

Explain how the logic behind the 4 paradigms.

A

Health= balance &communication btwn different paradigms.
Physical disease= caused by LT or severe disruption in the balance btwn mind/spirt/energy
Healing:
-heal the disruption then it breaksdown a barrier to allow the body to heal itself
-For chronic disease (of the body), you can affect the mind, spirit, energy to ensure those are preserved to help indie have an overall sense of well-being.

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15
Q
  1. Focus on improving health

Explain: BODY (of the 4 paradigms of CAHC) & provide an example.

A

Body: based on assumption that bio mech are the primary cause of disease.
- E.g. pain, fatigue, compromised immune system disease

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16
Q
  1. Focus on improving health

Explain: BODY-SPIRT (of the 4 paradigms of CAHC) & provide an example.

A
  1. Body-spirt: transcadel aspects of personalites can inflence disease.
    - E.g. loss of meaning/purpose
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17
Q
  1. Focus on improving health

Explain: BODY-NRG (of the 4 paradigms of CAHC) & provide an example.

A
  1. Body-energy: health and disease are the function of the flow and balance of life energies.
    - E.g. low NRG, NRG blocks
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18
Q
  1. Focus on improving health

Explain: BODY-MIND (of the 4 paradigms of CAHC) & provide an example.

A
  1. Body-mind: stress, psych coping style, social support in influencing the formation of health and disease.
    - E.g. anxiety, depression, dysphoria, irritability
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19
Q
  1. Focus on improving health

Many CAM therapies consider structural & functional disorders to be on a continuum. Explain.

A
  • subtle manifestations of illness preceding more serious illness, as if illness accumulates in layers
  • role for preventative therapy even in the absence of overt symptoms
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20
Q
  1. Focus on improving health

Many CAM therapies consider structural & functional disorders to be on a continuum. Provide 2 examples of this.

A

1) Healthy pt develops eczema, which develops to allergies then frequent colds then to asthma.
2) Healthy pt develops stress, which develops to HTN then angina then infarct/heart failure.

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21
Q

State & explain the 2nd commonality of CAM therapies.

Provide 3 examples of CAM healing therapies & what mechanism they affect.

A
  1. Work in conjunction w/ the body’s own self-healing mechanisms.

Many CAM therapies adhere to the principle(s) that:

  1. the body has the capacity to heal itself when NRG flow (qi) is unimpeded - “vitalism”
  2. disease occurs when the body’s NRG flow is obstructed
    - if we remove this obstruction, the body can heal itself
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22
Q

With regards to the 2nd commonality, provide 3 examples of CAM healing therapies & what mechanism they affect.

A

1) Acupuncture= qi
2) Ayurvedic medicine= prana
3) Homeopathy= vital force

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23
Q

State & explain the 3rd commonality of CAM therapies.

A
  1. Holistic approach to treatment

Many CAM therapies adhere to the principle(s) that:
1. when the body’s self-healing capacity is overwhelmed, the role of the practitioner is to remove obstacles to self-healing and free flow
of energy.
2. the goal of treatment is to restore balance, not to wage war/battle against illness.

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24
Q

State the 4th commonality of CAM therapies.

A

Involve the patient as an active participant

25
Q

What do the 4 commonalities of CAM therapies lead to?

A

Treatment individualization

26
Q

Why is patient individualization important? (name the factors)

A
  1. Psychological influences
  2. Cultural influences
  3. Enviro influence
27
Q

If you assume individualization is important. What does that mean?

A

Scientific studies become very difficult.

  • Randomized controlled studies are the gold STD for med research. It is considered to be the best way to answer qs for interventions & Tx.
  • This helps prevent biases & acendotal claims.
28
Q

Define integrative medicine.

A

The combination of conventional western medicine and CAM therapies for which there is some high-quality scientific evidence of safety and efficacy.

29
Q

Compare integrative and complementary medicine.

A
  • Both involve the combination of CAM and conventional medicine.
  • However, the CAM therapies involved in integrative have HQ scientific evidence of safety & efficacy.
30
Q

Who is the driving demand for integrative medicine?

A

The user, the consumer, the pt

31
Q

List the most common CAM therapies.

A
  1. Prayer for one’s own health (e.g. mind-body) - 43%
  2. Prayer by others - 24.4%
  3. Natural products - 18.9%
  4. Deep breathing exercises - 11.6%
  5. Participation in prayer group - 9.6%
32
Q

T/F - Dissatisfaction with conventional medicine is a predictor of CAM therapy users.

A

FALSE - <5% of CAM users avoid conventional medicine.

33
Q

What are the predictors of CAM therapy users? (8)

A

1) education**
2) poorer health status
3) a holistic orientation to health
4) having had a transformational experience that changed the person’s worldview
5) specific health problems (anxiety, back problems, chronic pain, urinary tract problems)
6) cultural creative (classified by commitment to environmentalism, feminism, interest in spirituality and personal growth psychology)
7) women - more likely to seek care in general (w/ the exception of chiro)
8) age 25-64

34
Q

What is the positive draw to CAM? (3)

A

1) safer, more natural

2) prevention (58%):
- promotes well-being (maintain health and vitality)
- emphasizes prevention of future illness

3) treat existing illness (42%) - my CAM practitioner:
- treats me as a whole person (not liver disease, not diabetic)
- spends more time & treats me as a unique individual
- is a better listener
- might help in addition to conventional medicine
- might be interesting to try

35
Q

Which types of pt are drawn to CAM therapies?

A

1) concerned well who aim to enhance their health for the LT
2) people with specific health problems, ranging from minor to major
- eg. mental health concerns, infectious disease, acute illness or injury, mental illness, long-term disability, chronic disease
3) people with a life-threatening illness
4) terminally ill
- e.g. cancer, HIV/AIDs

36
Q

List the most common CAM therapies used in Canada.

A

Most common CAM in CAD:

  1. Chiropractic 11%
  2. Massage 8%
  3. Accupuncture 2%
  4. Homeopathic/naturopathic 2%
37
Q

Describe the communication gap.

A

Pts are not talking to their providers about their use of CAM
-<30% of CAM therapies are disclosed to conventional practitioner

38
Q

From the pt’s perspective, why is there a communication gap - i.e. why pts not tell their HCPs about their CAM therapies?

A
  • doctor never asked (42%)
  • didn’t know I should (30%)
  • not enough time during office visit (19%)
  • didn’t think the doctor knew about CAM (17%)
39
Q

Describe the communication triangle.

A

1) Indie (self-care) CAM
2) Indie conventional practitioners
3) Conventional practitioners CAM practitioners

40
Q

For effective communication try thinking (blank/blank blank)

A

Product/practice continuum

41
Q

What is the continuum of therapeutic agents (3)?

A

1) Drugs: HQ, monitored, sci evidence
2) NHPs
3) Food: low health risk, low need evidence for effectiveness, prods widely available, regulated for quality

42
Q

NRG medicine - What are the two types?

A
  1. Veritable NRG fields - can be measured

2. Putative NRG fields - have yet to be measured (aka biofields)

43
Q

What is the advantage of ‘continuum’ thinking?

A

Ensures that specific categories of products/care are not classified as superior to one another, but are measured against appropriate parameters and standards of evidence

  • potency of the pharm/Tx action
  • nature of the evidence base
  • degree of regulation
  • extent of cultural acceptance
44
Q

Red flags re: “CAM practitioners” (5).

A

1) advises to stop or disparages conventional care
2) frightens patient about consequences of not using their particular treatment.
3) asks for payment in advance; offers discount for large block of treatment OR cost of care is excessive
4) makes recommendations outside of scope of practice
5) promises cure of incurable diseases

45
Q

What is the continuum of therapeutic therapies (4)?

A
  1. Conventional medicine
  2. Reflexology
  3. Homeopathy
  4. Acupuncture/chiropractic
46
Q

How should a pt choose a CAM practitioner?

A
  1. Via referral/recommendation from provider or institution or insurance or licensing boards or professional organizations
  2. Training qualification licensing, speciality?, evidence of effectiveness for complaint, time allocated to patient, Tx plan/cost
  3. Risk/benefits, SEs, Tx plan, buy equipment/supplies?
    - Could the therapy interact w/ conventional Txs?
    - Is this Tx CI’d w/ any conditions?
47
Q

Describe veritable energies

A
  • specific, measurable wavelengths & frequencies are used to treat patients
  • mechanical vibrations (e.g. sound) & electromagnetic forces (e.g. visible light, magnetism, monochromatic radiation, and rays from other parts of the electromagnetic spectrum)
48
Q

E.g. of veritable NRG use in conventional medicine to Dx or Tx disease.

A
  • MRI (electromagnetic fields)
  • cardiac pacemakers
  • radiation therapy
  • UV light for psoriasis
  • laser eye surgery
49
Q

What are the types of veritable energy therapy?

A
  1. Magnetic therapy
  2. Sound NRG therapy
  3. Light therapy
50
Q

Yellow flags re: “CAM practitioners” (6).

A

1) uses suspect Dx tests
- e.g. applied kinesiology, live blood analysis, surface electrical or temperature measurement (surface EMG, thermography, Voll testing), questionable laboratory exams
2) offers free Dx tests
3) sells vitamins, herbs, appliances or supplements that they prescribe
4) unlicensed
5) has many different designations; certificates from obscure institutions
6) exaggerates credentials

51
Q

Describe magnetic therapy.

A
  • Type of veritable energy therapy
  • Static magnets to relieve pain or increase NRG
  • Pulsating electromagnetic therapy to Tx OA, migraines, MS, sleep disorders
  • E.g. magnetic bracelets
52
Q

Describe sound energy therapy.

A

-Type of veritable energy therapy
-aka vibrational or frequency
therapy
-basis: specific sound frequencies resonate with specific organs to heal and support the body
-includes music, wind chime, and tuning fork therapy
-music therapy affects BP, reduces pain and anxiety, and modulate endorphin levels
-overlaps with mind body medicine

53
Q

Describe putative energies.

A
  • based on the concept that human beings are infused with a subtle form of energy
  • vital energy has not been unequivocally measured by any form of conventional measurement
  • therapists claim that they can work with this subtle energy, see it, and use it to influence health
  • most controversial of CAM therapies
54
Q

Describe light therapy.

A
  • Type of veritable energy therapy
  • high intensity light therapy for Seasonal Affective Disorder
  • used with less evidence for general depression and sleep disorders
  • low-level laser therapy is claimed to be useful for pain,inflammation, and wound healing
55
Q

Veritable v putative energies - which one is more controversial?

A

Putative !

56
Q

Describe acupuncture.

A

-type of putative energy therapy
-most prominent therapy (to promote qi flow)
-effective for some forms of pain
-MOA: unclear, but may involve regional effects on
neurotransmitter expression
oexistence of “energy” has not been validated

57
Q

Describe homeopathy.

A
  • type of putative energy therapy

- remedies mobilize the body’s vital force

58
Q

Describe Therapeutic Touch, Reiki & related practices.

A
  • type of putative energy therapy
  • movement of the practitioner’s hands over the patient’s body
  • attuned to the condition of the pt
  • practitioner may strengthen and reorient the patient’s energies
59
Q

Name 3 examples of putative energy therapy.

A
  1. Acupuncture
  2. Homeopathy
  3. Therapeutic touch, Reiki & related practices

AIII-Natural Health Products (19 decks)

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