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Finding Quality Online Information about Complementary and Alternative Medicine (CAM) National Network of Libraries of Medicine New England Region The headlines…. With the constant flux of new information on CAM… 1) How can we find information that is evidence based?

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finding quality online information about complementary and alternative medicine cam

Finding Quality Online Information about Complementary and Alternative Medicine (CAM)

National Network of Libraries of Medicine

New England Region

with the constant flux of new information on cam
With the constant flux of new information on CAM…

1) How can we find information that is evidence based?

2) What are the top consumer health and clinical resources to find quality information about CAM?

3) How can we help our patrons evaluate CAM information?

agenda
Agenda
  • Definitions
  • History and Impact
  • Usage and Therapies
  • Evaluating Web Sites
  • Avoiding Bad Science
  • Recommended Websites
  • Reviewing the Evidence
how do you get rid of a wart

garlic pills

cabbage

alfalfa pills

e

castor oil

banana peel

iodine

toothpaste

How do you get rid of a wart?

potato

windex

nail polish

raw meat

silk thread

duct tape

witch hazel

aloe

dandelion juice

cigarette ashes

apple cider

quarters

c

orange peel

what is cam
What is CAM?
  • Complementary and Alternative Medicine
  • Complementary: together with
    • aromatherapy to help with pain after surgery
  • Alternative: in place of
    • using garlic to lower blood pressure
cam becomes legit
CAM becomes “legit”
  • 1990
    • Wilk et al v. AMA
  • 1991
    • $2 million in funding to establish NIH Office of Alternative Medicine
  • 1994
    • Dietary Supplement Health and Education Act
cam becomes legit8
CAM becomes “legit”
  • 1995
    • NIH Office of Dietary Supplements http://ods.od.nih.gov/
    • FDA declassifies Acupuncture needles as experimental product
  • 1996
    • NIH Consensus Conference on Acupuncture
  • 1997
    • First large trial of CAM therapy, St. John’s Wort for depression
cam becomes legit9
CAM becomes “legit”
  • 1998
    • National Center for Complementary & Alternative Medicine (NCCAM) established http://nccam.nih.gov/
    • First full scale article in JAMA on herbal medicine
    • Office of Cancer Complementary and Alternative Medicine (OCCAM) established http://www.cancer.gov/cam/
  • 2001
    • CAM on PubMed (NCCAM and NLM)
impact of cam
Impact of CAM
  • CDC Report (2004)
    • 36% of adults used some form of CAM
    • 55% CAM + conventional treatments
    • 26% used CAM because a medical professional suggested it
    • $36-47 billion on CAM therapies in 1997
    • $5 billion on herbal remedies
  • JAMA (1998)
    • 12.1% of population use herbal medicine
impact of cam11
Impact of CAM

According to the National Health Statistics Report of the CDC, in 2007:

  • 4 out of 10 adults used a CAM therapy in the last 12 months
  • 1 out of 9 children used CAM therapies in the last 12 months
  • Between 2002 and 2007 increased use was seen among adults for acupuncture, deep breathing, massage therapy, meditation, naturopathy, and yoga
diseases and conditions 2002
Diseases and Conditions 2002
  • Back pain or problem
  • Head or chest cold
  • Neck pain or problem
  • Joint pain or stiffness
  • Anxiety/depression
  • Arthritis, gout, lupus or fibromyalgia
  • Stomach or intestinal illness
  • Severe headache or migraine

*Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC

diseases and condition 2007
Diseases and Condition 2007
  • Back pain
  • Neck pain
  • Joint pain or stiffness
  • Arthritis
  • Other, specify
  • Anxiety
  • Cholesterol
  • Head or Chest Cold
top 5 cam therapies 2002
Top 5 CAM Therapies 2002
  • Natural products, dietary supplements
  • Deep breathing exercises
  • Meditation
  • Chiropractic
  • Yoga

Top 5 CAM Therapies 2007:

Same as 2002

*Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC

top 10 supplements 2002
Echinacea

Ginseng

Ginkgo biloba

Garlic

Glucosamine

St. John’s Wort

Peppermint

Fish oil/Omega 3

Ginger

Soy

Top 10 Supplements 2002

Top supplement for 2007?

*Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC

top 10 supplements 2007
Top 10 Supplements 2007
  • Fish Oil or Omega 3 or DHA
  • Glucosamine
  • Echinacea
  • Flaxseed oil or pills
  • Ginseng

6. Combination herb pill

7. Ginkgo biloba

8. Chondrotin

  • Garlic Supplements
  • Coenzyme Q-10
categorization of therapies
Categorization of Therapies*
  • Whole Medical Systems
  • Biologically Based Practices
  • Energy Medicine
  • Manipulative and Body-Based Practices
  • Mind-Body Medicine

*National Center of Complementary and Alternative Therapy

whole medical systems
Whole Medical Systems
  • Complete systems of theory and practice that evolved independently
  • Traditional systems of medicine that are practiced by individual cultures throughout the world
    • Includes traditional Chinese medicine, Ayurvedic medicine, homeopathy, naturopathy

*National Center of Complementary and Alternative Therapy

biologically based practices
Biologically Based Practices
  • Includes: botanicals, animal-derived extracts, vitamins, minerals, fatty acids, amino acids, proteins, whole diets, and functional foods
    • Dietary supplements are a subset of biologically based practices

*National Center of Complementary and Alternative Therapy

biologically based supplements
Biologically Based - Supplements
  • What is a supplement?
  • Regulated by FDA http://www.fda.gov
    • no requirements for FDA testing
    • manufacturers responsible for ensuring product safety
    • label requirements
    • safety alerts: http://www.cfsan.fda.gov/~dms/ds-warn.html
energy medicine
Energy Medicine
  • Biofield therapies: qi gong, Reiki, Therapeutic touch, Bioenergetics
  • Bioelectricmagnetic based therapies:

Electromagnetic fields, magnetic fields

*National Center of Complementary and Alternative Therapy

manipulative and body based
Manipulative and Body-Based

Structures and systems of the body,

including the bones and joints, the soft

tissues, and the circulatory and lymphatic

systems. Includes:

  • chiropractic manipulation
  • massage therapy
  • reflexology
  • Alexander technique
  • Feldenkrais method

*National Center of Complementary and Alternative Therapy

mind body medicine
Mind-Body Medicine
  • Interactions among the brain, mind, body, and behavior
  • The ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health. Includes:
    • relaxation
    • hypnosis
    • visual imagery
    • meditation
    • yoga
    • biofeedback
    • tai chi
    • group support and
    • spirituality

*National Center of Complementary and Alternative Therapy

other cam therapies
Other CAM Therapies
  • Aromatherapy
  • Colonic Irrigation
  • Therapeutic Touch
  • EDTA Chelation
  • Cupping
  • Primordial Sound Meditation
avoiding bad science
Avoiding Bad Science
  • The “One Product Does It All” claim

http://www.emuoilcanada.com/

  • Personal Testimonials http://www.getslimslippers.com/
  • Quick Fixes/Cures

http://www.cure-your-asthma.com

  • The “No Risk Money Back Guarantee” http://www.naturalhpvcure.com/
  • The “Natural” claim

http://www.amtrueman.com/products.html

evaluating web sites
Evaluating Web Sites
  • Accuracy
  • Authority
  • Bias
  • Currency
  • Coverage
  • User Friendliness
examining the research
Examining the Research
  • Observational Studies
  • Clinical Trials/Studies
    • controlled
    • blind/double-blind
    • randomized
  • ClinicalTrials.gov
    • Government and private clinical studies involving humans
    • http://clinicaltrials.gov
clinical trials and cam
Clinical Trials and CAM
  • Why are there so few CAM clinical trials?
    • Drug companies have to do studies to go on the market—supplement companies do not, so clinical trials sponsored by supplement companies are rare
    • Alternative treatments are often customized for a specific person. Clinical trials try to prove something works for most people.
    • Belief systems of some CAM practitioners do not agree with the idea of Western studies, so they do not participate
    • CAM has only recently become “legit” in the scientific community
take home points
Take home points
  • Learn more about commonly used CAM to help you better serve your library users
  • Familiarize yourself with quality online resources for CAM
  • Be a “selective searcher”…evaluate online CAM information carefully
slide39
Thank You!

Michelle Eberle

Consumer Health Information Coordinator

michelle.eberle@umassmed.edu

National Network of Libraries of Medicine

New England Region

800-338-7657