Will duct tape cure my warts? Examining Complementary and Alternative Medicine - PowerPoint PPT Presentation

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Will duct tape cure my warts? Examining Complementary and Alternative Medicine

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  1. Will duct tape cure my warts? Examining Complementary and Alternative Medicine National Network of Libraries of Medicine South Central Region

  2. Agenda • Definitions • History and Impact • Usage and Therapies • Evaluating Web Sites • Avoiding Bad Science • Recommended Websites • Reviewing the Evidence

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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)

  8. 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

  9. Diseases and Conditions* • 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

  10. Top 5 CAM Therapies* • Natural products, dietary supplements • Deep breathing exercises • Meditation • Chiropractic • Yoga *Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC

  11. Echinacea Ginseng Ginkgo biloba Garlic Glucosamine St. John’s Wort Peppermint Fish oil/Omega 3 Ginger Soy Top 10 Supplements* *Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC

  12. 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

  13. 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

  14. 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

  15. 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

  16. Energy Medicine • Veritable - energy that can be measured • Includes sound, visible light, magnetism • Putative – energy that has yet to be measured • human beings are infused with a subtle form of energy • Includes qi (ki in Japanese); doshas; prana, homeopathic resonance *National Center of Complementary and Alternative Therapy

  17. Energy Medicine - Acupuncture • Few complications • Scientific evidence? • post chemotherapy management of nausea • pain relief • NIH Consensus Statement (1997) • http://consensus.nih.gov/1997/1997Acupuncture107html.htm

  18. 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, rolfing, Alexander technique,Feldenkrais method *National Center of Complementary and Alternative Therapy

  19. 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

  20. Other CAM Therapies • Aromatherapy • Colonic Irrigation • Therapeutic Touch • EDTA Chelation • Cupping • Primordial Sound Meditation

  21. 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

  22. Evaluating Web Sites • Accuracy • Authority • Bias • Currency • Coverage

  23. 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

  24. 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

  25. Reviewing the Evidence • Evidence Based Medicine: “What evidence do we have to justify the treatment…” • National Center for Complementary and Alternative Medicine (NCCAM) • CAM on PubMed

  26. Thank You! National Network of Libraries of Medicine South Central Region 800-338-7657