Integrative and Alternative Medicine Overview

Study Notes

Integrates conventional and complementary therapies to achieve optimal health and healing.
Focuses on the person as a whole, considering their illness or disease.
Employs an evidence-based approach.

A group of diverse medical and healthcare systems, practices, and products that are not presently considered part of conventional medicine.

Too few studies on some topics.
Studies are often of poor quality.
Small funding, small samples, and inexperienced researchers.
Easier to fund patentable products like drugs rather than natural products.
Research design may not reflect clinical practice as many therapies are holistically practiced, making it difficult to isolate one treatment aspect.
Difficulties with placebos and blinding, for example, procedures like acupuncture, lifestyle interventions, and counselling.
Challenges in choosing appropriate outcome measures, such as disease progression vs. quality of life vs. symptom relief.
Bias, such as uncritical acceptance of CAM among CAM practitioners or rejection among doctors.

Provides answers to efficacy, effectiveness, efficiency, safety, mechanisms.
Addresses limitations of evidence, interpretation bias, research agenda.
The best approach to clinical decision making combines the best available evidence with individual clinical circumstances.

Many studies have had encouraging results in terms of symptom control.
No definitive evidence suggests CAM treatment alters disease progression in breast cancer patients.
Several modalities seem to improve other outcomes.

"There is no evidence" can mean the study was methodologically unsound or the sample was too small to statistically demonstrate an effect.
It can also indicate a non-significant or statistically significant negative effect.
It can mean the topic has not been studied yet.

Respect and listen to the patient's views.
Think integrative, not alternative.
Check the evidence, even if it means asking the patient to return after conducting further research.
Encourage the use of proven therapies.
Discourage disproven, unsafe, or exorbitantly expensive therapies.