Teacher Guide for CAM (PHA 045) Module #1 PDF

Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class...

Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ Lesson Title: Introduction to Integrative Medicine Materials: Lesson Objectives: By the end of this module, the students Pen or Pencil should be able to SAS 1. Explain the principles of integrative medicine. References: 2. Identify the general applications of Integrative Medicine in What is Integrative pharmacy practice and the integral role of the pharmacist in Medicine? (n.d.). The its implementation. Andrew Weil Center for 3. Define some important terms related to Integrative Medicine Integrative Medicine. and Complementary and Alternative Medicine. https://integrativemedicine. 4. arizona.edu/about/definition.html https://dukeintegrativemedi cine.org/about/what-is- integrative-medicine/ Productivity Tip: Before you start, give your brain and body a boost of energy by doing stretching and push ups (or any light cardio exercise you can do in your home), breathe deeply, and shout your inspirational message to start your learning journey (e.g., “Laban!”, “Kaya ko to!”, “Fighting!” etc.) Don’t forget to hydrate yourself occasionally. During the time you are studying, don’t forget to write the important key concepts or words to maximize your learning. And lastly, don’t forget to rest very well after every study session. A. LESSON PREVIEW/REVIEW 1) Introduction (1 min) Integrative medicine is an approach to wellness that combines: Conventional (traditional Western) medicine, which includes drugs, surgery, and lifestyle changes. It helps maximize wellness for people with chronic and complex diseases. It combines conventional and complementary medicine practices. This principle of complementarity is at the heart of integrative medicine. An abundance of research shows that integrating multiple forms of medicine in a complementary way can have an additive effect and can be more effective than relying on any one approach by itself. This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ 2) Activity 1: What I Know Chart, part 1 (2 mins) Instruction: On the table next page, write on the first column on what you know about on this topic based on the question next to it. No worries if you aren’t sure with your answer for this is only your guide on what you and what to focus for this topic. Keep the third column blank as you will encounter them again on the part 2. What I Know Questions: What I Learned (Activity 4) 1. What is the difference between complimentary and integrative medicine? 2. What is the role of the Pharmacist in the Integrative Medicine? B.MAIN LESSON 1) Activity 2: Content Notes (30 mins) Instructions: Highlight and take note the important concepts you will encounter in the module. Integrative Medicine (IM) is a healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies. – Andrew Weil, MD ✓ Also known as integrative health care which means bringing conventional and complementary approaches together in a coordinated way. – National Center for Complementary and Integrative Health (NCCIH) Key Concepts 1. Patient-centered Care This means putting the patient at the center of the provider’s care, partnering with the patient, and removing patient labels. Hence, this allows for providers to help patients to look at their goals and desires for their optimal health. 2. Inclusive Approach The inclusive approach to healthcare means that providers utilize evidence-based approaches as well as complementary medicine modalities, therapies, and treatments. Integrative medicine providers have expertise in the research and literature so that they can effectively integrate different techniques when customizing a patient’s plan of care. 3. Self-Actualization Integrative medicine providers do not simply focus on treating a disease but rather work with patients to help them achieve self-actualization (optimal vitality) and thrive. This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ The Defining Principles of Integrative Medicine 1. Patient and practitioner are partners in the healing process. 2. All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body. 3. Appropriate use of both conventional and alternative methods facilitates the body's innate healing response. 4. Effective interventions that are natural and less invasive should be used whenever possible. 5. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically. 6. Good medicine is based in good science. It is inquiry-driven and open to new paradigms. 7. Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount. 8. Practitioners of integrative medicine should exemplify its principles and commit themselves to self- exploration and self-development. Historical Milestones of Integrative Medicine and Health 1. Development of Wellness Programs The people became more proactive about preventing diseases and taking responsibility for their own health. Hence, the people became aware of the benefits of exercise and nutrition in preventing high cholesterol levels, heart attacks, and stroke and likewise to lose excess pounds and to quit smoking. 2. Development of Health Promotion Programs The importance of wellness and health promotion programs is that people began to be enthusiastic about the value and benefits of a healthy lifestyle. People began to investigate ways to make themselves feel better through rest, stress management, exercise, and better eating habits. All of this paved the way for a natural progression of examining other treatment modalities, many of which came from European and Eastern countries. Why Do People Seek Alternative Forms of Medical Care? 1. They may be dissatisfied with conventional treatment as expensive, impersonal, and ineffective. 2. Alternative forms of treatment may be compatible with users’ own values and spiritual beliefs regarding the nature of their illness. 3. People may desire a greater sense of control over their own treatment and seek out a doctor who will allow them choices about their own health care. 4. Many individuals who use CAM tend to be innovative and at the cutting edge of cultural change. 5. They are very interested in the environment and the world and possess a great sense of spirituality. Applications of Integrative Medicine in Pharmacy Practice: 1. Dietary supplements 2. Herbal medicines 3. Homoeopathic remedies 4. Aromatherapy oils This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ Types of CAM Recommended by Pharmacists Community pharmacists’ knowledge, practices and beliefs about complementary and alternative medicine in Palestine: a cross-sectional study Naser Y. Shraim, RamziShawahna,Muna A. Sorady,Banan M. Aiesh,Ghadeer Sh. Alashqar,Raghad I. Jitan,Waed M. Abu Hanieh,Yasmeen B. Hotari,Waleed M. SweilehandSa’ed H. Zyoud BMC Complementary and Alternative Medicine BMC series – open, inclusive and trusted201717:429 Integral Role of Pharmacists: 1. Providing information on the appropriate use of CAM. This should include not only those products sold in the pharmacy but also those products and therapies received by patients outside of the pharmacy. 2. Asking customers questions about their use of CAM. 3. Being aware of potential adverse reactions and interactions with conventional medicines. 4. To ensure that stocks of homoeopathic medicines or herbal medicines or other complementary therapies are obtained from a reputable source of supply. Motivating Factors Reported by the Pharmacists toward Recommendations for Complementary and Alternative Medicine Use: 1. Product efficacy is scientifically proven. 2. Positive responses from customers on the effectiveness of the product. 3. Fewer side effects. 4. Doctors’ recommendations. 5. Less expensive. 6. Publicity of the product. 7. Highest profit. 8. Recommendations from Medical Representatives 9. Incentives from manufacturers This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ Types of Information needed in order to make appropriate recommendations by the Pharmacists about CAM 1. Drug interaction 2. Precautionary Measures (especially when Use by Pregnant and Children) 3. Side Effects 4. Indications 5. Dose 6. Patient Information (especially age, sex, Medications taken, History of patient’s illness) 7. Manufacturer Information Resources Used by Pharmacists 1. Drug Information phone services 2. Specific TV channels 3. Industry representatives 4. Professional seminars or conferences 5. Colleagues 6. CAM journals 7. Industry magazines or materials 8. Facebook 9. Medical Peer reviewed Journals 10. Product Package Instructions 11. CAM textbooks 12. Formal Pharmacy Education 13. Specific Website Complementary and Alternative Medicine or 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. National Center for Complementary and Integrative Health, (NCCIM). ✓ is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. ✓ includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being (O’Connor et al 1997) ✓ is an umbrella term used to describe a range of health systems, modalities and practices that may have little in common other than that they are practiced alongside or as an alternative to mainstream medicine- (Ministerial advisory committee on Complementary and alternative health July 2004). Philosophy of CAM 1. Focuses on empowering the individual to accept responsibility for at least a part of the task of recovery and future health maintenance. 2. Emphasizes sound nutrition as a core requirement for health. 3. Recommends a balanced lifestyle, adequate and appropriate exercise, rest, sleep, and relaxation as prerequisites for a state of good health 4. Attempts to ensure detoxification and the efficacy of the organs and systems of the body This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ 5. Recognizes the importance of the musculoskeletal system as a potential source of interference with nerve transmission and the body’s energy pathways, and as a reflection of the individuals internal physical and emotional state 6. Most importantly, treats the individual instead of his or her symptoms Categories of CAM Therapies 1. Mind-Body Medicine Mind-body therapies affect the mind’s ability to influence physiological functions as well as to improve feelings of well-being. Mind-body medicine encompasses a number of therapies, including meditation, biofeedback, hypnosis, guided imagery, visualization, relaxation therapy, art and music therapy. Increasingly, these therapies are being offered within conventional cancer care settings because of recent evidence that these therapies can enhance the quality of life of cancer patients. 2. Biological-based Practices Biological-based practices include natural health products, such as vitamins, minerals and herbs. 3. Manipulative and Body-based Practices Manipulative and body-based practices include a large group of therapies such as chiropractic and massage therapy as well as many other manual therapies. In particular, massage has become a popular therapy that is increasingly recognized by both health professionals and patients as a beneficial addition to conventional cancer treatment to reduce anxiety, depression, pain, and fatigue. 4. Energy Medicine Energy therapies are a group of CAM therapies that focus on influencing human energy fields and include such therapies as reiki, therapeutic touch, healing touch, magnet therapy and qi gong. Underlying many of these energy therapies is the belief that treatment is needed to either “balance” energy in the body or to relieve blockages of energy. Some energy therapies, such as therapeutic touch and healing touch, have a long tradition of being part of conventional health professions’ scope of practice (i.e., nursing) and have been offered within cancer care settings in recent years. 5. Whole Medical Systems Are based on complete systems of theory and practice and involve a range of modalities. These whole medical systems include traditional healing, naturopathy, traditional Chinese medicine, and Ayurveda. Four Major Elements of CAM 1. The first element is the association of CAM with nature - a metaphor for many alternative medicines or therapies. For example, food that is labeled as organic rather than processed is desirable. CAM therapies are supposedly more natural than artificial and pure rather than synthetic. 2. The second element identified was vitalism - The body’s capacity to heal itself. The enhancement or balancing of life forces, qi (chi), or psychic energy is a main theme and belief in the concept of vitalism. These life forces are not a physical force but are related to energy within the body that is capable of healing. For patients, there is intuitive appeal in this non-invasive notion of healing from within. This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ 3. The third element identified was science. Alternative medicine’s scientific process may match the steps of biomedical scientific techniques, but it depends greatly on observation. Alternative medicine is a more person-friendly science that embraces the concept of holism (connectedness of physical, mental, spiritual, emotional health). Sickness is viewed as a result of a weakened body that has fallen into an unbalanced condition. As such, it is remedied by overall strengthening of the body’s natural resistance to disease. The human experience becomes the central element of CAM science rather than being marginalized. 4. The fourth element was the aspect of spirituality. Spirituality does not refer particularly to religiosity, although for some, it may. Religion or spiritual experiences become important as people view health, illness, and healing. CAM offers a satisfying unification of the physical and spiritual because it bridges the gap between the domain of medical science and religion or spirituality, and the patient is allowed to make connections with nature and the universe This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ Evidence on the use of CAM This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ The Future of CAM Therapy I. Enlisting Support from Insurers and Providers 1. More and more insurers are covering alternative care, at least to some degree. 2. Support from professional organizations, such as the AMA, is increasing as more physician training programs require or offer electives in alternative treatment modalities. 3. CAM can offer new avenues to better health, but it is up to you to make sure that you are on the right path. II. CAM and Self-Care 1. Consult only reliable sources—texts, journals, and periodicals. 2. Remember that natural does not equal safe. 3. Realize that no one is closely monitoring herbal supplements. 4. Dosage levels may vary in herbal products. 5. Tell your doctor what you are taking, as interactions could occur. 6. Look for the word standardized or for the “USP Dietary Supplement Verified” seal. Definition of Terms. The following terms shall mean: (a) Allopathic Medicine - Western medicine, biomedicine, scientific medicine or modern medicine (b) Alternative health care modalities – other forms of non-allopathic, occasionally non-indigenous or imported healing methods, though not necessarily practiced for centuries nor handed down from one generation to another. Some alternative health care modalities include reflexology, acupressure, chiropractic, nutritional therapy, and other similar methods. (c) Alternative Medicine is used in place of conventional medicine (d) Biomedicine – that discipline of medical care advocating therapy with remedies that produce effects differing from those of the diseases treated. It is also called “allopathy”, “western medicine”, “orthodox medicine”, or “cosmopolitan medicine”. (e) Complementary Medicine: is used together with conventional medicine (f) Complementary and Alternative Medicine - a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. (g) Functional foods — foods or supplements designed to improve some specific aspect of physical or mental functioning (h) Herbal medicines – finished, labelled, medicinal products that contain as active ingredient/s serial or underground part/s of plant or other materials or combination thereof, whether in the crude state or as plant preparations. - Plant material includes juices, gums, fatty oils, essential oils, and other substances of this nature. Herbal medicines, however, may contain excipients in addition to the active ingredient(s). Medicines containing plant material(s) combined with chemically-defined active substances, including chemically-defined, isolated constituents of plants, are not considered to be herbal medicines. (i) Integrative Medicine - combines conventional and CAM treatments for which there is evidence of safety and effectiveness. (j) Intellectual property rights – is the legal basis by which the indigenous communities exercise their rights to have access to, protect, control over their cultural knowledge and product, including, but not limited to, traditional medicines, and includes the right to receive compensation for it. (k) Natural product – those foods that grow spontaneously in nature whether or not they are tended by man. It also refers to foods that have been prepared from grains, vegetables, fruits, nuts, meats, fish, eggs, honey, raw milk, and the like, without the use or addition of additives, preservatives, artificial colors and flavors, or manufactured chemicals of any sort after harvest or slaughter. This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ (l) Nutraceuticals— provide combined nutritional and pharmaceutical benefit Traditional medicine – the sum total of knowledge, skills, and practice on health care, not necessarily explicable in the context of modern, scientific philosophical framework, but recognized by the people to help maintain and improve their health towards the wholeness of their being, the community and society, and their interrelations based on culture, history, heritage, and consciousness. (m) Manufacture – any and all operations involved in the production, including preparation, propagation, processing, formulating, filling, packing, repacking, altering, ornamenting, finishing, or otherwise changing the container, wrapper, or labelling of a consumer product in the furtherance of the distribution of the same from the original place of manufacture to the person who makes the final delivery or sale to the ultimate consumer. (n) Traditional and alternative health care – the sum total of knowledge, skills and practices on health care, other than those embodied in biomedicine, used in the prevention, diagnosis and elimination of physical or mental disorder. (o) Traditional healers – the relatively old, highly respected people with a profound knowledge of traditional remedies. Activity 3: Skill-building Activities (10 mins) A. Essay. In your own words, kindly explain in 1 to 2 sentences only and give an example situation that will achieve the following principle of integrative medicine. 1. “Patient and practitioner are partners in the healing process” ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 2. “Effective interventions that are natural and less invasive should be used whenever possible.” ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ B. Essay. Give the four applications of integrative medicine in pharmacy practice and give examples each This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ C. Essay. In 1 to 2 sentences only, how will you apply your role as a Pharmacist in the Integrative medicine? D. Matching type. Match the following with the correct answer. Write your answer in CAPITAL LETTER before the number. _________1. is the legal basis by which A. Intellectual property rights the indigenous communities exercise B. Integrative Medicine their rights to have access to, protect, C. Traditional healers control over their cultural knowledge and D. Alternative Medicine product, including, but not limited to, E. Allopathic Medicine traditional medicines, and includes the F. Functional foods right to receive compensation for it. G. Natural product _________2. the relatively old, highly respected people with a profound knowledge of traditional remedies. _________3. is used in place of conventional medicine _________4. foods or supplements designed to improve some specific aspect of physical or mental functioning _________5. combines conventional and CAM treatments for which there is evidence of safety and effectiveness. 2) Activity 4: What I Know Chart, part 2 (3 mins) To review what was learned from this session, please go back to Activity 1 and answer the “What I Learned” column. Notice and reflect on any changes in your answers. 3) Activity 5: Check for Understanding (10 mins) Now it’s time for you to figure this one out on your own! Take time to read, analyze, and understand the following scenarios. Answer key will be provided during our discussion session. A. Multiple Choice: Choose the best and correct answer to every question. Write the CAPITAL LETTER of your final answer before the number. _____1. All but one is key concepts of integrative Medicine? A. Patient centered C. Inclusive approach B. Evidence based D. none of the choices This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ _____2. The elements of CAM are as follows, EXCEPT A. Patient centered C. none of the choices B. Evidence based D. all of the choices _____3. The following are the common diseases and conditions for which Complementary and Alternative Therapy is used, EXCEPT FOR A. Back pain C. cancer B. insomnia D. anxiety _____4. In Integrative medicine, all factors that influence health, wellness and disease are taken into consideration, including body, mind spirit and community. A. TRUE B. FALSE _____5. Treatments from conventional medicine and CAM for which there is some high-quality evidence of safety and effectiveness A. Alternative medicine C. Integrative medicine B. Complementary medicine D. Traditional medicine _____6. Dietary supplements needed in the following in spite of proper diet; EXCEPT: A. Pregrant and lactating women C. Alcohol and drug abuse B. People with robust appetite D. extensive injuries or have undergone surgery _____7. The Don’ts in Dietary Supplement, except; A. Don’t take dietary supplements with low concentration of iron B. Don’t use products that are labeled high potency C. Don’t take mega doses of diet supplements unless monitored by physicians D. Don’t succumb to random recommendations even if they were well-meant _____8. Based on the survey conducted among Americans the following uses CAM more often; A. Those with gastrointestinal disorders or sleeping problems B. Those hospitalized within the past year C. People with levels of higher education D. Former smokers _____9. The following are among the ten most common CAM therapies among US adults, except; A. Natural products C. Massage B. Yoga D. Acupuncture _____10. All are true about Special Supplements; except A. Not all supplements on the market today are directly derived from plant sources B. Increasing reports in the media on the health benefits of various vitamins, minerals, amino acids, and other specific biological compounds C. All of the choices D. None of the choices This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ C. LESSON WRAP-UP 1) Activity 6: Thinking about Learning (5 mins) A. Work Tracker You are done with this session! Let’s track your progress. Shade the session number you just completed. P1 P2 1 2 3 4 5 6 7 8 9 10 B. Think about your Learning Tell me about your thoughts for today’s lesson! 1. What interests you about the lesson today? 2. Do you have questions in mind that you are interested to be discussed? Please write it down. FAQs 1. What is the common CAM used by the Filipino patients in the Philippines? According to the study entitled “Complementary and alternative medicine among Filipinos: Prevalence, costs and patterns of use” (Morfe et al.), Herbal medicine, manipulative and aromatherapies were the most popular CAM forms used by the respondents in the study. Source: Morfe, J.H.D. & Lim, V.S.. (2013). Complementary and alternative medicine among Filipinos: Prevalence, costs and patterns of use. Phillippine Journal of Internal Medicine. KEY TO CORRECTION in ACTIVITY 3 A. 1. Answers may vary 2. Answers may vary B. (Examples to each may vary) 1. Dietary supplements 2. Herbal medicines 3. Homoeopathic remedies 4. Aromatherapy oils C. 5. Answers may vary D. This document is the property of PHINMA EDUCATION  Course Code: PHA 045 (Complimentary Alternative Medicine) Teachers’ Guide Module #1 Name: _________________________________________________________________ Class number: _______ Section: ____________ Schedule: ________________________________________ Date: ________________ 1. A 2. C. 3. D 4. F. 5. B. TEACHER-LED ACTIVITIES {These are standard instructions for teachers.} A. If this session happens to be a face-to-face, in-classroom learning session: 1) Collect completed work in the SAS. 2) Allocate your contact time with students to individual or small group mentoring, monitoring, and student consultations. 3) You may administer summative assessments (quizzes, demonstrations, graded recitation, presentations, performance tasks) during face-to-face sessions. 4) You may also explore supplementary activities that foster collaboration, provided that social distancing is observed. 5) You may provide supplementary content via videos, etc. It is important to remember that students who cannot make it to face-to-face, in-classroom sessions for health and safety reasons, should not be given lower grades for missing in-class activities and should be given alternative summative tests. B. If this session happens to be an at-home learning session for the students: 1) Check and grade collected SAS and other input from students. 2) Schedule phone calls/virtual calls/virtual chats to individual students or small groups of students to monitor work, provide guidance, answer questions, and check understanding. This document is the property of PHINMA EDUCATION