Perspectives on Complementary and Alternative Medicines (CAM) (#631)
Aim: To gain a perspective on the scope and meaning of CAM.
Method: 24 authors including traditional and CAM practitioners, researchers, educators, regulators and consumers were recruited to write about CAM from their perspectives.
Results: The definitions of CAM were problematic. The same therapy could complement traditional therapy, be used as an alternative or if assessed by randomised clinical trials, become a mainstream treatment. Whether a therapy is classified as a CAM may be culturally based (e.g. Chinese vs. Western). Classification by mechanism of action may be unhelpful since this can be unknown for both traditional therapies and CAM, or explanations such as external energy forces in CAM may have no counterpart in Western medicine. Distinctions between “natural” therapies and pharmaceuticals blur when vitamins are used in high dose like pharmaceuticals, or antioxidants in foods are extracted and prescribed as supplements. Studies on CAM usage can depend on classification, e.g. whether a widespread practice such as prayer is counted as a CAM or not. Perspectives on research differ. The Western approach isolates the active agent and trials it, whereas Chinese medicine relies on interactions of multiple natural products. A literature analysis prior to us performing a triple-blind randomised trial of intercessory prayer showed a resistance to investigating CAM where the mechanism is opaque to scientific investigation. Finally, consumers who were found to be polarised in their views on CAM in a qualitative study often wanted to speak to their clinicians about CAM but would not do so if they sensed disapproval. Their doctors should, at least, be able to advise on interactions of drugs with CAM.
Conclusions: A broadly based expert group on CAM had diverse views. Integrative clinics may bridge the gap between CAM and traditional medicine and make it easier for consumers to understand what is being offered.