Complementary and alternative therapies

Obtain a thorough history of non-prescription and prescription drug use and complementary and alternative therapies utilized, as well as identifying medication allergies. 

Fairfield KM, Eisenberg DM, Davis RB, Libman H, Phillips RS. Patterns of use, expenditures, and perceived efficacy of complementary and alternative therapies in HIV-infected patients [see comments]. Arch Intern Med 1998 158(20) 2257-2264. 

Continuing in the tradition of the acclaimed first edition. Pharmacodynamic Basis of Herbal Medicine, Second Edition examines in extensive detail the physiologic effects of complementary and alternative therapies, foods, supplements, vitamins, and traditional herbal remedies. This encyclopedic volume considers the site, mode, and mechanism of action to explain the desired and adverse effects and interactions of each herb, drug, and food. 

Bowling AC, Stewart TM. Current complementary and alternative therapies for multiple sclerosis. Curr Treat Options Neurol 2003 5 55-68. 

Integrative metlicine using complementary and alternate therapies... 

Conventional drag development normally follows an orderly process of preclinical studies using animals and cell cultures as well as phase I, phase II, and phase III studies, with the latter phase consisting of human clinical trials using large numbers of subjects. This orderly procedure does not usually lead to the development of complementary and alternative therapies, which traditionally and historically are based on anecdotal reports and word of mouth. Furthermore, there is usually little isolation of active ingredients from crude products. Little, if any, preclinical testing is conducted in the development of complementary and alternative therapies, and double-blind clinical studies are rarely involved. 

An exception to the normal evolutionary development of complementary and alternative therapies has been the discovery and development of Taxol (paclitaxel) from the bark of the Pacific yew tree (T. brevifolid), which is now widely used as a chemotherapeutic agent. The isolation, characterization, clinical, and preclinical studies involving Taxol have followed the conventional pathway to FDA approval and subsequent marketing. Wall and Wani have summarized the historical development from discovery to clinical use of Taxol. 

Beal, M.W. 1998. Women s use of complementary and alternative therapies in reproductive health care. /. Nurse-Midioifery 43 (3) 224-234. 

Cassileth, B.R. (1999). Evaluating complementary and alternative therapies for cancer patients. Cancer Journal of Clinicians, 49 (6), 362-375. 

Complementary and alternative medicine therapies, such as acupuncture, biofeedback, chiropractic manipulation, dietary supplements, herbal therapy, and homeopathic preparations, are used by individuals with allergic rhinitis.29,30 Use of bromelain, gingko, ginseng, licorice, quercetin, and Urtica dioica has been reported, but large-scale studies documenting efficacy are lacking.31,32 Caregivers should inquire routinely about patients use of alternative therapies and counsel patients about the lack of validated data to support such practices.12... 

Complementary and alternative medicines A group of practices and products that are not presently considered to be part of conventional medicine, including alternative medical systems (e.g., homeopathic medicine and naturopathic medicine), mind-body interventions (e.g., meditation and mental healing), biologically-based therapies (e.g., dietary supplements, vitamins, herbs, and other natural products), manipulative body-based methods (e.g., acupuncture and massage), and energy therapies (e.g., therapeutic touch and bioelectromagnetic-based therapies). 

Complementary and alternative medicine, which includes a range of practices outside of conventional medicine such as herbs, homeopathy, massage therapy, yoga, and acupuncture, hold increasing appeal for Americans. In fact, according to one estimate, 42% of Americans have used alternative therapies. In all age groups, the use of unconventional healthcare practices has steadily increased in the last 30 years, and the trend is likely to continue, although people born before 1945 are the least likely to turn to these therapies. 

Complementary and alternative medicine CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]... 

The prevalence of complementary and alternative medication (CAM) is increasing among older adults. In a recent report, nearly two thirds of ambulatory elderly used at least one form of CAM, but much of CAM use was unrecognized by physicians, CAMS have been associated with adverse events (Table 9) and important drug interactions between CAMs and conventional drug therapies have been... 

Because of the interest in and popularity of alternative and complementary medicines and healing practices, the scientific method is being applied to a wide variety of these remedies. Different types of studies seek to establish if and how individual, alternative medicines exert their effect. Clinical trials are being conducted to compare a specific alternative medicines with the accepted conventional medical standard of care for a specific condition thus, for example, an herbal extract may be compared with a pharmaceutical-grade drug to demonstrate unequivocally the safety and effectiveness of a product or practice. However, complementary and alternative medicine has only recently been deemed worthy of scientific scrutiny (for decades many natural remedies and practices were dismissed outright as being obviously inferior to Western science-based medicine), and many alternative therapies have not yet been... 

The list of complementary and alternative medicines for analgesics is quite long and depends on how far and wide you look for the information. The following is a list of alternative therapies for pain relief, including therapies which have reliable scientific data to support their use as well as those being studied ... 

Wetzel MS, Kaptchuk TJ, Haramati A, Eisenberg DM. Complementary and alternative medical therapies implications for medical education. Ann Intern Med 2003 138(3) 191-196. 

Adams KE, Cohen MH, Eisenberg D, Jonsen AR. Ethical considerations of complementary and alternative medical therapies in conventional medical settings. Ann Intern Med 2002 137(8) 660-664. 

Kessler RC, Davis RB, Foster DF, et al. Long-term trends in the use of complementary and alternative medical therapies in the United States. Ann Intern Med 2001 135 262-268. 

In the United States, the use of products, including botanicals, thought to fall within the realm of complementary and alternative medicine is very common. It is difficult to obtain reliable estimates of use or to compare many of the current publications in this area because of diverse definitions for categorizing these products (e.g., dietary supplement, food supplement, herbal medicine, natural remedy, traditional medicine, etc.) in both the United States and elsewhere. A recent report on the use of complementary and alternative medicine by U.S. adults in 2002 indicated that approximately 19% of the population used nonvitamin, nonmineral, and natural products, 19% used folk medicine, and 3% used megavitamin therapy in the past 12 months (1). 

In the past complementary therapies have been called alternative or fringe medicine but the position of conflict between complementary and conventional therapies is outdated. The term allopathic is used for the conventional, orthodox mainstream medicine and relies on gathering evidence through scientific research methodology. It examines outcomes, i.e. the results or consequences that follow from the action or intervention that we call the treatment. There is a clinical criterion called the gold standard clinical variable, which is often viewed as the measure of clinical improvement in a condition. This can be a simple quantitative measure for some conditions, e.g. blood sugar level for diabetes, peak air flow for asthmatics. Often there are multiple variables and simple quantitative criteria are inapplicable. 

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