Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare alternative medicine regardless of their disease, education, …
AMERICAN COLLEGE OF RHEUMATOLOGY POSITION STATEMENT SUBJECT: PRESENTED BY: Complementary and Alternative Medicine for Rheumatic Diseases Committee on Rheumatologic Care
FOR DISTRIBUTION TO: ACR Members Medical Societies Allied Health Professional Societies Arthritis Patients Managed Care Organizations/Third Party Carriers National Center for Complementary and Alternative Medicine NIH NIAMS National Council Against Health Fraud Arthritis Foundation 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 BACKGROUND: Complementary and alternative medicine CAM is a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine 1 The use of these therapies, by patients with musculoskeletal and rheumatic conditions, is extremely common Conventional therapies for many conditions in the spectrum of the rheumatic and musculoskeletal diseases are not completely effective, have side effects,
and can be expensive Patients desire less expensive, safe, simple, and effective alternatives They may feel helpless in the face of unpredictable, progressive, and disabling disease, and therefore seek therapies that offer them control of their illness 2 Surveys show that approximately 30 of Americans will at sometime try complementary or alternative medicine regardless of their disease, education, background, or socioeconomic status 3, 6 WHAT IS COMPLEMENTARY AND ALTERNATIVE MEDICINE? Complementary medicine is used together with conventional medicine, while alternative medicine is used in place of conventional medicine An integrative approach combines conventional medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness 1 There are many ways to categorize CAM therapies Broadly defined, CAM is a wide domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs
CAM includes such resources perceived by their users as associated with positive health outcomes 4 Not all conventional practices have been validated eg joint arthroscopy, and some CAM
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therapies have been shown to have some effectiveness eg glucosamine Scientific inquiry into little understood or unproven ideas, no matter whether they are from CAM or conventional medical sources, can lead to new information that in turn can lead to improvements in care for patients with rheumatic and musculoskeletal diseases RATIONALE: The American College of Rheumatology ACR recognizes that interest in CAM is widespread and is committed to scientific study of therapies Patients with rheumatic or musculoskeletal diseases seeking CAM, as well as practitioners, need care and guidance, and the practices themselves need assessment The ACR believes that a scientific
approach to health care delivery can bring opportunities for the incorporation of the best options from all sources of care, be it conventional medicine or CAM The challenge is to avoid bias and to approach each possibility with an appropriate degree of skepticism or belief Analysis of safety and risk-to-benefit ratios should be applied to CAM as it is to conventional medicine Treatment with CAM must include a discussion of safety, risks and benefits POSITION: The ACR recognizes the interest in CAM therapies The ACR supports rigorous scientific evaluation of all therapies that improve the treatment or rheumatic diseases The ACR understands that certain characteristics of some CAMs and some conventional medical interventions make it difficult or impossible to conduct standard randomized controlled trials For these therapies, innovative methods of evaluation are needed, as are measures and standards for the generation and interpretation of evidence 4 The ACR supports the integration of
those therapies scientifically proven safe and effective and advises caution for those not studied scientifically The ACR believes healthcare providers should be informed about CAM therapies, based upon appropriate scientific evaluation, and should be able to discuss them knowledgeably with patients REFERENCES: 1 NIH National Center for Complementary and Alternative Medicine, NIH, fact sheet: what is complementary and alternative medicine? URL: wwwnccamnihgov/health 2 Panush RS, editor Complementary and alternative therapies for rheumatic diseases Rheum Dis Clin North Am 1999;25:i-xvii789-995;2000;26:i-xx1-197 3 Complementary and alternative medicine use among adults: United States 2002 Centers for Disease Control National Center for Health Statistics; advance data and vital statistics no 343 4 Institute of Medicine 2005: complementary and alternative medicine in the United States Washington, DC: National Academies Press; 2005
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5 Institute of Medicine
2001: crossing the quality chasm: a new health system for the 21st century Washington, DC: National Academies Press; 2001 6 Ni H, Simile C, Hardy AM Utilization of complementary and alternative medicine by United States adults: results from the 1999 National Health Interview Survey Med Care 2000;40:353-8 Approved by Committee on Rheumatologic Care: Approved by Board of Directors: 06/25/05 07/21/01 08/06/05 10/25/02
Source:chirohealth.org
