Integrated medicine in the management of chronic illness: a qualitative study

Abstract

Complementary and alternative medicine (CAM) is popular with patients, yet how patients use CAM in relation to orthodox medicine (OM) is poorly understood. AimTo explore how patients integrate CAM and OM when self-managing chronic illness. Design of studyQualitative analysis of interviews. MethodSemi-structured interviews were conducted with individuals attending private CAM practices in the UK, who had had a chronic benign condition for 12 months and were using CAM alongside OM for more than 3 months. Patients were selected to create a maximum variation sample. The interviews were analysed using framework analysis. ResultsThirty five patient interviews were conducted and seven categories of use were identified: using CAM to facilitate OM use; using OM to support long-term CAM use; using CAM to reduce OM; using CAM to avoid OM; using CAM to replace OM; maximising relief using both CAM and OM; and returning to OM. Participants described initiating CAM use following a perceived lack of suitable orthodox treatment. Participants rejecting OM for a specific condition never totally rejected OM in favour of CAM. ConclusionPatients utilise CAM and OM in identifiably different ways, individualising and integrating both approaches to manage their chronic conditions. To support patients and prevent potential adverse interactions, open dialogue between patients, OM practitioners, and CAM practitioners must be improved.

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome

“…Its use may be a surrogate for empowerment and self-help [5,6]. Patients with chronic illnesses utilise CAM [7] for diverse reasons including engagement in one's own health, positive expectations of treatment and the need for hope [5,7].…”

“…Its use may be a surrogate for empowerment and self-help [5,6]. Patients with chronic illnesses utilise CAM [7] for diverse reasons including engagement in one's own health, positive expectations of treatment and the need for hope [5,7]. CAM treatments used by those with CFS include massage therapy, relaxation, meditation, homoeopathy, acupuncture, naturopathy and herbal therapies [7,8,9,10].…”

Individualised medicine from the perspectives of patients using complementarytherapies: a meta-ethnography approach

“…The process of shared decision making is currently the most discussed way to take into account individual preferences. However it must be noted, that complementary treatment options are still neglected in the development of decision aids [68], although patients prefer to integrate CAM into their “tailored care” to manage their individual medical conditions [69]. Again, in this context the link between “individualised medicine” and “integrative care” can be detected [1].…”

A Research Roadmap for Complementary and Alternative Medicine - What We Need to Know by 2020

“…-It would also be important to understand how CAM use differs between specific populations (healthy people and those with chronic illness) as we are aware that CAM is used mainly in addition to conventional care, but that its use is often not disclosed. This is potentially problematic because of interactions with conventional medications [8]; comparative studies between these different populations would be essential.…”