Integration of complementary and alternative medicine information and advice in chronic disease management guidelines

Abstract

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Complementary and alternative medicine: Interaction and communication between midwives and women

“…25 Furthermore, they value women having opportunities to make decisions, even if they do not want to pursue them. 25 In line with other research exploring the attitudes of doctors 36 and midwives, 28 our data indicates that CAM is not a key concern and other topics deemed more essential often take precedence. Midwives' attitudes reflected the assertion of Leap and Pairman 26 that persuading the woman to consider various options is a legitimate part of midwifery practice and central to working in partnership.…”

T Lymphocytes Influence the Mineralization Process of Bone

“…The arrays were pre-processed and normalized using R (22), the bead array (23), and Bioconductor (24) packages. Between arrays, quintile was normalized using the Lumi package (25).…”

The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II

“…Few studies have examined CAM guidelines. Content analysis of 10 guidelines on cardiovascular disease and type II diabetes revealed that CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction for health care professionals [34]. Analysis of 65 National Institute for Health and Clinical Excellence guidelines available in 2009 found that, among 17 guidelines that mentioned CAM, it was not clinically relevant to most; in 14 of 48 guidelines that did not mention CAM, available evidence on the safety and effectiveness of relevant CAM therapies had not been included [35].…”