Physicians and Healers — Unwitting Partners in Health Care

Murray, Raymond H.; Rubel, Arthur J.

doi:10.1056/nejm199201023260113

Cited by 119 publications

(56 citation statements)

References 10 publications

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“…Primary care physicians should be aware that at least 10% of their patients may have tried 1 or more forms of alternative/complementary medicine before presenting for consultation. 13,22 These herbal extracts have the potential to meet all of the requirements of appropriate medication that could be routinely used in the pediatric patient, 7,23,24 namely in vitro bacteriostatic and bacteriocidal activity against common pathogens, 25 immunostimulation ability, 26 antioxidant activity, 27 and anti-inflammatory effects. 28 They are also well-absorbed with good penetration into the tissue surrounding the tympanic membrane.…”

Section: Discussionmentioning

confidence: 99%

Naturopathic Treatment for Ear Pain in Children

2003

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ABSTRACT.Objective. Otitis media is 1 of the most frequent diseases of early infancy and childhood and 1 of the most common reasons for children to visit a physician. In the past 2 decades, there has been a substantial increase in the diagnosis of otitis media worldwide. In the United States, 93% of all children have had at least 1 episode of acute otitis media (AOM) by 7 years of age. Otalgia is the hallmark of AOM. Most affected children either complain of earache or manifest behavior that the parents interpret as indicating ear pain. Treatment of the ear pain early in the course of AOM decreases both parental anxiety and the child's discomfort and accelerates the healing process. The objective of this study was to determine the efficacy and tolerability of naturopathic versus traditional treatment for the management of otalgia commonly associated with AOM in children.Methods. The study was designed as a double-blind trial in an outpatient community clinic. A total of 171 children who were aged 5 to 18 years and had otalgia and clinical findings associated with middle-ear infection were studied. The children were randomly assigned to receive treatment with Naturopathic Herbal Extract Ear Drops (NHED) or anesthetic ear drops, with or without amoxicillin. On enrollment, the children were assigned by computer-numbered randomization to receive NHED (contents: allium sativum, verbascum thapsus, calendula flores, hypericum perfoliatum, lavender, and vitamin E in olive oil) 5 drops 3 times daily, alone (group A) or together with a topical anesthetic (amethocaine and phenazone in glycerin) 5 drops 3 times daily (group B), or oral amoxicillin 80 mg/kg/d (maximum 500 mg/dose) divided into 3 doses with either NHED 5 drops 3 times daily (group C) or topical anesthetic 5 drops 3 times daily (group D). A double-blind design was used, and all ear drops were placed in identical bottles. Treatment was initiated by the nurse in all cases. A single physician (M.S.) evaluated and treated all of the patients included in the study and recorded all of the data. The presence or absence of ear pain was assessed over 3 days with a visual analog scale. Ear pain was assessed by a specially devised observational instrument based on previous reports. One side of the instrument consisted of a linear numbered scale, from 1 (no pain) to 10 (worst possible pain), and a corresponding color scale, ranging from blue to dark red. The reverse side contained a scale of 5 facial expressions, ranging from broad smile (no pain) to a sad and crying face (worst possible pain), and a corresponding color scale, ranging from blue to dark red.Results. There were no significant between-group differences in patient age or gender, degree of fever, main symptoms, associated symptoms, and severity or laterality of acute otitis media. Each group had a statistically significant improvement in ear pain over the course of the 3 days. Patients who were given ear drops alone had a better response than patients who were given ear drops together with amoxicillin. Results...

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Section: Discussionmentioning

confidence: 99%

Naturopathic Treatment for Ear Pain in Children

2003

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“…Documented CAM use by patients in general is reported to be as high as 45%, yet the role of CAM in patient care has had little scientific support. However, studies at the National Cancer Institute (NCI) and the National Center for Complementary and Alternative Medicine are beginning to have an impact on this scientific evidence (Lerner & Kennedy, 1992;Murray & Rubel, 1992;Risberg, Lund, Wist, Kaasa, & Wilsgaard, 1998;Verhoef, Russell, & Love, 1994). Research suggests that up to 64% of individuals with cancer use CAM in addition to their prescribed cancer treatments (Ernst & Cassileth, 1998).…”

Section: Frequency Of Use Of Complementary and Alternative Medicine Imentioning

confidence: 99%

Frequency of Use of Complementary and Alternative Medicine in Women With Breast Cancer

Lengacher¹,

Bennett²,

Kip³

et al. 2002

Oncology Nursing Forum

114

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“…Using CAM to control OM side-effects and hence facilitate ongoing OM use has been described in patients receiving chemotherapy for cancer, 28 and HIV. 29 Other studies have documented commonly held beliefs about the curative nature of CAM, 10,30 and the role of OM in symptom relief. 31,32 In the present study, some participants were also unexpectedly able to reduce their OM use when they perceived they no longer needed it.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…This shifting pattern of participants' beliefs was based on their positive CAM experiences, 6,7 their perception of failure of OM, 8,34 and adverse OM drug reactions. 3,10,[35][36][37] Participants universally continued their OM use for other health problems. 7 The selection of CAM over OM did not reflect an ideological opposition to OM, 26 but suggests people manage their health by selecting and integrating elements of CAM/OM for their specific needs.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…5 Pull factors include the perceived effectiveness of CAM, 3,[6][7][8] and belief that CAM offers a holistic 3,8,9 and patient-centred approach. 3,10 The majority of patients who use CAM integrate its use with OM, 8,11 but we know little about how patients manage chronic conditions when using both approaches. Recent data suggest that people use and integrate CAM in different ways, as an alternative to OM, as a supplement to OM, or as a non-medical treat.…”

Section: Introductionmentioning

confidence: 99%

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

Brien¹,

Bishop²,

Riggs³

et al. 2011

Br J Gen Pract

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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.

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Physicians and Healers — Unwitting Partners in Health Care

Cited by 119 publications

References 10 publications

Naturopathic Treatment for Ear Pain in Children

Naturopathic Treatment for Ear Pain in Children

Frequency of Use of Complementary and Alternative Medicine in Women With Breast Cancer

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

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