Complementary and Alternative Medicine (CAM) Flashcards
(55 cards)
1
Q
What are complementary Alternative Medicines?
A
Treatments that fall outside of mainstream healthcare
2
Q
What is complementary medicine?
A
Use of CAM together with conventional medicine
3
Q
What is integrative medicine?
A
Blends use of conventional and complementary approaches
4
Q
What is alternative medicine?
A
Use of CAM in place of conventional medicine
5
Q
What is allopathy?
A
Medical treatment by convential means
6
Q
What is naturopathy?
A
Complimentary alternative medicine “natural healing”
7
Q
Name different classifications of CAM?
A
- Alternative medical systems (broad set of beliefs brought into one theory)
- Mind-body interventions
- Biologically based therapies
- Manipulative and body-based methods
- Energy therapies
8
Q
What are examples of alternative medical systems?
A
- Traditional Chinese Medicine
- Ayurvedic Medicine
- Homeopathy
- Naturopathy
- Indigenous healing systems
9
Q
What are examples of mind-body interventions?
A
- Meditation
- Yoga
- Deep-breathing exercises
- Qi gong
- Tai chi
- Guided imagery
- Biofeedback
- Dream therapy
10
Q
What are examples of biologically based therapies?
A
- Herbal medicine
- Bach flower remedies
- Bee venom therapy
- Chelation therapy
- Vegetable juice therapy
11
Q
What are examples of manipulative and body-based methods of CAM?
A
- Osteopathy
- Chiropractic
- Caniosacral therapy
- Alexander technique (body posture)
- Acupuncture
- Rolfing
- Kinesiology (broad bands on athletes)
12
Q
What are examples of energy therapies?
A
- Therapeutic touch
- Healing touch
- Reiki
- Magnet therapy
- Light therapy
- Crystal therapy
- Qi gong
13
Q
What alternative medical system does acupuncture derive from?
A
Traditional Chinese Medicine
14
Q
What is the average one year prevelance of CAM?
A
26.3%
15
Q
What is the average lifetime prevelance of CAM?
A
44%
16
Q
What are the most popular CAM modalities?
A
- Herbal medicine
- Homeopathy
- Aromatherapy
- Massage
- Reflexology
17
Q
What are the most popular CAM modalities with practitionars?
A
- Massage practitionar
- Osteopath
- Acupuncturist
- Chiropractor
18
Q
What does the history of homeopathy come from?
A
Samual Hahnemann in 1796
- Similia similibus curentur
- Like cures like
19
Q
Describe what is eant by “like cures like”?
A
Causes of disease were miasms and homeopathic treatments could remedy these
20
Q
How are homeopathic treatments made?
A
- Principle of similars
- Preperation undergoes potentisation in between dilutions
- Mother tincture is dilluted multiple times
- 2c or 2x dilution (diluted by 10 or 100 each time)
- More diluted means more potent in terms of homeopathy
21
Q
What are the harms/risks of receiving homeopathic treatments?
A
- No direct risk of interactions with ‘high potency’ medicines
- Indirect harm of delay in receiving appropriate treatment and practitioner’s attitudes may be problematic
22
Q
What are the regulatory bodies for heomeopaths in the UK?
A
No legal regulation in UK - Society of Homeopaths - Faculty of Homeopaths - British Homeopathic Association Products regulated by EU directive
23
Q
Is homeopathy available on the NHS?
A
No - used to be to some degree
24
Q
What does St John’s Wort (hypericum) have efficacy in treating?
A
Major depression (cochrane review proved this with 29 studies of 5489 patients)
25
What is a major risk of herbal medications?
Many ingerdiants many may often be unkown - difficult to know side-effects and interactions with other drugs . Quality control (batch to batch variation)
- May also delay patient appropriate treatment
26
What drugs is St John's Wort (Hypericum) thought to interact with
- Hormonal contraceptives
- Anti-depressants
- Anti-coagulants
- Anti-epileptics
- Heart mediccations
- Anti-cancer agents
- Anti-virals for HIV
- Possibly others
27
What body regulates herbal medicines in the UK market?
MHRA
28
What are the 3 levels of herbal medicine regulation in the UK?
- Marketing Authorisation (MA)
- Traditional Herbal Medicines Registrations (THR)
- Regulation 3 of the human medicines regulations 2012 (the "herbalist exemption")
29
What does the Marketing Authorisation (MA) ensure for herbal medicines?
Safety quality and efficacy as per any regular medicine
30
What does the Traditional Herbal Medicines Registration (THR) ensure for herbal medicine?
Safety and quality (not efficacy)
| - Based on traditional usage
31
What does the herbalist exemption allow for?
Do not need to prove efficacy, safety or quality to prescribe a herbal medicine
32
What is the difference between straight and mixed chiropacticors?
```
Straight = believe 95% of all diseases are caused by displaced vertebrae
Mixer = More specific
```
33
What are subluxations?
- Partially displaced vertebrae which block the flow of innate intelligence down the spinal cord
34
What is a major feature of chiropractic therapy and not osteopathy?
Spinal manipulations (adjustments)
- Fix / release subluxations
- Including high-velocity, low-amplitude thrusts (audible 'crack')
35
What are direct harms associated with chiropractic and osteopathic care?
- 50% of chiropractic patients suffer an adverse reaction
- Tearing of artery wall leading to stroke
- Injury to the spinal cord
- Chiropractix X-rays
36
What are the only 2 CA modalities under statutory regulation?
- General Chiropractic Council
| - General Osteopathic Council (GOsC)
37
What is acupuncture based on?
Ch'i (qi, "ch-ee") as a 'vital energy'
- Flows through 'meridians'
- Meridians associated with major organs
- Illness due to disrupted flow of Ch'i
38
How are needles placed in acupuncture?
- Insertion of needles along meridians
- Restores flow of Ch'i
- 1 - 10 cm in depth, with/without rotation
- Left in place for seconds to hours
39
What are the direct risks of acupuncture?
- Infections
| - Pneumothorax
40
How are acupuncture practitionars regulated?
- Voluntary regulation (e.g British acupuncture council)
| - Premises and practitioners must be licensed via local athority (much like tatoo parlors or piercings)
41
What is reflexology?
A type of massage that involves applying different amounts of pressure to the feet, hands, and ears. It's based on a theory that these body parts are connected to certain organs and body systems
42
What is an example of a drug which originally was not fully understood in how it worked or what it targetted but was used anyways?
Paracetamol - same principle can be applied for certain herbal / CAM therapies
43
What are factors which are thought to underlie the placebo effect?
- Endogenous opiates (proven through naloxone based studies)
- Conditioning (e.g Pavlov's dog)
- Expectancy (wine and placebo alcohol, dopamine and money)
- Motivation (a more compliant patient)
44
What does anthroposophic medicine mix together?
Herbal and homeopathic medicine
45
Are homeopathic medications any more effect than placebos?
NO
46
Why is it difficult to compare a acupuncture and a placebo?
Difficult to blind patient and/or doctor
- Sham acupuncture locations may hit meridians by chance
- Difficult to make sham acupuncture needles
47
What are some orthodox explanations of acupuncture?
- Gate control theory of pain
- Opioid release
- Placebo effect
48
Has there been shown a difference between sham and real acupuncture?
Yes - although only 10 point improvement on 100 point pain scale
- Suggest there must be a mechanism other than placebo at play
49
What did the cochrane review find for acupunture treating osteoarthritis?
Showed sham controlled trials do not show enough benefit
| - Acupuncture showed statistically significant and clinically relevant benefits
50
What did the cochrane review find for chiropractic interventions treating lower back pain?
Combined chiropractic interventions slightly improved disability in the short term and pain in the medium term for acute and subacute LBP
- No evidence to suggest their is a clinically meaningful difference for pain or disability when compared with other interventions
51
Why may people choose to use CAM?
- Health promotion (e.g general wellbeing)
- Believe will be more effective than conventional treatment
- Exhaustive conventional options
- Conventional options associated with side effects / risks
- No conventional therapy available
- Conventional approach emotionally / spiritually bereft
- Feeling more in control
52
What is medical pluralism?
Adoption of more than one medical system (beliefs/behaviours/treatments)
- E.g migrants trust in doctors/systmes back home, UK system may be confusing, pragmatism, speed of access
53
How much more likely were healthcare proffessionals who use CAM themselves to recommend CAM to patients? (pregnant women)
8 times
54
What percentage of pregnant women are recommended CAM?
1/3 (33%)
55
What are some natural impediments to making valid inferences?
- Placebo effect
- Natural history of disease (usually receive when disease at worst)
- Regression to the mean
- Reluctance to admit when wrong (i.e cognitive dissonance)
- Simple optimism (internal locus of control)
- Respect for authority
