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Dialogue between providers and patients lacking despite widespread use.
June 1, 2011
By: Sean Moloughney
Editor, Nutraceuticals World
A new online resource designed to give healthcare providers easy access to evidence-based information on complementary and alternative medicine (CAM), has been revealed by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH). With this new resource, providers can learn about various CAM practices and products and be better able to discuss the safety and effectiveness of complementary and alternative medicine with their patients. The portal on the NCCAM website, nccam.nih.gov, is tailored to fit the needs of all healthcare providers, including physicians, nurses and nurse practitioners, physician assistants and CAM providers. It includes information on the safety and efficacy of a range of common health practices that lie outside mainstream medicine—natural products, such as dietary supplements, herbs and probiotics, as well as mind-body practices such as meditation, chiropractic, acupuncture and massage. This resource was developed based on a series of NCCAM-sponsored focus groups where healthcare providers identified the need for an evidence-based, one-stop place to answer their patients’ questions on CAM. With this need in mind, NCCAM developed a resource that provides reliable, objective and evidenced-based information on CAM, including: links to relevant clinical practice guidelines; safety and effectiveness information; links to systematic reviews; summaries of research studies; scientific literature searches; programs for continuing education credit; and patient fact sheets. Annually, Americans spend nearly $34 billion out-of-pocket on CAM products and practices. Surveys show that nearly 40% of American adults and 12% of American children use some form of CAM. Other surveys show that patients do not regularly discuss these practices with their healthcare providers. “NCCAM is charged to study and provide evidence-based information on the safety and efficacy of CAM health practices that are readily available and already used by a great number of people,” said Josephine Briggs, MD, director of NCCAM. “As a physician, I understand the need to have easily accessible and accurate information on all health practices. This web resource is a way for NCCAM to share this valuable information with all providers.” The NIH resource comes at a time when a survey from AARP and NCCAM indicates Americans over the age of 50 often do not discuss CAM use with their healthcare providers, despite growing frequency of use. Overall, 53% of respondents reported they had used CAM at some point in their lives. Among those, 58% said they had discussed CAM with a healthcare provider. This dialogue is important because, while CAM is a part of health and wellness for many Americans, some CAM products can interact with conventional medicine. Use of CAM among the 50 and older population is widespread. The 2007 National Health Interview Survey found that 44% of people age 50-59 use some form of CAM, compared to the average adult use rate of 38%. “Older Americans want to lead healthy, active lives, and that means using healthcare safely,” said Elinor Ginzler, AARP vice president. “For many people, CAM is an important part of staying healthy, but some CAM products may make conventional medicines less effective or lead to potentially dangerous interactions. Healthcare providers and patients need to start talking together to ensure you get the full benefit of both CAM and your medications.” Other findings from the AARP/NCCAM survey suggest that if CAM is discussed at a medical appointment, it is most likely to be brought up by the patient. Respondents were twice as likely to say they raised the topic rather than their healthcare provider. According to the survey, the two main reasons that the patients gave for a lack of discussion with their healthcare providers are that the provider never asks (42%) and the patients did not know they should bring it up (30%). In the survey, the most frequently cited reasons for using CAM are for general wellness (77%), to help reduce pain or treat a painful condition (73%), to treat a specific health condition (59%) and to supplement conventional medicine (53%). Those surveyed were allowed to provide more than one reason for using CAM. “In this survey, we found that 37% of respondents have used an herbal product or dietary supplement in the past 12 months. Some of these natural products can interact with conventional treatments,” said Dr. Briggs. “As we’ve learned from NCCAM-funded research into herbal and dietary supplements, natural does not always mean safe. Thus, an open dialogue about CAM use, particularly herbals and dietary supplements, is vital to ensuring safe and coordinated care.” The AARP/NCCAM survey was conducted by telephone interview in October 2010, with a random sample of 1013 people age 50 and older.
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