Complementary and Alternative Medicine - Coursework Example

Complementary and Alternative Medicine Introduction Complementary and alternative medicine (CAM) are conceived as holistic in that they address the mental, physical, emotional, and spiritual components that make up a whole person. The term alternative medicine applies because they do not fit into the mainstream ways of looking at medicine and healthcare. Some of the examples of complementary therapy include acupuncture, aromatherapy, chiropractic, herbal medicine, homeopathy, Alexander technique, Osteopathy, and yoga. The growing interests in complementary therapies have enhanced scientific evidence regarding the history of traditional use, safety and effectiveness. The most prevalent reasons for the use of complementary and alternative medicine include a perceived beneficial response from complementary and alternative medicine and dissatisfaction with conventional medical practices (Rees 2001, p.5). Over the last 20 years, there has been significant research on the effectiveness of complementary therapies; nevertheless evidence is still insufficient. Much of the evidence on CAM is anecdotal, whereby scientific evidence tends to be uneven. TASK 1 A) Explain what you understand by reliability of information during complementary therapies Complementary therapies in the contemporary society are highly visible, and information about them is widely accessible to the general public. Like any decision regarding health, decisions about whether to use complementary therapies are crucial. Reliability of information centres on evaluating potential benefits, risks, and scientific evidence is essential to health and safety (Wellman 2000, p.62). Reliability, in this case, infers the consistency of results from the use of CAM therapies. There are diverse aspects to reliability that are especially relevant to consumers to discover which CAM therapies are consistent, effective, and safe. Hence, patients should consider evidence from scientific studies undertaken regarding the safety and effectiveness of the CAM therapies product or practice that interests the patient. B) Give an example of complementary therapies to explain how you will analyse the reliability of sources of information on complementary therapies An analysis of the reliability of CAM revolves around the evaluation of complementary therapy practices to ensure that their safety and effectiveness is proven. One of way of analyzing the reliability of sources of information on complementary therapies encompasses reviewing scientific evidence about the therapy (Cuellar, 2006, p.9). Arriving at a decision based on the facts is an effective way rather than using a therapy simply because of information in an advertisement or on a website. C) Explain what you understand by validity of information during complementary therapies Validity in an evaluation infers the degree to which evidence proposed during complementary and alternative medicine therapies reinforce patient outcomes. Validity may centre on evidence based on clinical trials, on response processes, on patient outcomes, and on relations to other variables. There are many sources of information regarding the provision of valuable and valid information. Overall, websites sponsored by governments institutions and university medical schools are some of the best for finding accurate and balanced content. D) Give an example of complementary therapies to explain how you will analyse the validity of sources of information of your choice on complementary therapies The widespread use of complementary and alternative health care presents providers with a fresh and daunting responsibility to become informed about appropriateness, effectiveness, and safety of CAM practices. There are many sources of information on CAM including journals, websites, database, compendia, and books. Randomized, placebo-controlled trials can be perceived as the most rigorous methods of attaining evidence of efficacy of CAM therapies. One must into account the intricacy, interactive nature of most CAM interventions due to the synergy of components (Olver and Robotin 2012, p.4). E) Give two examples of service users, which the application of reliability and validity of sources of information on complementary therapies There is an increasing interest in, and the application of complementary therapies, which appeal to a broad variety of social groups. Studies indicate that the dominant users of contemporary therapies include high-income earners, patients with chronic conditions, and well educated women. The use among adults is higher among females and those with enhanced levels of education and higher incomes. A study undertaken by the school of Medicine at University of South Hampton indicated that complementary therapy service users mainly encompass middle aged women, especially those with considerable educational attainment. Similarly, the study indicated that service users using ACM therapies tended to have more than one medical condition (Chisholm and Sheldon 2011, p.24). No therapy should be perceived as proven to be safe and effective if service users have not been engaged in its design and evaluation. TASK 2 A) Explain the benefits and disadvantages of two complementary therapies of your choice Acupuncture features as one of the most natural forms of alternative medicine whereby endorphins are released into the blood stream so as to attain maximum pain relief. During acupuncture, the nerves within the spinal cord are stimulated, triggering the release of endorphins. Benefits of Acupuncture Acupuncture can be regarded as an all encompassing and natural substitute to medicine. The procedure enhances stamina, restores energy, regulates hormones, and improves the immune system (Ratcliffe, Thomas, MacPherson, and Brazier 2006, p.626). Similarly, the therapy might be responsible for enhanced blood flow, hence resulting in increased supply of vital nutrients to the affected area (Ma 2009, p.138). This may aid in removing toxins and maintenance of overall health. Disadvantages of Acupuncture Whereas acupuncture can eliminate the root of certain diseases and provide relief from pain, the procedure cannot diagnose a disease, injury or other condition. Similarly, acupuncture might not be advisable for individuals suffering from certain bleeding disorder and/or patients on blood thinners (Shifrin 1993, 91). Moreover, patients can experience a considerable amount of post treatment soreness; besides, if the needles used are unsterilized or re-used, this may lead to infections. Improper placement of the needles can lead to bleeding and swelling. Osteopathy Osteopathy infers branch of medicine that dominantly places a strong emphasis on the musculoskeletal system (the body’s interconnected system of muscles, bones, and nerves), and its impact on diseases, and overall health. Osteopathy employs a variety of non invasive, drug-free therapies centring on the massage and manipulation of the body. Benefits of osteopathy The therapy has been scientifically proven to relieve pain associated with neck and back problems. The therapy removes the underlying causes of pain by minimizing stiffness in muscles and joints and increasing range of motions in the joints. Osteopathy also relieves chronic pain via non invasive treatment. Osteopathy is an excellent supplemental treatment as it poses little risk of orchestrating negative interactions with other mediations and treatments. Disadvantages of Osteopathy There are a number of conditions that cannot be treated with the therapy such as ligament damage, joint and bone infections, bone cancer, and dislocated or broken bones. Osteopathy may be accompanied by side effects, majority of which are temporary such as headaches, fatigue, and soreness. B) Explain the importance of these benefits to the service users of your choice Most individuals seek acupuncture so as to manage pain and other diseases such as insomnia, stress and fatigue. Acupuncture service users may be suffering from chronic illnesses, musculoskeletal pain migraines, fibromyalgia, and arthritis, besides aiding in coping with bothersome symptoms of allergies and menopause (MacPherson, Sinclair-Lian, Thomas 2006, p.21). The procedure may also minimize nausea after patients undergo surgery or receive chemotherapy. Osteopathy has strongly been found to be effective against depression, asthma, menstrual pain, chronic obstructive pulmonary disease, pain associated with recovering from surgical procedures, and ankle injuries. Nevertheless, acupuncture is not a diagnostic procedure, but a means of coping with known maladies. C) Explain how you think that the service users might gain access to claims the benefits of your chosen complementary therapies One of the benefits of acupuncture and osteopathy lies in their application in treating a wide range of diseases and conditions. Service users of both acupuncture and osteopathy report that the therapies promote the vital flow of energy through every part of the body. The two therapies are non invasive treatment with minimal side effects or recovery time (Rees 2001, p.8). Thus, the procedures may reduce dependence on medications and the need for unpleasant medical procedures. TASK3 A) Make recommendations based on the evidence gathered for the use of complementary therapies of your choice, and within specific service users who are using health and social care services Acupuncture has been found to be highly effective in the treatment of a diverse range of problems falling within musculoskeletal category. Acupuncture is usually recommended to cancer patients as a complementary therapy for chemotherapy-induced nausea and vomiting. Despite the placebo effect, studies indicate that complementary and alternative therapies can avail a safe and effective pain relief and enhanced joint mobility. Studies show that patients report clinically significant pain reduction and enhanced function when using acupuncture. Similarly, acupuncture aids HIV patients minimize some of the side effects of antiretroviral drugs, besides aiding patients with multiple sclerosis to manage symptoms. Research indicates that acupuncture is cost-effective, especially in treating low back pain (Smith, Hancock, Blake-Mortimer and Eckert 2007, p.78). It will be crucial to eradicate a series of barriers that may stand in the way of integrating acupuncture into conventional medicine. Firstly, there is a need to address the gap in information about safety and side-effects of acupuncture. Secondly, it is essential to attend to the legal position of physicians making referrals to acupuncturist in order to safeguard. Thirdly, statutory regulatory bodies for acupuncture should be instituted (where absent) grounded in integrated health. Fourthly, there is a need to avail more information to physicians and other healthcare professionals in the discipline of acupuncture so as to familiarise them with acupuncture (Deng et al. 2009, p.85). Recommendations Public demand for complementary medicine has enhanced to a level where communication and cooperation with orthodox health service is essential. There is a need to consider the value of research exploring the effectiveness of acupuncture. Evidence indicates that an integrative approach to therapy with complementary treatment mainly enhances patient outcomes. The health service should agree to research findings about the effectiveness of acupuncture in treating low back pain and as a complementary therapy for chemotherapy-induced nausea and vomiting. Despite the mutual mistrust between CAM therapies and conventional medicine, it is essential to revamp the move towards integration and closer cooperation. This is motivated by an increasing evidence base for CAM therapies, as well as a growing understanding on the need for convergence in regulatory, clinical, and scientific standards. There is a need to carry out a full assessment of the effectiveness and efficacy of acupuncture and the potential role that the therapy can play within the NHS. Research indicates that acupuncture may have advantages in terms of costs and benefits, in the arena of musculoskeletal conditions in general practice (Manheimer et al. 2008, p.254). Establishing an extensive body of knowledge on the effectiveness of acupuncture in treating diseases requires further research. Funds should be made available for further research into acupuncture so as to develop a unified research agenda, and establish a more rigorous evidence base relating to acupuncture (Manheimer et al. 2005, p.651). B) Explain your future expectations on the use of complementary therapies of your choice for a particular service user My future expectations in the use of complementary and alternative medicine revolve around the capability of CAM therapies in responding to patient expectations and enhancing patient centred care. This may be crucial in influencing satisfaction and effectiveness of treatment. Patient expectations of the osteopathic service revolve around central areas, which include clinic environment (accessibility and flexibility); professionalism (continuity of care and technical skill); treatment (holistic approach); relationship (respect, and trust, shared decision-making tailored to the individual); and outcome (reduction of pain and enhanced quality of life). Future expectations in the use of osteopathy are to attain an immediate, perceptible improvement in symptoms (Wellman 2000, p.63). Service users of osteopathy expect to have a quick recovery time return to their normal activities by managing their problem, and avoiding recurrence. TASK4 A) Explain what you understand on the current regulation systems for the use of complementary therapies Regulation of certain aspects of the health service and medical practice falls into three categories; direct government-administered regulation, government-sanctioned self regulation, and independent, self regulation. Many practitioners of CAM therapies within the UK remain largely unregulated. The benign legal climate has yielded few formal obligations to respond to any standard, and practitioners have been able to follow their own path and set their own professional body, devoid of sanction. On 21 November 2000, the House of Lords Select Committee on Science and Technology released a report of its enquiry into complementary and alternative medicine. The report categorises CAM disciplines into groups. Group 1 (professionally organized therapies such as acupuncture, chiropractic, herbal medicine, homeopathy, and osteopathy) incorporates disciplines that possess a well-developed process of voluntary self-regulation (House of Lords 2000, p.5). CAM disciplines such as Chiropractic and Osteopathy already have moved along the path of statutory regulation. The House of Lords also highlighted herbal medicine and acupuncture as two therapies ready for moves towards statutory regulation under the Health Act 1999. Voluntary self regulation details a single, professional body that lacks a statutory status. Nevertheless, voluntary self-regulation mimics statutory regulatory bodies in aspects such as administration, although it cannot protect its title or impose practitioners to join. Most working groups engaged in voluntary self-regulation work closely with the Prince’s Foundation for Integrated Health. The working groups include Alexander technique self-regulation group, aromatherapy council, reflexology, British Council for Yoga therapists, the Shiatsu regulatory group, cranial forum, and Bowen forum. B) Explain the effectiveness of the regulation on the complementary therapies of your choice Regulation is necessary to the establishment of high standards of training, safety, and competency (code of practice) in the administration of CAM therapies. Regulation balances the interests of consumer protection with the profession’s requirements for established minimum standards and continued innovation and development. In order to be effective, regulations are expected to demonstrate that they have an impact on outcomes rather than processes (Mills 2001, p.158). Osteopathic practice standards have delivered effective and efficient support to patient safety and quality of care. A significant portion of osteopaths takes the necessary action in addressing key issues such as competence and professional development. Osteopathic regulatory interventions have supported the establishment and development of professional behaviours and safe and effective practice, besides supporting patient expectations of osteopathic treatment. C) Evaluate the importance of regulation in controlling the use of complementary therapies Within the healthcare environment, regulation infers the establishment of rules and standards for training, practice, and registration, besides the implementation of procedures to respond to complaints and deal with disciplinary procedures. Regulation has been critical to the establishment of accountable, safe, and effective practice and maintenance of the efficacy of complementary therapies (Dickinson 1995, p.10). Self regulation has aided in the development of common standards of training and practice. D) Opinion/ideas on the future of regulation in monitoring the complementary therapies to prevent accident or injury to users of the services Future regulation should be geared at protecting the public from unqualified or inadequately trained practitioners, especially within the CAM disciplines that lack statutory regulations. This requires adequate information supporting efficacy and claims (evidence-based best practices). Governments should undertake extensive research into the role of CAM in the NHS. Complementary and alternative medicine may fill gaps in NHS provision of healthcare in alleviating anxiety, stress, depression, and pain relief, to which CAM therapies hold immense potential (Mills 2001, p.160). Patients should be able to enjoy full benefits of both approaches. Future regulation should be geared towards harmonization of the two approaches. TASK5 A) Suggest on how government should improve the use of complementary therapies of your choice Despite the exponential growth in uptake of the complementary treatments, there are a number of safety and legal issues surrounding their use. In UK, the barriers to complementary therapies on the NHS include inertia, regulation, financial concerns, and mixed evidence of effectiveness and the placebo question. Since the bulk of CAM therapies remain largely unregulated, consumers need to be informed and equipped with tools to access appropriate, safe, and effective treatment (Thomas, Nicholl and Coleman 2001, p. 3). Governments need to develop a set of guidelines that are context specific and provide easy access to reliable information for consumer use. The government has a central role to play in facilitating a safe and effective use of CAM; it should avail ample research funding for extensive clinical trials of complementary and alternative medicine to guarantee effective therapies. Herbal medicine is unregulated, except the Register of Chinese Herbal Medicine, which has its own standards and code of ethics. The safety and efficacy of herbal medicine, as well as quality control/safety monitoring, are prominent concerns for healthcare authorities and the public. The overall absence of adequate information on herbal medicines, and the deficiency in appropriate evaluation methods are some of the factors that delay or derail the creation of national policies, laws, and regulations on herbal medicines (Mills 1996, p.48). Governments should initiate the establishment and implementation of a regulatory framework on herbal medicine that guarantees safe use of herbal medicines. Similarly, the government has a role to play in regulating complementary therapists and encouraging effective self regulation to CMA disciplines that lack statutory regulation. B) Give examples with a specific service user to explain your recommendation for improving regulatory systems for the use of complementary therapies Standardization of the regulatory regime within the health service can ensure that regulation and administrative procedures guarantee protection of service users, meet the needs of therapists and applicable agencies the procedures are realistic (minimize the burden of compliance) and professional bodies remain independent and accountable. Many childbearing women are significantly subscribing to CAM therapies, especially in the course of pregnancy, childbirth, and the postnatal period. The CAM therapies (whether self administered or practitioner administered) are perceived to be emotionally and physically beneficial by many women, especially for pain relief during childbirth and for healing purposes consequent to the childbirth (Furlan, Tulder, Cherkin et al. 2005, p.944). This makes understanding and appreciation of the gains of CAM therapies a critical aspect of midwifery. Complementary and alternative therapies should be perceived with caution and a level of expertise that is evidence based. Recommendations Midwives who administer CAM therapies should go through an appropriate education and training programme so as to be competent in line with the set guidelines. In circumstances where a qualified CAM therapist is involved in the care of the women, the midwife should ensure that the patient gives informed consent. Midwives with the knowledge, skills, and competence in CAM therapies should cooperate with other practitioners in the formulation and implementation of guidelines. An immediate platform should be set up for dialogue between CAM therapists and midwives. Facilitating workdays for diverse therapy organizations with intent to encouraging federation into representative organization for each therapy is an essential step before harmonization of CAM therapies practice. References List Chisholm, A. & Sheldon, H. (2011). Service User Feedback Tools: An Evidence Review and Delphi Consultation for the Health Professions Council, Oxford, Picker Institute Europe.pp. 6-24. Cuellar, N. (2006). Conversations in complementary and alternative medicine: Insights and perspectives from leading practitioners. London, Jones and Bartlett. pp.9-20. Deng, G. et al. (2009). Evidence-based clinical practice guidelines for integrative oncology: Complementary therapies and botanicals, Journal of the Society for Integrative Ontology, vol. 7, no.3. pp.85-120. Dickinson, D. (1995). Complementary therapies in medicine: The patient's perspective, Complementary Therapies in Medicine, vol. 3. pp.9–12. Eisenberg, M., Post, E., & Davis, B., et al. (2007). Addition of choice of complementary therapies to usual care for acute low back pain: A randomized controlled trial, Spine vol. 32, no.2. pp.151–158. Furlan, A., Tulder, M., Cherkin, D., et al. (2005). Acupuncture and dry-needling for low back pain: An updated systematic review within the framework of the Cochrane collaboration. Spine, vol. 30, no.8. pp.944–963. House of Lords (2000). Report of the Select Committee on Science and Technology: Complementary and Alternative Medicine, London, The Stationary Office. pp. 5-8. Ma, L. (2009). Acupuncture as a complementary therapy in chemotherapy-induced nausea and vomiting, Baylor University Medical Centre, vol.22 no.2. pp.138-141. MacPherson, H., Sinclair-Lian, N., Thomas, K. (2006). Profiles of acupuncture patients: a national survey, Complementary Therapies in Medicine vol. 14, no.1. pp.20-30. Manheimer, E., & Pirotta, M., et al. (2008). 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