Complementary and Alternative Medicine in the United States

Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate. Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings. It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards. Table of Contents Front Matter Executive Summary 1 Introduction 2 Prevalence, Cost, and Patterns of CAM Use 3 Contemporary Approaches to Evidence of Treatment Effectiveness: A Context for CAM Research 4 Need for Innovative Designs in Research on CAM and Conventional Medicine 5 State of Emerging Evidence on CAM 6 An Ethical Framework for CAM Research, Practice, and Policy 7 Integration of CAM and Conventional Medicine 8 Educational Programs in CAM 9 Dietary Supplements 10 Conclusion Appendix A: CAM Therapies, Practices, and Systems Appendix B: Consortium of Academic Health Centers for Integrative Medicine Appendix C: Table 1-1 List of Abbreviations Appendix D: Liaison Panel Organizations Appendix E: Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice Appendix F: National Center for Complementary and Alternative Medicine Research Centers Appendix G: Public Meetings Appendix H: Committee Biosketches Index