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Complementary therapies: an overview Hugh MacPherson  Senior Research Fellow Department of Health Sciences [email_address]
What is CAM (Complementary and Alternative Medicine)? ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Estimated number of “big five”* consultations per year in UK**:
Adult use of complementary therapies 1997/8
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Effectiveness gaps in primary care – according to GPs perceptions*
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Musculo-skeletal problems Patient defined problems for all five therapies*: 23%  Back 19%  Low back  13%  Neck 9%  Sciatica 7%  Arthritis 7%  Shoulder 4%  Knee 3%  Hip *Thomas et al 1991
[object Object],[object Object],[object Object],[object Object],Underlying principles
Patients of osteopaths appreciate: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Provision of CAM on the NHS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Barriers to complementary therapies on the NHS ,[object Object],[object Object],[object Object],[object Object]
And is it all placebo? ,[object Object]
And is it all placebo? Ben Goldacre  The Lancet  2008; 371:985-986 ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Current regulation of therapies
The fundholding experience ,[object Object],[object Object],[object Object],[object Object],[object Object],Sustaining Complementary Therapy Provision in Primary Care: Lessons from Existing Services.   Thomas  CTiM  2000
Since the end of fundholding … ,[object Object],[object Object],[object Object],[object Object]
Reasons to consider expanding provision with practice based commissioning ,[object Object],[object Object],[object Object],[object Object]
Specialist databases ,[object Object],[object Object],[object Object],[object Object],[object Object]
Bibliography:   Fisher,  P., Van Haselen, R., Hardy, K., Berkovitz, S., & McCarney, R. 2004, "Effectiveness gaps: a new concept for evaluating health service and research needs applied to complementary and alternative medicine", J.Altern.Complement Med, vol. 10, no. 4, pp. 627-632. House of Lords  2000, Report of the Select Committee on Science and Technology: Complementary and Alternative Medicine, The Stationary Office, London. Kane  M 1993, The patient's perspective: a qualitative study of low back pain and osteopathic treatment, Masters Thesis, University of Exeter.  MacPherson H , Sinclair-Lian N, Thomas K. Profiles of acupuncture patients: a national survey. Complementary Therapies in Medicine, 2006; 14(1): 20-30. Thomas  KJ, Nicholl JP, & Coleman P 2001, "Use and expenditure on complementary medicine in England: a population based survey.  9 :2-11.",  Complementary Therapies in Medicine , vol. 9, pp. 2-11. Thomas,  K. J., Carr, J., Westlake, L., & Williams, B. T. 1991, "Use of non-orthodox and conventional health care in Great Britain",  BMJ , vol. 302, no. 6770, pp. 207-210.

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Complementary Therapies Yrmg July 2008 For Handouts

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