صفحه 1:
8 طرالمع
۳
صفحه 2:
Complementary
Medicine
Why bother for a whole
term?
www.bradfordvts.co.
صفحه 3:
Complementary or
Alternative
* Which is more acceptable to
who?
* Needs complementing?
° Need for alternative?
° Whose need?
¢ What can we learn from these
practitioners?
صفحه 4:
One image !
صفحه 5:
Or Another?
Caring
Holistic
No iatrogenic
problems?
صفحه 6:
Why Bother?
“Scientific medicine is making big
advances in drugs, technology, and
genetics, yet more and more
patients use complementary
therapies. EBM dominates our
discourse, yet health professionals
increasingly refer to and practice
complementary therapies that have
little scientific evidence of efficacy.”
صفحه 7:
*What is the meaning
behind these paradoxes?
*What can we learn that
will usefully inform our
practice of orthodox
medicine?
¢Why do people go to
complementary
practitioners?
صفحه 8:
Why Bother?
¢ What skills are they using?
¢ What skills could we borrow?
° What patient needs are they
addressing?
* Are they needs we should seek to meet?
¢ Should we support them?
° Should we attack them?
* How should we respond?
صفحه 9:
How Many?
* Over one thousand forms of
complementary medicine
have been indexed
* About 26 are “common”
° There are at least 40,000
therapists in the UK
صفحه 10:
How Popular?
° Hard data lacking ° Ever used 14-
* Relies on survey 30%
data * Last year 10-14%
* Geographical ۰ Ever seen
practitioner 33%
* World wide ever
3 seen practitioner
* Socio-economic 20-75%
variation
variations
¢ Cultural variations
صفحه 11:
How Popular?
° 10% of GPs treat
patients with
complementary
* 45% of GPs endorse
or recommend the
use a medicine themselves
یی ae) * US (1990) made 425
m. Visits to comp.
5 21% of GPs refer Practitioners and
patients to 388 m. Visits to
complementary family physicians
practitioners
صفحه 12:
How Popular?
٠ Phenomenal growth
* UK consumption of homeopathic
remedies growing at 20% per year
* Number of UK practitioners has
doubled every 5 years for the last
15 years
٠ Growth is occurring right across
the west
صفحه 13:
Which Therapy?
1984 survey 1989 survey 1993 survey
° Acupuncture Acupuncture * Acupunctur
* Chiropractic- Chiropractic ١ ١
٠ 167۵1 ° Faith * Chiropractic
medicine healing * Herbal
* Homeopathy: Homeopathy medicine
* Osteopathy ° Homeopathy
* Osteopathy | Ostenpathy
صفحه 14:
Who?
° 40% of women
° 27% of men
* 33% of people >35years
° 26% of people <35years
¢ More popular in south and west of UK
* 38% of people use more than one form
of complementary medicine at the
same time
صفحه 15:
What Sort of
Problem?
°Musculoskeletal - 88%
°Psychological- 3%
° Respiratory - 2%
*Neurological - 2%
° Other - 4%
صفحه 16:
Evidence
“Conventional”
° Counselling
* Ultrasound
۰ Bed rest
° Chiropody
° Many operatior
صفحه 17:
Evidence
“Complementary
* 4000 articles
in medline
م
2 لوحت St johns wort *
* Manipulative
therapies
* Eczema
صفحه 18:
In Summary
° Very popular and growing
° Are we failing?
° What can we gain?
° Should we end any divisions
and just go for “good
medicine” - anything that
works?
صفحه 19:
Aims of the Term
* Can be divided into the
obvious and the hidden
¢ There are, I now hope many
reasons why we should bother
¢ So that you know where I am
coming from my hidden and
overt aims are as follows:
صفحه 20:
Aims of the Term
Covert
¢ Improve critical
appraisal skills
¢* Improve EBM
skills
¢ Improve
presentation skills
۰ Foster self worth
Overt
¢ Learn about
complementary
practitioners
¢ Be able to better
advise our
patients
¢ Learn applicable
skills
صفحه 21:
And Some Objectives
٠ Natural
«0
° Irrational
¢ Harmless
* Holistic
* Unregulated
¢ Alternative
صفحه 22:
Starting Points
www.quackwatch.com/
Maybe a obvious slant but
fascinating !
صفحه 23:
Starting Points
The Which? Guide to
Complementary
Medicine
Which ? Books
Barbara Rowlands
1997
An excellent fairly balanced
introduction
صفحه 24:
Starting Points
ABC of Complementary
medicine
Starting BMJ 319 11/9/99
Page 693
But shouldn't be all you use!
صفحه 25:
Starting Points
Medline - 4,000
references to
complementary
medicine
EMBase
Many books
صفحه 26:
The Good
The bad
And the ugly
صفحه 27: