As Americans' use of complementary and alternative medicine (CAM) continues to rise, scientists and health professionals should evaluate the value and efficacy of these treatments using the same standards of evidence they use for conventional medicine, according to the January Institute of Medicine (IOM) report "Complementary and Alternative Medicine in the United States."
"CAM is here, it's not going away, and it accounts for a large portion of health-care spending in this country," says psychologist Susan Folkman, PhD, the director of the Osher Center for Integrative Medicine at the University of California, San Francisco, and a member of the IOM committee that produced the report.
In fact, according to the report, each year more than a third of Americans use some form of CAM, from acupuncture to herbal remedies to chiropractic care.
Psychologists should be paying attention to CAM's growing importance in the health-care field, says Folkman. "There's a whole area of mind-body medicine that involves psychologists," she explains.
She and her colleagues, for example, are beginning a randomized clinical trial of a mindfulness-based meditation for people with early-stage HIV. Psychologists might also research how people access and use all kinds of health care--traditional and CAM--and how those treatments influence and are influenced by mental health, Folkman suggests.
The report's authors acknowledge that some aspects of CAM therapies--such as nonstandardized practitioner approaches and hard-to-measure outcomes--make the treatments more difficult to evaluate via randomized clinical trials than most traditional medical treatments. However, they suggest that researchers can use other methods, such as observational and case-control studies, to evaluate CAM therapies.
The report also suggests a method to prioritize research to make the best use of limited federal research funding. Top priority, the authors suggest, should go to treatments for which a plausible biological mechanism exists, for which some evidence already exists and for common or debilitating ailments.
The report is online at www.nap.edu.
Letters to the Editor
- Send us a letter