Complementary and alternative medicine for noncancer pain.
In summary, the past several years have shown an increase in the quality of trials examining the clinical efficacy of various CAM modalities for pain conditions. There is still need to raise the quality of the studies from a scientific and methodological point of view in many areas of CAM research by randomization, appropriate sample size, blinding, and developing more sophisticated sham procedures. However, much work still has to be done to find ways to preserve the clinical authenticity of CAM treatment methods when brought into the light of a research protocol. Recent attempts have been made to find a method of maintaining the standardization and reproducibility of research protocols while allowing the kind of flexible treatment that would normally be applied in a clinical setting. Other questions that should be answered with future studies include understanding how treatment length influences outcome, if maintenance treatments are needed for chronic conditions, and cost and risk comparisons with standard pharmacological treatment. Providing this kind of detail will assist both with reproducibility as well as help us gain a better understanding about whether certain treatment paradigms are superior to others for specific clinical conditions. Finally, physicians who have an interest in pursuing CAM research should educate themselves both about the methodological issues inherent with the particular area of interest as well as about ways to maintain the authenticity of the CAM treatment protocols so that the literature is not populated with more poorly designed studies. With the emerging interest in integrative medicine, there is a growing interest in collaboration and a greater number of physicians are interested in obtaining training in CAM modalities to help bridge this gap between CAM and conventional clinicians. For example, the American Academy of Medical Acupuncturists (AAMA) has been formed to help as both an educational and research forum for physician acupuncturists and the American Holistic Medical Association provides educational exposure in a broad range of Integrative and CAM modalities. The future of medicine will likely be Integrative and the more health care providers can educate themselves about this area of medicine, the better they will be able to provide the highest quality of care to their patients.
Patel
Gira
G
Osher Integrative Care Center, Harvard Medical School, Osher Institute, Division for Research and Education in Complementary and Integrative Medical Therapies, Kiiko Matsumoto International, 1647 Washington Street, Newton, MA 02465, USA.
Euler
David
D
Audette
Joseph F
JF
D000529:Complementary Therapies; D006801:Humans; D059408:Pain Management