CAM in the real world: you may practice evidence-based medicine, but your patients don't.
BACKGROUND
Complementary and Alternative Medicine (CAM) approaches are widely used among individuals suffering from headache. The medical literature has focused on the evidence base for such use and has largely ignored the fact that these approaches are in wide use despite that evidence base.


CONCLUSIONS
This article focuses on the uses of CAM by patients and suggests strategies for understanding and addressing this use without referring back to the evidence base. The rationale for this discussion pivots on the observation that patients are already using these approaches, and for many there are anecdotal and historical bases for use which patients find persuasive in the absence of scientific evidence.


CONCLUSIONS
Until such time as the body of scientific literature adequately addresses non-conventional approaches, physicians must acknowledge and understand, as best as possible, CAM approaches which are in common use by patients. This is illustrated with a case study and examples from practice. This article does not review the evidence base for various CAM practices as this has been done well elsewhere.
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Robert P
RP
Cowan
D001291:Attitude of Health Personnel; D000529:Complementary Therapies; D019317:Evidence-Based Medicine; D005260:Female; D006261:Headache / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D012651:Self Medication
complementary and alternative medicine; headache; migraine