PERT Program

Tip of the Month: August 2003


Complementary Therapies

The popular press and news media are paying more attention to a growing trend in American health care. That trend is the increasing consumer use of complementary therapies, both to promote wellness and to treat various medical conditions.

Complementary therapies is a broad term that encompasses medical systems and philosophies of healing and health care as well as specific techniques. Complementary therapies can be defined as therapies that do not conform to the standard of care in the conventional medical community.1 Another way to describe complementary therapies are those therapies that are not widely taught in US medical schools and are not widely available in US hospitals.2 Examples of complementary therapies are shown in the table below.


COMPLEMENTARY THERAPIES

Category Examples
Alternative Medical Systems Homeopathic
Naturopathic
Ayurveda
Traditional
Chinese medicine
Native American medicine
Mind-body Interventions Meditation
Prayer
Biofeedback
Dance
Art
Biologically-based Interventions Herbal products
Dietary supplements
Mega-vitamin therapy
Manipulative and Body-based Therapies Osteopathic manipulation
Chiropractic manipulation
Massage
Rolfing
Energy Therapies
  • Biofield therapies




  • Bioelectromagnetic-based therapies

Acupuncture
Reiki
Qigong
Therapeutic touch

Magnetic fields
Pulsed fields
Alternating or direct current fields


Some of the complementary therapies in use today, such as acupuncture and herbal medicine have been in existence for thousands of years. Others such as Rolfing (a form of bodywork) or biofeedback are relative newcomers to the arena.

All complementary therapies share the following common characteristics:3,4
The use of complementary therapies in the United States has increased significantly in the past 10 years.5 If you haven’t encountered the use of complementary therapies with your residents, chances are good that you will in the future. What’s driving the increased popularity? According to the Hospice and Palliative Nurses Association, several reasons are involved including:
Complementary therapies are easily and naturally integrated into hospice and palliative care because they share a holistic framework and approach to patient care. Both are concerned with the emotional, physical, and spiritual well-being of patients and view the patient (not the condition or symptom) as the focus of care. The role of complementary therapies in hospice and palliative care focuses on the easing of symptoms, improving quality of life, and the maintenance of well-being through the dying process for the terminally ill as well as the caregivers. The specific complementary therapies used by any one patient are based on the needs, values, and symptoms of the individual.

Complementary therapies are more readily accepted by the current medical communities in European and Asian countries. Part of the controversy over the use of complementary therapies in the US is the lack of scientific evidence that these therapies are effective. This is changing. As the interest in and use of complementary therapies grows in this country, so do the research dollars available to evaluate their effectiveness. As a result, some therapies that were considered complementary a few years ago are now accepted as part of standard medical care (e.g., glucosamine for arthritis, exercise for cardiovascular disease). As research into complementary therapies continues we can expect to see others move from the realm of complementary to standard of care.


What has been your experience with complementary therapies in your practice setting? Please contact the PERT Program, with your comments.



References

  1. Gevitz N. Three perspectives on unorthodox medicine. In: Gevitz N, ed. Other healiers: unorthodox medicine in America. Baltimore: Johns Hopkins University Press; 1988:1-28.
  2. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. Jan 28 1993;328(4):246-252.
  3. Micozzi MS. Fundamentals of Complementary and Alternative Medicine. 2nd ed. Philadelphia: Churchill-Livingstone; 2001.
  4. Osterlund HB, P. Complementary Therapies. In: Ferrell BC, N., ed. Palliative Nursing. New York: Oxford; 2001:374-381.
  5. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. Nov 11 1998;280(18):1569-1575.
  6. HPNA. Position Statement on Complementary Therapies. Hospice and Palliative Nurses Association. Accessed July 14, 2003, 2003.
    http://www.hpna.org/position_therapies.asp