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Public Trends |
Research Trends | Continuing
Education |
EBM
Module |
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Trends in Integrative Medicine, CAM Research |
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Many Americans use one
or more health promotion, illness prevention or healing
practices that are considered complementary and alternative
medicine (CAM). In recognition of this, the United States
Congress legislated in 1991 that the National Institutes of
Health (NIH) establish the Office of Alternative Medicine (OAM)
with an annual budget of $2 million to coordinate esearch on
nontraditional health practices. Specifically, OAM was to
evaluate CAM practices, support CAM research and training, and
establish a CAM information clearinghouse for the general
public.
In 1998, Congress established the National Center for
Complementary and Alternative Medicine (NCCAM), with an annual
budget of more than $68 million, to supersede OAM. NCCAM's
mission is to support basic and applied CAM research and
provide information to healthcare providers as well as the
public. A number of factors contributed to the creation of
NCCAM, including the popularity of unproven medical practices
and increased recognition of the importance of traditional
healing practices among an ethnically diverse American
population. |
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Activities of NCCAM in
its first five years include: |
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built a
center responsive to its mission and integrated into the
other institutes at the United States National
Institutes of Health |
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funded over
780 projects at 123 institutions, resulting in over 700
scientific publications |
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awarded more
than 100 individual doctoral and postdoctoral training
and career awards |
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enrolled
nearly 40,000 participants in clinical protocols |
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received over
1.5 million visitors to the website
www.nccam.nih.gov
each year who search for information about CAM, clinical
trials, and research opportunities |
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developed a
database known as CAM on PubMED that lists nearly
400,000 articles on CAM-related subjects published in 45
languages from 70 countries |
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informed
public policy, patient choice and clinical practice
through outreach activities, including public town
meetings, public media, and scientific and professional
conferences |
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| Setting
Priorities |
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Given the diversity of
CAM approaches and questions about their safety and efficacy,
setting research priorities for NCCAM is a significant
challenge. The $117.7 million allocated to NCCAM in 2004,
while generous by most standards, permits only a limited
sampling of possible CAM approaches. To develop its approach,
NCCAM sought input from diverse communities of stakeholders.
The resulting first strategic plan (2001-05) stressed
investment in basic and clinical research, training,
dissemination of findings, and integration of safe and
effective practices. A second strategic plan (2005-09) is
currently in draft form. To learn more about NCCAM and its
research agenda, visit the NCCAM web site at
http://nccam.nih.gov/research/. |
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References |
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Astin JA, Marie A,
Pelletier KR, Hansen E, Haskell WL. A review of the
incorporation of complementary and alternative medicine by
mainstream physicians. Arch Intern Med.
1998;158(21):2303-2310.
Astin JA. Why patients
use alternative medicine: results of a national study. JAMA
1998; 279: 1548-1553.
Barnes P, Powell-Griner
E, McFann K, Nahin R. CDC Advance Data Report #343.
Complementary and Alternative Medicine Use Among Adults:
United States, 2002. May 27, 2004.
Berman BM, Singh BB,
Harnoll SM, Singh BK, Reilly D. Primary care physicians and
complementary-alternative medicine: training, attitudes, and
practice patterns. J Am Board Fam Pract. 1998;11:272-281.
Davant C III. What you
should tell patients about alternative medicine. In: Micozzi
MS, Bacchus AN, eds. The Physician's Guide to Alternative
Medicine. Atlanta, Ga: American Health Consultants;
1999:363-366.
Eisenberg DM, Kessler
RC, Foster C, et al. Unconventional medicine in the United
States. N Engl J Med. 1993;328(4):246-252.
Eisenberg DM, David RB,
Ettner SL. Trends in alternative medicine use in the United
States: 19901997. JAMA 1998; 280: 1569-1575.
Flannery MF, et al.
Complementary and Alternative Medicine Use among Patients in
Kentucky Ambulatory Network Practices. (manuscript completed)
Jonas WB. One kind of
medicine or many? The view from the NIH. In: Micozzi MS,
Bacchus AN, eds. The Physician's Guide to Alternative
Medicine. Atlanta, Ga: American Health Consultants;
1999:367-369.
Kessler RC, Davis RB,
Foster DF, et al. Long-term trends in the use of complementary
and alternative medical therapies in the United States. Ann
Intern Med. 2001;135:262-268.
Micozzi MS.
Characteristics of Complementary and Alternative Medicine. In:
Micozzi MS, ed. Fundamentals of Complementary and Alternative
Medicine. New York, NY: Churchill Livingstone; 1996:3-8.
National Center for
Complementary and Alternative Medicine. Accessed on October
11, 2004 at
http://nccam.nih.gov.
Novey DW. Basic
principles of complementary/alternative therapies; The dilemma
of evidence; Leaving the medical model; and Integration. In:
Clinician's Complete Reference to Complementary/Alternative
Medicine. St. Louis, Mo: Mosby; 2000:5-7, 7-9, 10-12, 13-16.
Pelletier KR. The Best
Alternative Medicine. New York, NY: Simon & Schuster; 2000.
Pelletier KR, Astin
JA. Integration and reimbursement of complementary and
alternative medicine by managed care and insurance providers:
2000 update and cohort analysis. Altern Ther Health Med.
2002;8(1):38-39, 42, 44.
Pelletier KR, Astin
JA, Haskell WL. Current trends in the integration and
reimbursement of complementary and alternative medicine by
managed care organizations (MCOs) and insurance providers:
1998 update and cohort analysis. Am J Health Promot.
1999;14(20:125-133.
Thomas KJ, Nicholl JP,
Coleman P. Use and expenditure on complementary medicine in
England: a population based survey. Comp Ther Med.
2001;9:2-11.
University of Maryland
Medicine, An Introduction to CAM. Accessed on October 11, 2004
at www.umm.edu. |
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