Starting Conversations About Complementary and Integrative Medicine

Pharmacists know medications come in many different formulations, but we very rarely recognize that treatment regimens come in various forms, as well.

Complementary and alternative medicine (CAM) is the umbrella term under which Western medicine categorizes these other forms of treatment. However, pharmacists should discuss these treatment regimens under a new name: complementary and integrative medicine (CIM).

Here are 3 reasons why:

1. It’s on the rise.

In melting pot of America is the adoption and adaption of culture, ideals, and even forms of healing. For some patients, visiting a physician or pharmacist is the first item on their checklist when they feel sick. For others, these health care professionals are only seen after multiple other options, some of which are natural products (eg, dietary supplements), traditional Chinese medicine, homeopathy, and meditation.

According to a 2012 survey, about 33% of American adults and 11% of children use complementary medicine. Between 2002 and 2012, the usage rates for chiropractors, acupuncture specialists, and yoga classes increased among those lacking insurance coverage. Based on these statistics, it’s apparent patients are increasingly investing in complementary medicine.

2. It offers a new perspective.

We know complementary medicine is gaining popularity, but why change its name from CAM to CIM? Well, the new name brings a new perspective to this scope of medicine, and thus, a new approach to its application.

For that reason, the National Institutes of Health developed the National Center for Complementary and Integrative Health (NCCIH) and was careful to define the following terms:

• Mainstream medicine: conventional or Western medicine commonly used in the United States.
• Complementary medicine: nonmainstream medicine used together with mainstream medicine.
• Alternative medicine: nonmainstream medicine used in place of mainstream medicine.
• Integrative medicine: coordination of mainstream and nonmainstream medicine for the achievement of therapeutic goals.

Pharmacists have studied the safety and efficacy of mainstream medicine and can make recommendations. Even though we aren’t always able to recommend nonmainstream medicine with the same confidence, we must discuss it with patients as complementary medicine after careful research. Otherwise, patients will believe they must use conventional medicine or nonmainstream medicine as an alternative, when they might actually be able to use both.

Of course, there are exceptions. For instance, St. John’s wort interacts with many medications like warfarin, so its use as complementary medicine shouldn’t be recommended.

Integrative medicine is crucial because it allows patients to voice their interests and concerns about nonmainstream medicine and allows pharmacists to listen and give advice.

3. It requires pharmacists’ expertise.

Pharmacy students: what does the “P” stand for in the SOAP note? You probably guessed it: plan!

In pharmacy school, pharmacists learn to assess patients and produce treatment plans to help them achieve a particular goal. Although this may not be common in practice, the “P” in the SOAP note is still our responsibility.

Regardless of whether you’re behind the counter at a community pharmacy or sitting with a patient in a clinic, there are always opportunities to start conversations about complementary medicine use. When patients grab an herbal medicine from the OTC aisle and ask whether they can use it, they’re expecting you to remain nonjudgmental about their complementary medicine use and be willing to research the product to determine whether they can integrate it into their treatment regimen.

As our patient populations gain interest in CIM, let’s not dismiss these treatment options as “alternative.” Instead, let’s figure out how to integrate them into treatment plans to make our patients healthy and happy.

Reference

NCCIH. 10 most common

complementary health approaches among adults in 2012. https://nccih.nih.gov/sites/nccam.nih.gov/files/NHIS-10-Most-Common-Approaches-Adults-2012-01.gif. Accessed July 12, 2016.