Update on
Integrative Medicine
Deborah Ann Ballard, MD, MPH
T
he International Research Congress on
Integrative Medicine and Health (IRCIMH) was held in Miami, Florida in
May, 2014. This conference was convened by
the Consortium of Academic Health Centers
for Integrative Medicine. The organizing and
program committees included researchers from
Columbia, Georgetown, Boston, Temple, Harvard and Duke Universities as well as Canada, Hong Kong, Korea,
Germany, Australia, Sweden and China.
The researchers at this conference were keenly aware that integrative medicine is criticized by some as being pseudoscience or
even worse, belief in “magic.” IRCIMH researchers recognized the
limitations of past studies on acupuncture and other aspects of
traditional Chinese medicine (TCM), tai chi, yoga, meditation and
other therapies previously lumped in the category of “alternative.”
They frankly discussed how difficult or even impossible it can be
to apply the western standard of the randomized, double-blind,
placebo controlled trial (RCT) to these therapies. However, they
also pointed out that relying solely on RCTs ignores some very
compelling evidence for non-drug, non-surgical treatments. They
challenged us to find the best research methodology to study a particular integrative medicine therapy. Sometimes that may be the RCT,
sometimes not. One interesting lecture addressed the value of well
done case reports. Case reports can shed light on rare conditions,
unusual presentations, and responses to integrative medicine. When
enough case reports are amassed on a particular topic, they provide
a body of evidence that can be interpreted with accepted statistical
methodology. I attended a workshop entitled “The Selection, Use,
and Interpretation of Outcome Measures in Integrated Medicine
and Health.” This provided me with a number of standardized,
widely accepted tools I can use in my research. Other workshops
were “Evaluating and Interpreting Systematic Reviews in CAM:
Acupuncture as an Example” and “Writing a Grant: Challenges in
Clinical Trial Design and Important Statistical Considerations.”
Here are some highlights that may influence your practice:
1.
Acupuncture can be a good alternative for many people with
chronic low back pain. Acupuncture’s effectiveness increases
with the number of needles used and the frequency of treatments. Acupuncture is most effective for people who believe
it will work, so your attitude toward it is very important in
assuring a positive outcome.
2.
Meditation can be effective in preventing and treating posttraumatic stress disorder in military personnel. This offers
hope for all sufferers of PTSD, whether it is caused by childhood abuse, accidents, or combat experience. Meditation can
also improve cardiovascular outcomes and enhance the effect
of anti-hypertensive drugs. Meditation can cause telomeres
to lengthen. Longer telomeres correlate with better immune
function and longer life.
3.
Tai chi can improve cognitive performance in older adults. It
should be considered as therapy for those showing early cognitive impairment. It effectively reduces depression in heart
failure patients. It is also an effective treatment for osteoarthritis,
especially of the knee.
4.
Group visits help patients implement and sustain positive
health behaviors by providing more frequent contacts with a
health care provider and a peer support group. They are also
one pragmatic way to provide psychosocial support in the face
of limited reimbursement.
5.
Health coaching that is culturally appropriate can be an effective
strategy to promote behavior change in individuals and high
risk populations. Health coaches are most effective when they
form an empathetic, compassionate bond with their clients.
6.
Mind-body medicine, which includes techniques such as meditation, guided imagery, yoga, and tai chi, offers benefit for
chronic pain sufferers. Sophisticated functional neuro-imaging
studies demonstrate how these techniques stimulate certain
regions of the brain to reduce the perception of pain.
When I return from integrative medicine conferences, I always feel
joyful about practicing this type of medicine. Integrative medicine
is all about providing better options for practitioners and patients.
It focuses on promoting health. Its goal is healing the whole person,
not just treating specific diseases.
(continued on page 8)
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