Office of Public Health &Environmental Hazards

Introduction to Complementary and Alternative Medicine

in the VA

Jeanette E. Akhter, M.D., M.AcWar Related Illness and Injury Center

Washington, DC

Important Questions

1. What is CAM?

2. Why is it important for me to know about it?

3. Is the VA involved in CAM?

Definition of CAM

“Diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine”

(NCCAM)

National Center for Complementary and Alternative Medicine

(NCCAM) Federal Government's lead agency for

scientific research on CAM 1 of the 27 institutes and centers that

make up the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services

http://nccam.nih.gov

NCCAM's mission

To explore CAM practices using rigorous scientific methods and build an evidence base regarding the safety and effectiveness of these practices Basic, translational ("bench-to-bedside"), and

clinical research Research capacity building and training Education and outreach programs

Further Definition

"Complementary medicine" refers to use of CAM together with conventional medicine. Most use of CAM by Americans is complementary.

"Alternative medicine" refers to use of CAM in place of conventional medicine.

"Integrative medicine" (also called integrated medicine) refers to a practice that combines both conventional and CAM treatments for which there is evidence of safety and effectiveness.

Types of CAM

Natural products Mind-body medicine Manipulative and body-based practices Movement therapies Traditional healers Energy field manipulation

Types of CAM

Whole medical systems Ayurvedic medicine Traditional Chinese medicine

Acupuncture Herbs

Homeopathy Naturopathy

CAM Online Education Series

10 lectures with videos and transcripts

A question and answer transcriptAn optional online testAdditional resource linksA certificate of completion

Why incorporate CAM in the VA?

Numerous Veterans have complex and difficult-to-diagnose, difficult-to treat health problems following deployment

Treatment

First response: Provide the highest quality traditional western medical care available

Sometimes results are not completely satisfactory Residual pain Side effects of treatments

Veterans, their families, and their care providers seek additional beneficial therapies

Use of CAM in US

The 2007 National Health Interview Survey (NHIS) showed that approximately 38 percent of adults use CAM.

VHAHCS Complementary and Alternative Medicine

2002 VA Health Agency Information Group Study

84% of VAs offered either in-house CAM therapies or referred out

Study being repeated this year

VA Central Office preparing publication of guidelines for

CAM Standardization of criteria to

determine which CAM modalities should be integrated into VA care

Credentialing requirements for practitioners

Mechanisms for CAM delivery Documentation, billing, etc.