Complementary and Complementary and Alternative Medicine (CAM) Alternative Medicine (CAM)

Wellness Program Wellness Program

LTC (ret) Fujio McPherson, LTC (ret) Fujio McPherson,

DAOM, ARNP, LAc. DAOM, ARNP, LAc.

So Why CAM?So Why CAM?

Patient demandPatient demand Perception that CAM Perception that CAM

is natural with less is natural with less side effects then side effects then medicine. medicine.

Access to allopathic Access to allopathic care is limitedcare is limited

Efficacy of CAM Efficacy of CAM therapy therapy

Mandated to DoD Mandated to DoD pain Task Force. pain Task Force.

Why CAMWhy CAM

Shift from a mindset Shift from a mindset of dependent care to of dependent care to self care and self care and responsibility. responsibility.

Focus on wellness Focus on wellness and not illnessand not illness

Portal for patients Portal for patients who need education who need education in how to be healthy. in how to be healthy.

MAMC Pain Initiative: MAMC Pain Initiative: CAM Wellness ProgramCAM Wellness Program

Mission: to provide a resource for Mission: to provide a resource for wellness education, assist patients in wellness education, assist patients in self-care behaviors and therapies, self-care behaviors and therapies, offer clinical interventions when offer clinical interventions when needed, and facilitate existing needed, and facilitate existing psychological and cognitive therapy psychological and cognitive therapy for patients who have an interest in for patients who have an interest in wellness. wellness.

CAM Wellness ProgramCAM Wellness Program

AcupunctureAcupuncture Chiropractic Chiropractic CareCare Nutrition counselingNutrition counseling Movement therapy (exercise, tai chi, Movement therapy (exercise, tai chi, yogayoga)) Mindfulness Based Stress Reduction (Mindfulness Based Stress Reduction (MBSRMBSR)) Chronic Disease Self Management (CDSM)Chronic Disease Self Management (CDSM) Massage TherapyMassage Therapy Cognitive Behavioral TherapyCognitive Behavioral Therapy BiofeedbackBiofeedback

approaching the approaching the biopsychosocial model in a biopsychosocial model in a

different waydifferent way Physical/biologicalPhysical/biological

PsychologicalPsychological PsychosocialPsychosocial otherother

Acupuncture/yogaAcupuncture/yoga chiropractic carechiropractic care Mind-body, CBT Mind-body, CBT CDSMCDSM Nutrition, exercise, Nutrition, exercise,

movement (focus movement (focus on doing)on doing)

Does it work?Does it work?

Acupuncture services have been Acupuncture services have been available at MAMC since 2000. available at MAMC since 2000.

Study conducted to evaluate efficacy Study conducted to evaluate efficacy 2005-2006 (IMC Acupuncture service)2005-2006 (IMC Acupuncture service)

55 patients55 patients Six week, weekly treatment sessions. Six week, weekly treatment sessions.

Referred by their PCM. Referred by their PCM.

DemographicsDemographics

89% female 11% male89% female 11% male Average age 46Average age 46 Average length of pain 5.2 years.Average length of pain 5.2 years. ER 58%, PT 23%, Ortho 29%, Neuro 5%, Psych 27%ER 58%, PT 23%, Ortho 29%, Neuro 5%, Psych 27% Narcotic Use: 81%Narcotic Use: 81% Nsaids: 82%Nsaids: 82% Low back 40%, shoulder 12%, neck 10%, knee 7%, Low back 40%, shoulder 12%, neck 10%, knee 7%,

abdominal 6%, headache 6%. abdominal 6%, headache 6%. Average pain rating: 7.36Average pain rating: 7.36

Pre-enrollment Pre-enrollment

OutcomesOutcomes

Anxiety StudyAnxiety Study

Currently in progress: July 2010Currently in progress: July 2010 Enrollment 19 patientsEnrollment 19 patients CAM Therapies being used:CAM Therapies being used:

AcupunctureAcupuncture ExerciseExercise NutritionNutrition JournalingJournaling Breathing/meditationBreathing/meditation Massage therapyMassage therapy

Preliminary outcomesPreliminary outcomes

Conclusion/ChallengesConclusion/Challenges

Continued evaluation (Research based)Continued evaluation (Research based) Incorporation of other CAM assets Incorporation of other CAM assets

within the MTF (biofeedback, MBSR).within the MTF (biofeedback, MBSR). Continued exploration of what CAM Continued exploration of what CAM

therapies to use. therapies to use. Assess pain by function and behavior Assess pain by function and behavior

vs. pain scale or narcotic use.vs. pain scale or narcotic use. Measure or prescreen patients who Measure or prescreen patients who

have the ability to help themselves. have the ability to help themselves.

Thank-youThank-you

Questions: Questions: Fujio.mcpherson@

us.army.mil Maple Team, IMC, Maple Team, IMC,

MAMCMAMC 253-968-3317253-968-3317