Many people are interested in using complementary and/or alternative medicine (CAM) when they are dealing with physical or mental health concerns. This is sometimes because they are worried about side effects from traditional medical treatments. Sometimes it is because they are not seeing the relief they expected from the traditional treatment prescribed by their medical provider and are desperate to find some help. Either way, it is important in the primary care setting to have a way to ask about use of CAM and to figure out a way to integrate it into the recommended medical treatment or talk with patients about the possible negative consequences of ongoing use.
In CAM, the term complementary refers to a treatment that is added to western medication treatment and the term alternative refers to a treatment that replaces western medication treatment. CAM is also sometimes referred to as integrative medicine, particularly if a provider is utilizing both types of treatments in his practice.
A primary concern that medical providers have about CAM is the limited research to support the claims and the limited standardization of the supplements. The data is not as robust as it is for traditional medical treatments that undergo a more stringent procedure for FDA approval. For the CAM supplements that have some evidence, it is largely based on case studies and anecdotal reports rather than controlled randomized studies.
A major (and potentially dangerous) belief that many users of CAM have is that because these supplements are natural, they don’t have side effects and drug interactions with their prescribed medications. In some cases, patients may not even think to inform their medical provider that they are using supplements unless they are asked explicitly. Or they are worried about their medical providers’ response.
Therefore, it is important for medical providers to have a non-judgmental and open way to ask about CAM use. Some ideas are:
“How are you taking care of yourself?”
“How have you tried to deal with this problem on your own?”
“What medications are you currently taking, both prescribed and over the counter?”
Part of the reason it is important to ask about CAM use is to help monitor for drug interactions and to assess if the CAM has a role in the presenting complaint. It is important to provide psychoeducation to patients using CAM about the possibility of drug interactions and side effects, not to necessarily discourage use, but to make sure they are fully educated about their medical choices.
The National Center for Complementary and Integrative Health (NCCIH) has a variety of easy-to-access and easy-to-read articles on different CAM treatments.
National Center for Complementary and Integrative Health: Health Information
NCCIH Resources for Health Care Providers
Complementary, Alternative, or Integrative Health: What’s In a Name? | NCCIH
Sleep Disorders: In Depth | NCCIH
Anxiety at a Glance | NCCIH
Depression and Complementary Health Approaches: What the Science Says | NCCIH
Menopausal Symptoms: In Depth | NCCIH
Hopefully these resources can be helpful when a discussion about CAM comes up in the primary care setting.