Malaysian Healthy Ageing Society Overview Of Complementary And - PowerPoint PPT Presentation

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Overview Of Complementary And Alternative Medicine Dr. Sivaneswaran Poobalasingam Director of Integrative Medicine Amrita Integrative Health Centre TIL0303 Level 3 One IOI Square IOI Resort , Putrajaya Dr Siva Poobalasingam Amrita Integrative Health Centre

Complementary Medicine is used by up to 80% of the population WHO

39% reported using some form of CAM therapy 2011 Millenium Cohort Study(United States) Dr Siva Poobalasingam Amrita Integrative Health Centre

Expenditure United States(2010) USD 34 billion annually Dr Siva Poobalasingam Amrita Integrative Health Centre

Broad domain of healing resources that encompasses all health systems, modalities and practices and their accompanying theories and beliefs other than those intrinsic to the politically dominant health cycle of a particular society or culture in a give biological period Cochrane Collaboration Dr Siva Poobalasingam Amrita Integrative Health Centre

Complementary Medicine  CAM is a group of diverse medical and health care systems, practices and products that are not presently considered part of conventional medicine Dr Siva Poobalasingam Amrita Integrative Health Centre

Complementary Medicine  Holistic approach to health  Emphasis on disease prevention over disease treatment  Deals with patient as a whole  Treatment of the whole patient (body mind and spirit) versus a single pathogen Dr Siva Poobalasingam Amrita Integrative Health Centre

Complementary Medicine  Mind and body linked  Disease stems from a disturbance at the physical, mental, emotional and spiritual level  Therapeutic intervention is to restore balance and facilitate the body’s own healing response Dr Siva Poobalasingam Amrita Integrative Health Centre

Complementary Medicine  Complementary medicine dates back to 5000 years  For centuries complementary medicine kept people healthy  Complementary medicine gave birth to modern medicine Dr Siva Poobalasingam Amrita Integrative Health Centre

Complementary Medicine  Complementary medicine Used together with conventional medicine  Alternative medicine Used in place of conventional medicine  Integrative Medicine Combines mainstream medicine and CAM therapies Dr Siva Poobalasingam Amrita Integrative Health Centre

MAJOR TYPES OF COMPLEMENTARY AND ALTERNATIVE MEDICINE Dr Siva Poobalasingam Amrita Integrative Health Centre

National Center for Complementary and Alternative Medicine  Classification into 5 categories  Alternative medicine systems  Mind-Body medicine  Biological based systems  Manipulation and body based methods  Energy medicine Dr Siva Poobalasingam Amrita Integrative Health Centre

1. Alternative medicine systems Built upon complete systems of theory  and practice Evolved apart from and earlier than  conventional medicine E.g. Homeopathy Naturopathy  Traditional Chinese Medicine  Ayurveda  Dr Siva Poobalasingam Amrita Integrative Health Centre

2. Mind – Body Medicine  Concept that the mind is important in treatment is integral in many traditional therapies  Hippocrates (400B.C) advocated this concept  Varieties of intervention techniques  E.g. Meditation Yoga Prayer Therapies such as music Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

3. Biologically Based Therapies • Use substances found in nature such as herbs, vitamins and foods • E.g. Dietary supplements Herbal Products Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

4. Manipulation and Body Based Methods • Based on manipulation and/or movement of 1 or more parts of the body • E.g. chiropractic manipulation osteopathic manipulation massage Dr Siva Poobalasingam Amrita Integrative Health Centre

5. Energy Medicine  Deals with energy fields  Two types of energy fields:  Bio-electromagnetic based therapies(Veritable)  Bio-fields(Putative) Dr Siva Poobalasingam Amrita Integrative Health Centre

Energy Medicine  Bio-electromagnetic based therapies • Can be measured • Uses electromagnetic fields, mechanical vibrations • Uses specific wavelengths and frequencies in therapies • e.g. magnet therapy Dr Siva Poobalasingam Amrita Integrative Health Centre

Energy Medicine  Bio-fields  Yet to be measured  Based on concept that human beings are infused with subtle forms of energy  Vital energy or life force  Has various names  E.g. Qi, ki, prana, orgone, etheric energy  Illness results from disturbances of this energy field  E.g. reiki, qi gong,yoga, healing touch Dr Siva Poobalasingam Amrita Integrative Health Centre

42% of Americans used CAM in 1998 as compared to 34% in 1990 JAMA Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

“Less Than 5% of Patients Use CAM on Its Own. More Than 95% Use It Integrated With Modern Medicine.” Gerard Bodeker, Global Initiative for Traditional Systems (GIFTS) of Health, Institute of Health Sciences, University of Oxford, England. Dr Siva Poobalasingam Amrita Integrative Health Centre

42% used complementary therapies Of the CAM users 74% used CAM with conventional medicine Survey done by Landmark Health Care Dr Siva Poobalasingam Amrita Integrative Health Centre

76% used CAM Among CAM users 95% used integrative medicine Survey done by National University of Singapore Dr Siva Poobalasingam Amrita Integrative Health Centre

Malaysia  65% use CAM  Indians 45% Chinese 32% Malays 22%  78% reported that their condition improved Hassan et al. Use of complementary and alternative medicine among patients with chronic diseases at outpatient clinics .Complementary therapies in clinical practice 2009 Dr Siva Poobalasingam Amrita Integrative Health Centre

 Number of hospitals offering CAM has tripled since 2000  In 2000 14% of hospitals provided CAM Dr Siva Poobalasingam Amrita Integrative Health Centre

Commonly Used CAM in Adults  Herbal remedies  Echinacea-immune function  Gingko --- Cognitive Function  Saw Palmetto --- Prostrate Enlargement  Mind-Body Medicine  Meditation  Yoga  Chiropractic Manipulation  Acupuncture  Massage Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

Malaysia  Nutritional supplements (48%)  Herbal medicine (26%)  Traditional Chinese Medicine (4%) Hassan et al. Use of complementary and alternative medicine among patients with chronic diseases at outpatient clinics .Complementary therapies in clinical practice 2009 Dr Siva Poobalasingam Amrita Integrative Health Centre

Qi Gong and Taiji Patients with early stage dementia can slow their physical, mental and psychological decline:  Improved cognitive function  Improvement in self-esteem  Improvement in physical function  E.g. balance Burgeones et.al American Journal of Alzheimer’s Disease and other Dementia , 2008 Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

Yoga Improvement in sleep quality and mental health indicators Chen K.M et.al .Sleep quality depression state and healthy status of older adults after Silver Yoga Exercises. Int J Nurs Stud 2008 Dr Siva Poobalasingam Amrita Integrative Health Centre

Yoga Significant reduction in pain and improvement in energy levels Groessl EJ et al. Yoga for veterans with chronic back pain. J Altern Complement Med 2008 Dr Siva Poobalasingam Amrita Integrative Health Centre

Research  CAM therapies not patentable which may lead to reduced funding from the private sector  Can be marketed without any proof of efficacy in contrast to pharmaceuticals.  Disinterest from manufacturers to fund scientific research Dr Siva Poobalasingam Amrita Integrative Health Centre

Common Health Problems  General Health  Musculoskeletal E.g.Back,hip,arthritis  Anxiety, depression  Sleep disorders  Gastro-intestinal disorders  Diabetes  Coronary artery disease  Hypertension  Allergies  Pain Management Dr Siva Poobalasingam Amrita Integrative Health Centre

Dr Siva Poobalasingam Amrita Integrative Health Centre

What Are The Reasons For The Use Of CAM? Dr Siva Poobalasingam Amrita Integrative Health Centre

Majority of patients choosing alternative medicine do so mainly because those approaches are more aligned with their values, beliefs and philosophical orientations towards health and life. JAMA Dr Siva Poobalasingam Amrita Integrative Health Centre

Why Do People Use Cam?  Changing needs and values in modern society contributes to an increase in the popularity of CAM  An increased sense of entitlement to quality life  Increase in public access to health information  Reduce tolerance to paternalism Dr Siva Poobalasingam Amrita Integrative Health Centre