Complementary /Alternative Therapies in Family Physician Practice PhD, MD Mira Florea UMF Cluj-Napoca

SUMMARY OF THE COURSE Physicians' reactions to the patients‘ increasing interest in Complementary Therapies Integrative Medicine - An Ideal ? Complementary therapies classification Indications, Non-Indications

Course Motivation Increased demand for complementary therapy to the public The need for communication and co-operation with the medical services of conventional/scientific medicine Ideally -integrative medicine Purpose -the safety of patients

DEFINITIE Medical and health care practices outside the realm of conventional medicine, which are yet to be validated using scientific methods Complementary: together with conventional practices Alternative: in place of conventional practices MC/A =Unconventional Medicine =Unorthodox =Natural Medicine - whole concepts + practices different from those of Conventional Medeicine =Scientific=Academic=Orthodox=Technique Medicine= Modern

DEFINITION MC / A - uses the notion of body energy which works by influencing and shaping the energy component, influencing disease symptomatology, not the disease etiology and pathogenesis Effects of alternative practices are not proved, though there are patients who confirm benefits Contraindications are reduced and the risk of adverse effects or overdoses is reduced Convenţional/ Scientific Medicine- addresses the anatomical body, the etiological component, influences disease's pathogenesis and symptomatology The scientific allopathic remedies are proved, but not all symptoms can be affected in the long term, and the side effects sometimes limited duration of therapy

Growing interest of patients for Complementary Therapies The natural source of these remedies, their Non-Toxicity increase patients’ adherence They are focused on the Emotional and Spiritual component of “Well-being” Therapists offer availability, time, communication, touch Scientific Medicine suffers from lack of time and that important “T T T” for the patients “ Time, Talk, Touch”

The prevalence of Complementary Therapies use 62% of adults >18 ani use CAM More women than men Higher educated !!!! Pain- is the most frequent symptom Top 10 in EUROPE –41% Homeopathy, –35 % Fitotherapy, Gemotherapy –20% Acupuncture –18% Chiropractic – 15% Diet-based therapies –11% Massage –6% Yoga

The prevalence of Complementary Therapies use Top 10 in USA –43% Prayed for self; 10% participate in Prayer group –19% Fitotherapy, Gemotherapy –12% Deep breathing exercises – 8% Meditation – 8% Chiropractic – 5% Yoga – 5% Massage – 4% Diet-based therapies –4% Homeopathy, – 3% Acupuncture

Doctors' reactions to the increasing patients' interest for MC / A diverse, from excitement and interest to the criticism, even circumspection British Medical Association-BMA manifested in favour of promoting some complementary therapies In England 40% of contracts concluded in the primary care offers complementary medicine services Many Family Physicians follow complementary medicine courses with various motivations: -the need to cope with the demands and interests of patients -the wish to increase their therapeutic resources

Doctors' reactions to the increasing patients' interest for MC / A The desire to widen conventional medicine which sometimes they feel stressful and unsatisfactory Maintaining a balance between increasing technologization of Conventional Medicine and a more humane approach of Complementary Medicine Complementary medicine Practice appeals to personality traits of doctors, facilitates communication and provides therapeutic satisfaction even for difficult patients or depressed patients.

Doctors' reactions to the increasing patients' interest for MC / A The majority of practitioners of MC/A originating outside the conventional framework of healthcare, WITHOUT MEDICAL QUALIFICATION and acting through a network of parallel health care services In the US and the EU there was growing interest for MC/A particularly in diseases with high rates of morbidity, mortality or for those for whom Conventional Medicine do not fulfilled their expectations It is also called Parallel Medicine intense associated with nutritional supplements

PRINCIPLES of MC / A 1. To exclude organic disease that can benefit from Conventional /Allopathic therapy 2. In addition to an allopathic treatment, with the agreement of the expert/specialist

CLASSIFICATION OF COMPLEMENTARY THERAPIES Groupe 1. Complementary Therapies benefiting from their own professional organizations Homeopathy Acupuncture; Electropuncture; Moxaterapy Chiropractice Osteopathy

CLASSIFICATION OF COMPLEMENTARY THERAPIES Groupe 2. Herbalism Fitotyerapy; Gemotherapy Hidrotherapiy; Kinetotherapy Masotherapy Reflexotherapy, Presopuncture, Talasotherapy Yoga; Meditation Aromatherapy Cromotherapy - therapy by colors Melotherapy

CLASSIFICATION OF COMPLEMENTARY THERAPIES Groupe 3. Complementary disciplines Ayurvedic Medicine (India) Traditional Chinese Medicine Oriental – Tibetan Medicine Cristalotherapy Sacrotherapy

HOMEOPATHY Similarity principle \"similia similibus curantur" was known from Hippocrates period Samuel Hahnemann (1755), the founder of Homeopathy. The similarity lies in the fact that any sick can be healed with small doses of the substance that causes in large doses to healthy person symptoms similar to those of the disease ► the totality of the symptoms and signs of disease present in a patient can be healed of a substance likely to produce similar symptoms in a healthy person.

HOMEOPATHY Indications: Acute diseases: Viral Infections, Urinary infections, Functional digestive diseases Chronic diseases: especially those with imunopathogenesis - bronchitis, asthma, arthritis

ACUPUNCTURE

Stimulating the various meridians of the body to restore the energy balance Electro-acupuncture - is associated with skin electrical stimulation It is successful in the algo-therapy, particularly in rheumatic disorders, but also in obesity – Hunger Center Control Moxa-therapy, moxibustia -intradermal application of a combustion plant, dermal irritation - algolisis

GEMOTHERAPY- modern fitotherapy Use of vegetable-fresh buds, sprouts, under the action of a mixture of Glycerin and alcohol Most frequent used: chestnut, birch, cedar, silver fir, Hawthorn, fig tree, lemon Their content in: citokinine, fitocrom, glibereline work like a genuine micro-tissue therapy Bio-Stimulines plant achieved a drainage, flebotonic action, cerebral tonus, strengthen fractures

CHIROPRACTIC, OSTEOPATHY CHIROPRACTIC Vertebral manipulation techniques/manevre + massage with the aim of restoring joint mobility and joint function OSTEOPATHY repeated pressure of trigger points of joints, ligaments, tendons, bone insertions decreasing pain, tenderness, stiffness

NATURAL MEDICINE CLINICAL ECOLOGY –Monodiet –ex.Hyper-Proteic –Fasting-diet, –Vegetarianism, –Veganism SACROTHERAPY Therapy in Prayer group