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So, What’s Integrative Medicine? Jeffrey P Schaefer MSc MD FRCPC March 28, 2008
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Objectives Introduce Integrative Medicine, Describe CHR directions, Encourage you to think broadly about health and illness.
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What’s in a label?
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Complementary & Alternative Medicine A broad domain of healing resources that encompass all health systems, modalities, and practices, and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historic period. Complementary modalities used with, but different from, mainstream medicine Alternative modalities not generally recognized by the medical community and used instead of standard treatments not taught in schools of western medicine
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Frequency of Use - CAM n = 1,584 adults in South Carolina
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CAM TherapyLife< 1 yr Any use complementary alternative medicine 52%44% Personal therapies (home remedies, herbal medicine, homeopathy, or vitamin therapy) 28%25% Relaxation techniques (including massage therapy, imagery, or visualization) 26%23% Chiropractors 21%9% Healing (including healers, spiritual healing, Native American healers, energy healing) 5%4% Commercial weight loss programs 5%3% Life-style diets 4% Self-help groups 3%2% Hypnosis or biofeedback 2%1%
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Reasons for CAM No. CAM Us er s n= 15 48 To Stay Healty Why CAM Therapy Was Used To Treat a Specific Health Problem MSK or Neuro Psycho social Cardio- vascular & Endo Uro- genital GI Allergy & Resp Other Personal therapies62248%11%1%4%6%3%18%10% Relaxation47856%22%13%1% 5% Chiropractors33212%83%1%0% 1%2%0% Healing8760%8%6%3% 2%14% Weight loss programs8276%1% 21%0% 1% Life-style diet6785%3%0%10%0%2%0% Self-help4441%9%2% 0% 2%34% Hypnosis or biofeedback4142%5%12% 0%5%0%15% All other therapies CAM7823%27%1%9%10%14%9%6% Stay Healthy, MSK & Neuro, CV & Endo, Urogenital, GI, Allergy & Resp
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Demographic CharacteristicsLifetime Education Less than high school49% High school diploma47% Some college59% College graduate55% Family income Less than $15,00052% $15,000-$29,99953% $30,000-$49,99951% $50,000 and over60% Age, Marital Status, Race, Gender (F>M – slight)
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Satisfaction with CAM % Reporting CAM as Extremely or Very Effective % Having "Bad Experience" With CAM Therapy % Who Would Recommend CAM to Friends/Family Personal therapies (including home remedies, herbal medicine, homeopathy, or vitamin therapy) 62%4%88% Relaxation techniques (including massage therapy, imagery, or visualization) 64%2%92% Chiropractors 63%8%86% Healing (including healers, spiritual, healing, Native American healers, or energy healing) 79%3%89% Commercial weight loss programs 45%11%69% Life-style diets 72%7%82% Self-help groups 74%8%88% Any CAM use 63%5%88%
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Physicians and CAM % Physicians Who Recommend ed CAM Use % Patients Who Told Provider of CAM Use % Physicians Unaware of Patient's CAM Use Personal therapies (including home remedies, herbal medicine, homeopathy, or vitamin therapy) 15%26%63% Relaxation techniques (including massage therapy, imagery, or visualization) 31%18%56% Chiropractors 25%34%50% Healing (including healers, spiritual, healing, Native American healers, or energy healing) 7%21%73% Commercial weight loss programs 17%33%56% Life-style diets 33%35%43% Self-help groups 33%43%38% Hypnosis or biofeedback 39%12%53% Any CAM use 24%26%57%
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CAM - Canada Complementary and alternative medicine use among colorectal cancer patients in Alberta, Canada. Tough SC, Johnston DW, Verhoef MJ, Arthur K, Bryant H. n= 871 with colorectal cancer d = Population-based questionnaire completed by 70% (pt or family of deceased) 49% used CAM since diagnosis psychological and spiritual therapies (65%) vitamins and minerals (46%) herbs (42%) 68% informed their medical doctors Altern Ther Health Med. 2002 Mar-Apr;8(2):54-6
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So, What’s Integrative Medicine? I.M. uses the combination of both conventional and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness. It emphasizes respect for the human capacity for healing, the importance of the relationship between the practitioner and the patient, a collaborative approach to patient care among practitioners, and the practice of conventional, complementary, and alternative health care that is evidence-based. UC-SF School of Medicine Osher Centre for Integrative Medicine
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Integrative Medicine Holistic physical, mental, spiritual, social determinants of health Evidence-based held to the same standard No distinction traditional, alternative, complementary, folk… Target focus on unique characteristics of the patient
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Alternative Medical Systems: Complete systems of theory and practice e.g. Homeopathy, Ayurveda and TCM Mind-Body Interventions: Support groups (now considered conventional), cognitive therapy, meditation, visualization, art, music, dance therapy Biologically Based Therapies: Herbs, vitamins, foods and other dietary products. Manipulative and Body-Based Methods: Chiropractic, osteopathy and massage. Energy Therapies: Qi Gong, Therapeutic Touch, Reiki
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Integrative Medicine – other attributes emphasis on relationship-centered care patient is active partner prevention and maintenance of health nutrition, exercise, stress-management, emotional wellness provider as educator & mentor use least invasive (& cost) method remove barriers to healing compassion is always helpful collaboration with others in the health care team cure sometimes, heal often, support always
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Integrative Medicine ‘Good’ Medicine Dr. Andrew Weil Harvard Medical School Program Director of the Program in Integrative Medicine (PIM) at University of Arizona; started in 1994 patients do best utilizing both mainstream and alternative medicine mainstream medicine well- suited to crisis intervention alternative medicine is best utilized for prevention and health maintenance IM is an intelligent combination of both
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Regional History and Initiatives Programs and Initiatives Clinic for Mind-Body Medicine Guided Imagery Program Spirituality Heart Math Exploring Health and Healing Conference Traditional Chinese Medicine
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Spirituality quest for ultimate meaning, purpose, relationship, hope, and transcendence. Religion convictions & practices of a community of faith. Sacred concepts of God, the Devine, the Transcendent or Ultimate Reality. Health a balance of the physical, emotional, social, spiritual, and intellectual well-being. Dr. Chris Carruthers - Manager of Spirituality in Chronic Disease Management
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Regional History and Initiatives Institutional and Community Partnerships University of Calgary Mount Royal College Canadian Institute of Natural & Integrative Medicine Community and CHR Providers Scripps Clinic
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Elaine Danelesko
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9 – 10 am Oct 19 Nov 30 Apr 4 May 9 Foothills Auditorium Telehealth to RGH & PLC & Rural
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Network or Distributed Model
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