Complementary and alternative medicine and prevention. The approach to populations as patients: a common CAM questionnaire

Objective

The first objective is to propose a common Complementary and Alternative Medicine (CAM) questionnaire. The second objective is to emphasise the role of epidemiology in disease prevention and CAM research within general populations. Community diagnoses of the distributions of health and disease can be readily combined with studies of prevalence, incidence and mortality of conditions shown in current evidence-based studies to be susceptible to CAM advice and treatment.

Materials and methods

The University of Michigan Complementary and Alternative Medicine Research Center is in the fifth year of three randomised controlled trials (RCTs). As of November 2002 results were as follows:

1. The Management of Chronic Pain in Diabetic Painful Neuropathy: an Alternative Approach: 176 patients have completed either Reiki Energy Healing or mimic Reiki to control pain
2. Randomised Clinical Trial of a Crataegus oxycantha extract in Chronic Heart Failure: 98 patients with congestive heart failure have been randomised to treatment with or without hawthorn (C. oxycantha)
3. Qigong and Psychosocial Effects during Rehabilitation after Cardiac Surgery: 426 surgical patients participated in a randomised clinical trial to study the effects of external energy healing therapy on incision wound healing and pain through the use of Qigong and its psychosocial effects on rehabilitation after cardiac surgery.

Results

Pending final analyses of these three projects and concurrent reviews of the state-specific prevalence of CAM use in the USA and the use of complementary medicine in England, a selection of validated risk factors is being incorporated into a standardised questionnaire for self-completion in a general population. Plans are to pilot what could become a definitive instrument, in appropriate samples of existing cohorts in general populations such as the Tecumseh Community Health Study and the Renfrew and Paisley/Midspan study population. There is just as much need for standardisation today as there was in the early days of identifying cardiorespiratory risk. Researchers in CAM would appear to have made an earlier start in what was sometimes a difficult and contentious process for their predecessors.

Conclusion

Lack of population-based epidemiological studies and, notably at this stage, failure to standardise terms, criteria and methods within and between disciplines, will remain a serious handicap until epidemiology is more widely integrated into CAM teaching and practice.

(This research is funded in part by NIH grant #P50-AT-00011.)