Acquisition, distribution and perspectives of healthcare information in complementary and alternative medicines (CAM)
There is an underlying need to gather information for a better understanding of the mechanisms of action, safety, efficacy and cost-effectiveness of CAM. Once this information has been collected, the research needs to be distributed amongst healthcare professionals, the public and governing bodies. In my work, I looked at the range of German and UK general practitioners' attitudes toward CAM and medical students' CAM attitudes in the UK, USA, Canada, New Zealand and Hong Kong. GPs' CAM attitudes did not differ across countries but a lack of information regarding safety and efficacy, as well as CAM training opportunities were criticized. CAM education was found to vary across countries due to different curricula and personal CAM use was a better predictor of CAM attitudes than was CAM exposure in the medical schools' curricula. I furthermore collected information on how CAM practitioners respond to specific patient and researcher health queries via e-mail. Medical herbalists, chiropractors, reflexologists, acupuncturists and homeopaths were contacted. lt was found that response rates to a fictitious patient were significantly higher than those given to a researcher. Some of the advice given online was interpreted as misleading or dangerous. Regulations for CAM practitioners dealing with potential clients' postal or online health queries should be put in place. I co-authored various systematic reviews, which summarize data from clinical trials and thus assessed the efficacy of mistletoe, co-enzyme Q10, guided imagery acupuncture and Ukrain for cancer care and music therapy for cardiovascular conditions. To summarize these reviews I conclude that some CAM modalities play an important role as an adjunct to conventional medicine in palliative cancer care and are based on a non-specific effect. Specific effects of CAM for certain health conditions are rather small. There is a need to regulate how CAM information is distributed. More rigorous clinical trials need to be financed and carried out independently to assess CAM efficacy and safety in those CAM modalities where a specific effect is suspected and in others with non-specific effects possibly CAM therapist evaluations should be carried out. Further international regulations should be put in place regarding CAM education in medical schools and CAM training for healthcare professionals.