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ARTICLES
A) Knowledge and exposure to complementary and alternative medicine in pediatric doctors: a questionnaire survey Click Here Simon Fountain-Polley, Grace Kawai, Amanda Goldstein and Titus Ninan
BMC Complementary and Alternative Medicine 2007, 7:38doi:10.1186/1472-6882-7-38
Published:29 November 2007
Background
Complementary and alternative medicines are increasingly used by the general population. A survey was conducted to ascertain the knowledge of Complementary and Alternative Medicines (CAMs) amongst pediatric physicians, and whether seniority increases the likelihood of its use being considered in consultations, or of families discussing it.
Methods
Anonymous survey of general pediatric doctors in a large inner-city district general hospital (DGH) and tertiary children's centre (TC) using a questionnaire. Statistical analysis was calculated using Minitab.
Results
43 / 49 (88%) questionnaires were returned correctly. 13 (30%, CI 17 - 46%) doctors had personally used CAMs. 24 (56%, CI 40 - 71%) of their families had used CAMs. 13 (30%, CI 17 - 46%) had received formal CAMs education. 21 (49%, CI 40 - 71%) could name a total of 5 types of CAMs. Consultants were significantly more likely to ask about CAM use than middle-grades and juniors (p<0.05, CI 48 - 93%, 35 - 90%, 8 - 33% respectively) and have had a clinical encounter where they felt it was significant. 32 (74%, CI 59 - 86%) of the clinicians had been asked about CAMs. 33 (77%, CI 61 - 88%) of doctors had successful CAM use reported to them, and 20 (47%, CI 31 - 62%) had failure of CAMs reported to them.
Conclusions
CAM use is relatively common in pediatric doctors and their families. They have received little formal CAMs education. Consultants were more likely than juniors to ask about CAM use and have had a clinical encounter where it played a significant part. Around half of all doctors irrespective of grade have been asked about CAMs in a clinical encounter.
B) A study of efficacy and cost-effectiveness of Guided Imagery as a portable, self-administered, presurgical intervention delivered by a health plan.
Deborah Schwab, Dana Davies, Tracy Bodtker, Lucy Anaya, Keren Johnson, Maria Chaves, Advances in Mind Body Medicine. Summer 2007 Vol.22, #1.
The study describes the Blue Shield of California Presurgical Guided Imagery Program, and assesses its impact on surgical outcomes, patient satisfaction, and cost savings.
Survey data was collected pre- and post-surgery among 905 eligible health plan members. Additionally, retrospective analysis of medical claims for a subset of 126 hysterectomy patients were compared to similar patients who did not use guided imagery, for differences in length of stay and charges billed.
Data revealed an adoption rate of 74% (extremely high for any voluntary patient education program). Patients who used the guided imagery intervention reported significantly reduced anxiety and high levels of satisfaction. A trend toward shorter hospital stays (8% reduction, p=0.07) was also observed in the imagery group, as well as reduced pharmaceutical costs (14% reduction, p=0.181).
In total, there was a 14% total reduction in mean total charges billed per procedure in the imagery patients, amounting to an average savings of $2,003. The study couldn't isolate differential cost of lab and imaging fees, but the research team speculated that these factors probably played a part in the cost savings as well.
C) A pilot study of mindfulness-based stress reduction for hot flashes.
Carmody J, Crawford S, Churchill L. james.carmody@umassmed.edu
Menopause. 2006 Sep-Oct;13 (5): pages 760-9
Researchers from the University of Massachusetts Medical School in Worcester did a feasibility study to see if participating in a mindfulness-based stress reduction (MBSR) program had any effect on the severity of hot flashes and menopause related quality of life.
Fifteen women volunteers who had reported having at least seven moderate to severe hot flashes a day were recruited to attend eight weekly MBSR classes at the University of Massachusetts Medical School. Participants were assessed for menopause-related quality of life before the beginning and at the conclusion of the MBSR program. The women also kept a daily log of their hot flashes through the course of the program and for 4 weeks following its conclusion.
The study determined that the women's scores on quality-of-life measures increased significantly, and the median severity of hot flashes decreased 40% over the course of the 11 weeks of the assessment period. The women were also individually interviewed at the completion of their participation, and the results of the interviews were consistent with the results from their daily diaries.
The study concluded that these results provide preliminary positive evidence of the feasibility and efficacy of MBSR in supporting women who are experiencing severe hot flashes, and that the method's efficacy warrants further investigation.
D) Potential synergism between Hypnosis and Acupuncture:Is the whole more than the sum of its parts?
Elad Schiff; Steven Gurgevich; and Opher Caspi
Evidence Based Complementary Alternative Medicine. 2007;4(2):233-240. ©2007 Oxford University Press
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Abstract
Both hypnosis and acupuncture have gained credibility over the years in their effectiveness for treating various health conditions. Currently, each of these treatments is administered in distinct settings and separate times. That is, even if patients receive both treatments as part of a multidimensional therapeutic program, they would typically receive them separately rather than simultaneously at the same session. This separation however might be undesirable since, at least theoretically, hypnosis and acupuncture could potentially augment each other if administered concomitantly. In this article we outline the rationale for this hypothesis and discuss the potential ramifications of its implementation.
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