NCCAM Strategic Plan 2010

Now in its third cycle of 5-year strategic planning, NCCAM continues to explore CAM healing practices in the context of science, train CAM researchers, and disseminate authoritative information to public and professional communities.

BO SO

BO SO

rcent 3O er

2O 1O O

Thought Conventional conventional medical medicine would professional not help suggested it

Thought it would be interesting to try

Conventional medicine too expensive

Thought CAM combined with conventional medicine would help

Figure 11-5 Reasons people use complementary and alternative medicine (CAM) therapies.

(From Barnes PM, Towell-Griner E, McFann K Nahin RL: Complementary and alternative medicine use among adults: United States, 2002. CDC Advance Data Report No 343,2004.)

Table 11-4 Guiding Principles: 2002 White House Commission on Complementary and Alternative Medicine Policy

1. A wholeness orientation in health care delivery

2. Evidence of safety and efficacy

3. The healing capacity of the person

4. Respect for individuality

5. The right to choose treatment

6. An emphasis on health promotion and self-care

7. Partnerships are essential for integrated health care

8. Education as a fundamental health care service

9. Dissemination of comprehensive and timely information

10. Integral public involvement

NCCAM's course for 2010-2014 is to create priority areas of CAM research to focus efforts that would best serve public need while meeting fiscal realities, as guided by four factors: (1) scientific promise, (2) extent and nature of practice and use, (3) amenability to rigorous scientific inquiry, and (4) potential to change health practices.

Nahin and Straus (2001) and Ahn and Kaptchuk (2005) discuss the unique challenges that CAM presents to conventional research approaches in evidence-based medicine (see Chapter 8). Many CAM study therapies are complex and heterogeneous compared with the more familiar single-drug trial of biomedicine. As such, innovative research strategies, such as those for sham acupuncture, will need to be continually developed. CAM may help the science of medicine to further evolve, as reflected on by Linde and Jonas (1999):

The continuing interface between orthodox and unorthodox medicine today provides the opportunity for new research strategies and methodologies to arise. By purposefully maintaining a creative tension between the established and frontier, we can advance scientific methods and more clearly define the boundaries and purpose of the scientific process for medicine.

Table 11-5 Recurring Perspectives from IOM Summit on Integrative Medicine and the Health of the Public

Vision of optimal health: Alignment of individuals and their health care for optimal health and healing across a full life span.

Conceptually inclusive: Seamless engagement of the full range of established health factors—physical, psychological, social, preventive, and therapeutic.

Lifespan horizon: Integration across the life span to include personal, predictive, preventive, and participatory care.

Person-centered: Integration around, and within, each person.

Prevention-oriented: Prevention and disease minimization as the foundation of integrative health care.

Team-based: Care as a team activity, with the patient as a central team member.

Care integration: Seamless integration of the care processes, across caregivers and institutions.

Caring integration: Person- and relationship-centered care.

Science integration: Integration across approaches to care (e.g., conventional, traditional, alternative, complementary), as the evidence supports.

Policy opportunities: Emphasis on outcomes, elevation of patient insights, consideration of family and social factors, inclusion of team care and supportive follow-up, and contributions to the learning process.

From Institute of Medicine (IOM). Integrative Medicine and the Health of the Public: a summary of the February 2009 summit. Washington, DC, National Academies Press, 2009, p 5.

Table 11-6 How the Physician of the Future Will Function

The care process is...

The doctor's role will be.

Patient centered

A navigator

Team based

Part of a multidisciplinary team

High-touch, high-tech

Grounded in the community

Genomic and personalized

Preventive

Integrative

Support of social and environmental policies promoting health

And supports patients through.

And will follow.

Complementary and alternative practices

Evidence-based, outcome-focused practices

Belief that the body helps heal itself

Principles for creations of healing environments

The lead of empowered patients

From Institute of Medicine (IOM). Integrative medicine and the health of the public: summary of the February 2009 summit. Washington, DC, The National Academics Press, 2009, p. 43.

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