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Heather White.
CAM Therapy
Complementary medicine and alternative medicine (CAM) have been gaining in mainstream acceptance and popularity. In particular, those patients who suffered from 2 or more chronic conditions were most likely to utilize these forms of treatment, (Falci et al., 2016). Hypertension and diabetes are considered chronic conditions, (Arcangelo et al., 2016) so it can be inferred these patients would be more likely to utilize CAM. Cancer patients, as well, have a high rate of CAM utilization with over half reporting some type of CAM treatment, (Keene et al., 2017).
With this high prevalence of CAM utilization, it is important that the advanced practice nurse (APN) get a complete history from the patient regarding all supplements as well as other forms of CAM, (Arcangelo et al., 2016). There is a definite safety consideration involved with CAM treatment that must be addressed by the provider. Education regarding potential interactions between medications and supplements in particular should be a key point of discussion between the provider and the patient.
The provider should have an open and honest conversation about the patient’s expectations of the CAM treatment and how that fits in with their traditional medical treatment. With hypertension there are some known CAM treatments that are evidence based treatment the provider can discuss with the patient and see if they are a good fit for a patient-centered plan of care, (Lattanzio & Weir, 2020).
Patients with diabetes are faced with many products that offer claims of treatment. These patients must be educated to look at results of studies that show actual benefit. There are some supplements that have shown promise in lowering A1c more than half a percent such as ginger, oral aloe vera and fenugreek, (Grossman et al., 2018). These type of supplements are a proven type of CAM that could be included with a patient-centered plan of medication, diet and exercise to help bring about a good outcome for the patient.
One of the reasons patients look to CAM treatments is to try take charge of their medical care, (Arcangelo et al., 2016). This can especially be true for patients who feel like they have no control over their diagnosis. A chronic medical condition diagnosis or a cancer diagnosis can be devastating to a patient. These patients may need to feel empowered regarding their health care, (Aujoulat, 2008). Engaging in CAM is a way patients can feel empowered when facing a diagnosis that is out of their control.
Cancer patients in particular, can need this sense of empowerment. Management of traditional treatment side effects is one driver of CAM usage. Acupuncture and hypnosis have shown efficacy for nausea, pain and anxiety. Cupping has been utilized for lymphedema treatment resulting from breast cancer treatment. Supplements such as ginger, turmeric and curcumin and even saffron have shown beneficial outcomes for cancer patients, (Inci & Inci, 2020). Supplement use can sometimes interfere and inhibit traditional medicine so it is imperative these topics are addressed with the patient, (Berretta et al., 2017).
As a practitioner, I would not have a problem supporting a patient that chose this path in their treatment. I think patient education and full disclosure of side effects, expectations, and evaluating outcomes should be imperative in a patient-centered plan of care.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2016). Pharmacotherapeutics for advanced practice (4th ed.). Lippincott Williams and Wilkins.
Aujoulat, I., Marcolongo, R., Bonadiman, L., & Deccache, A. (2008). Reconsidering patient empowerment in chronic illness: a critique of models of self-efficacy and bodily control. Social science & medicine, 66(5), 1228-1239.
Berretta, M., Della Pepa, C., Tralongo, P., Fulvi, A., Martellotta, F., Lleshi, A., … & Facchini, G. (2017). Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey. Oncotarget, 8(15), 24401.
Falci, L., Shi, Z., & Greenlee, H. (2016). Multiple Chronic Conditions and Use of Complementary and Alternative Medicine Among US Adults: Results From the 2012 National Health Interview Survey. Preventing Chronic Disease, 13. https://doi.org/10.5888 /pcd13.150501
Grossman, L. D., Roscoe, R., & Shack, A. R. (2018). Complementary and alternative medicine for diabetes. Canadian journal of diabetes, 42, S154-S161.
Inci, H., & ?nci, F. (2020). Complementary and alternative medicine awareness in cancer patients receiving chemotherapy. World Cancer Res. J, 7.
Keene, M. R., Heslop, I. M., Sabesan, S. S., & Glass, B. D. (2019). Complementary and alternative medicine use in cancer: A systematic review. Complementary therapies in clinical practice, 35, 33-47.
Lattanzio, M., & Weir, M. R. (2020). An evidence-based appraisal of complementary and alternative medicine strategies for the management of hypertension. Journal of Hypertension, 38(8), 1412-1419.
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