Complementary and Alternative Medicine Essay.

Complementary and Alternative Medicine Essay.

 

Introduction
In recent years, there has been an increasing interest in complementary medicine, and indeed alternative medicine (Lee-Treweek 2002, Andrews 2004, Barry 2006).Complementary and Alternative Medicine Essay. Moreover the number of professionally trained therapist and practitioners has increased giving the patient/client a better choice and at more competitive rates (Smallwood, 2005).

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In this essay a critical assessment of the view that ‘patients use of complementary and alternative medicine, can be understood as part of the individualisation of responsibility for health’ will be made and argued, that there are many aspects which influence the uptake of such therapies. Responsibility for health has changed and this will be discussed by examples of sociological theories. Medical sociologists have been previously concerned with illness rather than health. Functionalists such as Parsons (1951) suggested illness was a deviance and had the effect of disruption on society which had to be controlled. He used the sick note to illustrate that the sick person was excused from performing normally, but this had to be kept to a minimum and the sick person had to want to get better.Complementary and Alternative Medicine Essay. The function of the medical profession was to socially control the use of the sick note to those genuinely sick (Webb, Westergaard, 2004). However in today society the working person aims to keep working during some illnesses or at least limit the time spent away from work. To do this it involves taking some responsibility for keeping healthy and reducing the time actually being ill. Therefore by choosing to use CAM and alternative medicine, it could provide an additional method which may combat illness and help speed up recovery (Lett, 2000).Complementary and Alternative Medicine Essay.
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Possible reasons why patient/clie…

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…t approach of dictating the direction the Nation Health Service should follow. This caused a vast change in how services were delivered, with cost influencing many decisions.Complementary and Alternative Medicine Essay.

Prescribed Drugs with CAMs (Complementary and Alternative Medicine )

Order Description
A 35-year-old male, Mr. NX, presents to your clinic today with complaints of back pain and “just not feeling good.” Regarding his back, he states that his back pain is a chronic condition that he has suffered with for about the last 10 years. He has not suffered any specific injury to his back. He denies weakness of the lower extremities, denies bowel or bladder changes or dysfunction, and denies radiation of pain to the lower extremities and no numbness or tingling of the lower extremities. He describes the pain as a constant dull ache and tightness across the low back.Complementary and Alternative Medicine Essay.

He states he started a workout program about 3 weeks ago. He states he is working out with a friend who is a body builder. He states his friend suggested taking Creatine to help build muscle and Coenzyme Q10 as an antioxidant so he started those medications at the same time he began working out. He states he also takes Kava Kava for his anxiety and garlic to help lower his blood pressure.

His historical diagnoses, currently under control, are:

Type II diabetes since age 27

High blood pressure

Recurrent DVTs

His prescribed medications include:

Glyburide 3 mg daily with breakfast

Lisinopril 20 mg daily

Coumadin 5 mg daily

Directions:

Based on the above case study, address each section of the Unit 9 Assignment template. Be sure to first view the Unit 9 Assignment Grading Rubric (found in the Grading Rubrics section under Course Home) and use it to guide your completion.Complementary and Alternative Medicine Essay.

Download the Unit 9 Assignment template.
Rename the downloaded template file as “FirstInitial+LastName_ MN553_Unit9.docx” (e.g., JDoe_MN553_Unit4.docx).
Review the Assignment grading rubric.
Complete the template, basing your responses on the case study above.
Support your arguments with appropriate evidence from the literature, citing and referencing in APA 6th edition style.
Upload your completed file to the Dropbox. Please be sure to confirm that your file uploaded correctly. For help in uploading, review the Student Guide to the Dropbox.Complementary and Alternative Medicine Essay.

Unit 9 Assignment template.

Case Study: MN553 Advanced Pharmacology
Unit 9 Case Study
“Prescribed Drugs with CAMs”(Complementary and Alternative Medicine)
Student Name
Date of Submission

This paper addresses a pharmacological management plan for Mr. NX, including consideration of possible contraindications for CAMs, prescriptive, and non-prescriptive recommendations for management of acute pain and other ongoing disease processes, followed by evaluation strategies.

Conventional and Alternative Medicine
It is important to track the front of the existing dilemmas in the issue of conventional and alternative medicine. In that respect, there are various locations that accompany to diseases and good health, in gathering the steps that is entitled for it to be taken out by an individual and then as to advocate full health. Patients are getting frustrated with doctors that seem pushy with drugs and surgeries as cures. We can likewise retain an open mind on both of these ways.Complementary and Alternative Medicine Essay.
However, conservative methods are on the other hand, are being utilized; medicine is a perfect example of the existence of the two attitudes. The conventional medicine’s main focus is with methodical work and knowledge. There also
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Conventional medicine, takes into account principles, still depends mostly on medications and surgical operations. This will be more effective for administering critical situations or quick-fixes, but it’s less effective for healing chronic diseases. Furthermore, it is expensive. Alternative medications are more cost effective, it ensures strong results, but it’s also a healing process and may not be a legitimate solution for a quick answer for the patient.
Conventional medicine relies discretely on chemically manufactured drugs; alternative medicine uses natural elements such as herbs as remedying substances. Alternative medicine also utilizes ancient methods of treating diseases, such as acupuncture, massage, and yoga. Conventional medicine puts more efforts on logical methods of diagnosing and treatment, although acupuncture and massage are applied on a steady basis.Complementary and Alternative Medicine Essay.
Alternative and conventional medicines have distinctive approaches when it comes to treatments and healing diseases. Conventional medicine often visualizes the disease by itself and concentrates focuses more on a quicker fix than on different approaches.

Prescribed Drugs with CAMs (Complementary and Alternative Medicine )
Paper , Order, or Assignment Requirements

A 35-year-old male, Mr. NX, presents to your clinic today with complaints of back pain and “just not feeling good.” Regarding his back, he states that his back pain is a chronic condition that he has suffered with for about the last 10 years. He has not suffered any specific injury to his back. He denies weakness of the lower extremities, denies bowel or bladder changes or dysfunction, and denies radiation of pain to the lower extremities and no numbness or tingling of the lower extremities. He describes the pain as a constant dull ache and tightness across the low back.Complementary and Alternative Medicine Essay.

Did you know you get a free plagiarism report, free title page, free bibliography and 24/7 email and phone support once you place an order on All A+ Essays? I thought you should knowHe states he started a workout program about 3 weeks ago. He states he is working out with a friend who is a body builder. He states his friend suggested taking Creatine to help build muscle and Coenzyme Q10 as an antioxidant so he started those medications at the same time he began working out. He states he also takes Kava Kava for his anxiety and garlic to help lower his blood pressure.Complementary and Alternative Medicine Essay.

Complementary and alternative medicine (CAM) is very popular with patients frequently combining it with orthodox health care. The high prevalence of CAM use and satisfaction with CAM reported by patients directly challenges an orthodox system that can only approve such use if it results from the application of biomedical concepts and science. Studies highlighting this as a cultural, sociological and historical phenomenon emphasise the value of choice for consumers of health care. Musculoskeletal conditions typify common problems for which the effectiveness of orthodox care is often unclear. We postulated that the reasons people give for using or not using CAM for musculoskeletal conditions, would therefore indicate the full range of expectations that people have of health care. Furthermore, these reasons would indicate how much people feel orthodox health care is or is not meeting their expectations. Therefore, this study aims to investigate people’s reasons for choosing or avoiding CAM for non-traumatic musculoskeletal conditions.Complementary and Alternative Medicine Essay.

Methods

A systematic search and narrative synthesis was conducted of published qualitative and quantitative studies related to CAM and non-traumatic musculoskeletal conditions.Complementary and Alternative Medicine Essay.

Results

We identified 169 relevant papers detailing 152 separate studies, from which 1486 justifications were extracted concerning CAM use. Content analysis resulted in 11 distinct categories across four themes: practical aspects of care, clinical effectiveness, non-clinical outcomes of care, and a person’s philosophy of illness and care. People provided similar rationales for both using and avoiding CAM, emphasising that, whilst CAM is perceived by many patients with musculoskeletal conditions to fill gaps in care (such as practitioner time or quality of the therapeutic relationship), orthodox care also seeks to deliver these aspects of care. However, people who used CAM also highlighted its alignment with their general philosophy and ideas about illness and health care, and often emphasised CAM’s capacity to give them control over their condition and its treatment.Complementary and Alternative Medicine Essay.

Conclusion

Currently, CAM appears to have a significant role for patients with common painful long-term conditions in providing choices to enable individual needs to be met.Complementary and Alternative Medicine Essay.

Introduction

The model of modern orthodox scientific Western medical practice can be summarised as ‘find the pathological disease underlying a patient’s illness and treat it; identify causal mechanisms underlying the disease and prevent it occurring in the first place’. The sick patient gets better; the incidence of disease declines. Musculoskeletal conditions, in total estimated to be the commonest reason for disability globally [1], contain examples of the application and success of this traditional model—the prevention of rickets, joint replacements for patients with osteoarthritis, and drugs which target and counter inflammation in rheumatoid arthritis.Complementary and Alternative Medicine Essay.

There is no single model of complementary and alternative medicine (CAM). Some therapies, such as herbal remedies, may be developed, tested and applied entirely within the orthodox biomedical framework. Others, such as traditional acupuncture, have a philosophy and principles of action which do not originate and may not fit with orthodox Western medical science. For many people, this makes much CAM implausible and beyond justification as a rational approach to ill-health.

However, there is now widespread acceptance that Western medicine, for all its successes in diagnosing and treating disease, needs a wider view of the sick person than biology and pathology alone provide and must set care in the wider context of a patient’s personal, emotional, social and cultural life, especially for long-term illness such as common musculoskeletal conditions (back pain, osteoarthritis) for which ‘scientific cures’ are often lacking. This reflects the importance of patient autonomy, self-care, choice and expectations, and growing evidence that wider components of care beyond biomedical treatments can improve response to those treatments [2]. Belief in the potential of a treatment to help, for example, and the shared expectation of patient and clinician in its likely success may have powerful effects in relieving musculoskeletal pain [3].

Attention to this wider context of care has been a feature of the traditional healer in societies across the world, and researchers and CAM proponents have argued that this, and placing support for self-care at the heart of the consultation in many types of CAM, is what CAM can deliver [4,5]. Others have argued that this wider care, although important, should only be built around scientifically proven interventions. Orthodox Western practitioners such as family doctors would also argue that this wider care has long been an important component of conventional health care anyway [6]. Yet CAM is very popular, especially among patients with musculoskeletal conditions [7], and the prevalence of CAM use has been increasing for many years, with patients often combining it with orthodox health care [8,9]. This high volume of use and satisfaction with CAM reported by patients is a direct challenge to a conventional system that can only sanction such use if it results from the application of biomedical concepts and science. It has been studied as a cultural, sociological and historical phenomenon, with conclusions that emphasise the value of choice for consumers of health care [10,11].

Musculoskeletal conditions typify common problems for which the effectiveness of orthodox care is often unclear. We hypothesised that the reasons people give for using or not using CAM for musculoskeletal conditions would highlight the full range of expectations that people have of health care. Furthermore, these reasons would indicate how much people feel orthodox health care is or is not meeting their expectations.Complementary and Alternative Medicine Essay.

We therefore set out to identify and categorise the body of reasons that people give for seeking out and using CAM for musculoskeletal conditions and the reasons others avoid it, by conducting a systematic search and narrative synthesis of literature related to CAM and musculoskeletal medicine.

Methods

Research question

In people with non-traumatic musculoskeletal conditions, what are the justifications given for choosing, continuing, avoiding or discontinuing CAM?

Inclusion and exclusion criteria

Types of studies.

Quantitative and qualitative studies of any design were included. Intervention studies were only included if participants were able to choose whether they were allocated to CAM therapy or not and their reasons for choice reported. We did not restrict searches by country or date. However, for practical reasons, all non-English language articles were excluded, as were conference abstracts and studies where the full text could not be retrieved.

Types of participants.

Individuals of any age, sex or ethnicity with non-traumatic musculoskeletal conditions were included, whether from a general or specific population e.g. primary care and disease/condition specific population. Studies of post-operative pain, trauma-related conditions e.g. acute sprains and fractures, and conditions that were primarily neurological e.g. multiple sclerosis, were excluded if no other non-traumatic musculoskeletal condition was included.Complementary and Alternative Medicine Essay.

Types of interventions.

We included any intervention considered a complementary and alternative medicine (CAM), defined as “…‥health care approaches developed outside of mainstream Westernor conventionalmedicine for specific conditions or overall well-being.” [12], whether it was being used alongside (complementary) or instead of (alternative) orthodox biomedical healthcare.

CAM covers a large and diverse range of interventions. A list of specific CAM therapies and treatment modalities was devised based on the operational definition identified by the Cochrane Collaboration [13,14], database subject headings, and CAM therapies listed by NHS Evidence, Wikipedia and Natural Therapy Pages [15–17]. This included both practitioner-based care, and self-treatment using over-the-counter products e.g. homeopathic remedies and herbal preparations. Studies concerning psychotherapeutic interventions were excluded.

To summarise, inclusion criteria for screening were:

  • Complementary and alternative medicine (CAM)
  • A non-traumatic musculoskeletal condition
  • If an intervention study, participants were given the choice of whether to use CAM or not
  • Justifications for using or not using CAM were explicitly provided by participants
  • Original report of an empirical study

Measures or descriptions of justification

The focus of this review was on any measurement or description concerning individuals’ justifications for use or choice of CAM. This included justifications to begin or continue use of CAM (this may include specific facilitators), and any justifications for not using or discontinuing use of CAM (this may include specific barriers).Complementary and Alternative Medicine Essay.

Search method

A comprehensive search strategy was designed to capture as much of the relevant literature as possible. Systematic searches were conducted across six electronic databases (EMBASE, MEDLINE, CINAHL, ASSIA, AMED and Web of Science) from inception to July 2011. The searches were rerun in February 2017 (see ‘Update and assessment of robustness’ section below). The search strategy utilised text word searching in the title or abstract along with the database Subject Headings and combined terms for: i.) General or specific CAM therapies; ii.) General or specific musculoskeletal conditions; and iii.) Justification for CAM use (see S1 Appendix for full search strategy for OVID MEDLINE). For the other databases search terms were adapted to the search capabilities of the database platform.

In addition, key journals not fully indexed in the online databases searched were hand searched (Social Theory and HealthAnthropology and Medicine and European Journal of Integrative Medicine), and reference lists from relevant articles, including all those included in the review, were checked.Complementary and Alternative Medicine Essay.

Study selection

The initial screening of papers by title was conducted by one reviewer (NC) by excluding clearly irrelevant articles. At this stage these were primarily articles about non-musculoskeletal conditions e.g. varicose veins and multiple myeloma, or where the intervention was an orthodox approach e.g. a specific drug therapy or physiotherapy.

The abstracts of the remaining articles were then assessed independently by two reviewers (NC and JJ) for relevance and were excluded by agreement. The reason for excluding each paper was recorded. In addition to condition and intervention, many non-English language and conference abstracts (where no full text article could be found) were identified for exclusion. If it was unclear as to whether a publication was relevant or not, it was included for the next stage. Full text copies of all remaining papers were then obtained and matched against the inclusion criteria.Complementary and Alternative Medicine Essay.

The process of selecting studies for inclusion or exclusion.

All full texts were assessed for inclusion by one reviewer (NC), with the two other reviewers (JJ and PC) independently screening separate samples to check consistency (n = 50 and n = 24 respectively, representing 11% of the total). There was a high level of agreement between the reviewers (96% and 100% agreement respectively for each of the two ‘second’ reviewers) on which articles to include and exclude. Disagreements were documented and resolved between the reviewers. The number of excluded papers was recorded according to the reason.Complementary and Alternative Medicine Essay.

Data extraction

A data extraction form was specifically designed for the review and used to record relevant information from each study in a spreadsheet (see S2 Appendix). Data extraction from each paper involved identifying all distinctive justifications mentioned in that paper, drawing on survey results, qualitative quotes from individuals, and any themes or items extracted by the paper’s authors. One reviewer (NC) conducted the data extraction from all papers and a sample was independently checked by a second reviewer (JJ). The following information was extracted:Complementary and Alternative Medicine Essay.

  • study design
  • sample size
  • study setting
  • country
  • age of participants
  • percentage of female participants
  • medical condition(s)
  • CAM therapy/type
  • justification for CAM use

Data synthesis

To comprehensively explore all justifications for CAM use by individuals with non-traumatic musculoskeletal conditions, inclusion of both quantitative and qualitative research was necessary. A narrative synthesis process was used to enable the different forms of evidence to be combined, informed by guidance produced by Popay et al. [18].

Identification of categories.

Content analysis was used to categorise textual data. Using the data entered in the spreadsheet, a list of all the justifications recorded from each paper was produced alongside its unique identifier (i.e. a separate ‘ID’ number for each recorded justification). Blinded to other details of the study, justifications were coded using a five step approach to identify and categorise the reasons for CAM use or non-use:

  • Step 1Linguistically identical/similar: justifications which were identically phrased or were identical except for linguistic nuances were identified and coded (with an ‘A’ group code) by NC and reviewed by JJ and PC. For example, “expensive drugs” [ID36], “prescription drugs too expensive” [ID49] and “affordable alternative to expensive prescription drugs” [ID480] were all coded as A36.
  • Step 2Conceptually identical/similar: justifications which were considered identical/very similar conceptually were identified and coded (with a ‘B’ group code) and provided with a code descriptor by NC and reviewed by JJ and PC. For example, those coded A36 (see above) along with similar justifications coded in Step 1 including “conventional treatment too expensive” [ID961], “cost” [ID372], “low cost compared to medical services” [ID710] and “”stopped going to physical therapy because couldn’t afford it any more“” [ID981] were all given the same code (B30 –which can be summarised here as ‘Motive: CAM cheaper than orthodox care’).
  • Step 3Categorisation: justifications from steps 1 and 2 were sorted and grouped to identify broader categories by NC which were coherent and could be designated with a unifying label. During this process there was a point at which no new categories emerged i.e. saturation of categories was attained. Preliminary labels were then assigned to each category. For example, those coded B30 (see above) along with similar justifications including those coded as B139 ‘Barrier: CAM perceived/considered too expensive to try’, B6 ‘Discontinued: too expensive, could not afford’, B191 ‘Continue: cost-effectiveness’ and B273 ‘Motive: CAM covered by insurance’ were labelled ‘COST’.
  • Step 4: Categories identified and labelled in step 3 were presented to the two ‘second’ reviewers. Discussion between all three reviewers led to minor amendments in the contents and labels of some categories e.g. ‘COST’ was merged into the category ‘ACCESS’. Then, using these amended categories, two reviewers (JJ and PC) independently allocated a randomly selected subset of all justifications to the available categories (consisting of 10% of all phrases in each category as allocated by the lead reviewer). This provided a check on the appropriateness and robustness of the categorisations. Disagreements were documented and resolved through discussion between all three reviewers.
  • Step 5: Finally, all justifications were arranged according to their assigned category and then were checked again independently by all three reviewers to ensure accuracy and consistency of categorisation.Complementary and Alternative Medicine Essay.

Justifications could be assigned to more than one category: this was particularly pertinent for qualitative studies where multiple reasons were often given in one statement.

Update and assessment of robustness

The search was rerun at the beginning of February 2017 and new papers fitting the inclusion criteria were identified. Full texts were retrieved and justifications were identified to check if any additional reasons were given beyond those already described. In this way, the robustness of the categorisation was checked, using the criterion that no new justifications would be identified with the publication of new studies.Complementary and Alternative Medicine Essay.

We followed the PRISMA statement guidelines for reporting systematic review of studies that evaluate health care interventions [19], as far as was relevant for this systematic search and narrative synthesis: see S3 Appendix for PRISMA checklist.

Results

One hundred and fifty-two studies, reported in 169 papers (see S4 Appendix for full list of included papers), were identified for inclusion in this narrative synthesis (see Fig 1). Almost three quarters (74.3%) of studies were based in North America (n = 67) and Europe (n = 46, of which UK = 29); however, Asia (n = 16), Australia and New Zealand (n = 12), the Middle East (n = 9) and Africa (n = 2) were also represented.Complementary and Alternative Medicine Essay.

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