Reducing the risk of complementary and alternative medicine (CAM): challenges and priorities

White, A., Boon, H., Alraek, T., Lewith, G., Liu, J-P., Norheim, A-J., Steinsbekk, A., Yamashita, H. and Fonnebo, V. (2013) Reducing the risk of complementary and alternative medicine (CAM): challenges and priorities. [in special issue: Ensuring and Improving Patients' Safety in Integrative Health Care] European Journal of Integrative Medicine, 1-5. (doi:10.1016/j.eujim.2013.09.006).

Abstract

Introduction

The safety of health care is increasingly prominent concern of the public, applying to complementary and alternative medicine (CAM) as well as conventional treatment. In 2009, a group of academic and clinical CAM researchers held a workshop to discuss the constraints and priorities of research into CAM safety. This group here report their discussions, and offer collaboration with practitioners internationally with the aim of improving patient safety for CAM practices and products.

Discussion

Research into the safety of healthcare presents challenges, including definitions of terms where a recent WHO initiative is significant. Particular problems that must be addressed include: the apparently low incidence of harmful incidents; the limited regulatory setting for CAM practice including the omission of CAM interventions from most mainstream adverse event reporting schemes; the widespread perception of CAM as natural and safe; the complexity of CAM therapies; interactions between CAM and conventional care; professional complacency; and the special challenges unique to specific CAM therapies such as the concept of a ‘healing crisis’. The researchers reached a consensus that the first priority for CAM safety research is active surveillance, or the measurement of actual harm from CAM. The second priority is research into beliefs and attitudes of practitioners, public and professional organisations, and what influences those attitudes; the final research area covers the procedures used to ensure safe practice, and their effectiveness.

Conclusions

International collaboration between experts in the field, including practitioners and researchers, may be the best way to achieve the required levels of expertise.

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