COMMENTARY

Integrative Medicine: Sorting Fact From Fiction

Kenneth R. Pelletier, MD, PhD

Disclosures

November 02, 2007

 


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Integrative medicine is the "evidence-based [1]" combination of conventional with complementary and alternative medicine (CAM) for assuring the maximum therapeutic benefit for patients and practitioners.[2,3] Under the 5 category taxonomy of the NIH National Center for Complementary and Alternative Medicine (http://nccam.nih.gov), there are many areas of CAM and integrative medicine where there is a substantial and growing body of evidence based on research and clinical practice.[4,5]

To cite but a few representative examples, there are the domains of:

  1. Mind-body medicine where such approaches constitute the most extensive body of CAM research documenting the efficacy of such interventions for the largest number of conditions for the greatest number of patients.[6]

  2. Acupuncture with 16 systematic reviews in the Cochrane Library (www.cochrane.org) demonstrating efficacy in conditions as diverse as depression, back pain, Bell's palsy, dysmenorrhea, arthritis of the knee,[7] and fibromyalgia.[8]

  3. Specific herbal interventions (www.herbalgram.org) and a growing sophistication regarding drug-herbal interactions (www.herbmed.org; www.healthyroads.com).

  4. Traditional Chinese medicine (TCM) with several international NCCAM Centers of Excellence to focus on irritable bowel syndrome (IBS), side effects of cancer treatment, and allergic asthma.[5]

  5. Upwards of 50 ongoing research studies annually from the NIH-NCCAM (http://nccam.nih.gov). Among the many diverse CAM/IM areas being researched are dietary practices and supplements, chiropractic, homeopathy, naturopathy, electromagnetic effects, and Ayurvedic medicine, chelation, and spiritual healing.[9,10,11,12]

Based on the 2006 Institute of Medicine report on CAM, it is clear that integrative medicine is part of a rapidly evolving era of genomics, international medicine, and evidence-based approaches (www.nap.edu/catalog/11182.html). Through acknowledging and addressing the need for an adequate "evidence-based" foundation in conventional, CAM, and integrative medicine, the standards whereby all medicine should be judged will be raised for the benefit of both patients and practitioners.

That's my opinion. I'm Dr. Kenneth R. Pelletier, Clinical Professor of Medicine at the University of Arizona School of Medicine and the University of California School of Medicine in San Francisco.

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