Do Clinicians Base CAM Recommendations to Patients on Evidence of Efficacy?

Désirée A. Lie, MD, MSEd

Disclosures

February 28, 2014

Conclusion

Overall, the literature suggests that nurses are most likely to report use of CAM, followed by pharmacists, whereas physicians demonstrated greater variability in and lower rates of CAM use. The surveys and studies among healthcare professionals also suggest a link between self-reported use of CAM and recommendation to patients, whether the evidence was available for efficacy or not.

Pharmacists were most likely to report discomfort with the evidence for efficacy, and all professions appear to desire greater training and access to evidence about CAM modalities.[17,18,24,25,26] Both pharmacists and nurses are likely to recognize and report a disconnect between their own use of CAM and the strength of evidence supporting efficacy.

In the patient with back pain described earlier, it is likely that a nurse, pharmacist, or physician would recommend some form of CAM, on the basis of their own self-use. The likelihood of recommendation is higher if the providers had themselves tried a modality. The modalities that may be recommended include acupuncture, massage, manipulation, and dietary supplements. Training and continuing education about CAM is needed among all health professions to ensure consistent recommendations based on the best evidence.

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