Complementary Medicine inWomen’s HealthWomens Health 2012: The 20th Annual CongressMarch 16, 2012Josephine P. Briggs, M.D.Director, National Center for Complementary andAlternative MedicineNational Institutes of Health
DISCLOSUREI HAVE NO FINANCIAL INTERESTS ORCONFLICTS OF INTEREST TO DISCLOSE
What is Complementary Medicine? A group of diverse medical and health care interventions, practices, products, or disciplines that are not generally considered part of conventional medicine Boundaries are Gray Moving Cultural
N at ur % of Adult Population al pr 10 15 20 0 5 od D uc ee ts p br ea th in g M ed ita tio C n hi ro pr ac 38.8 million tic Therapies: 2007 M as sa ge 16 million Yo Sp ga ec iaBarnes et al., 2008 ld ie ts R Adult Use of Selected CAM el ax at io n Im ag A er y cu p un ct ur e
% of those adults who used CAM Ba 0 5 10 15 20 ck pa Ne in ck pa Jo in i nt p ai n Ar th rit 14.3 million Conditions: 2007 is 5 million An xi et Ch ol y es te ro lBarnes et al., 2008 Co O ld s th er m Adult Use of CAM for Selected us He c ad ac he In so 1.8 million m ni a
Adult Use of Selected CAM Therapies:2002 vs. 2007 2002 2007 *** % of Adult Population 10 5 0 Barnes et al. 2004, 2008
Reasons for CAM Use: 2007 87% Treatment 76% Wellness 42% Wellness 54% Treatment% using therapy for given 100% 90% Other Reasons 80% 70% reason 60% 50% Treatment AND 40% Wellness/Prevention 30% 20% 10% 0% Treatment only Wellness/Prevent only Stussman, 2010
NHIS CAM Survey: Use and Costs, 2007 CAM use in U.S.: Overall Use by Gender 40% of adults Women Men Average 12% of children 43% 34% 40% CAM spending in U.S.: $34 billion out-of-pocket 1% of total health care expenditures 10% of total out-of-pocket costs Across all demographics Women > men West >Midwest >Northeast >South Greater use in people with higher education levels
The Range of Research Questions How does Can it be What are the How well does it it work? studied in specific work in real world people? effects? settings? Outcomes Basic Translational Efficacy and Science Research Studies Effectiveness Research
Hierarchy of Evidence Guidelines Systematic reviews Rigorous human studies Basic biological understanding
Research SpotlightIsoflavone soy protein supplementation and atherosclerosis progression in healthy postmenopausal women: a randomized controlled trial.Hodis HN, Mack WJ, Kono N, et al. Isoflavone soy protein supplementation and atherosclerosis progression in healthypostmenopausal women: a randomized controlled trial. Stroke. 2011;42(11):3168–3175.
Research SpotlightNaqvi AZ, Harty B, Mukamal KJ, et al. Monounsaturated, Trans, and Saturated Fatty Acids and Cognitive Decline in Women. J ofthe American Geriatrics Society. 2011;59(5):837-843.
Research SpotlightBarbosa-Cesnik C, Brown MB, Buxton M, et al. Cranberry juice fails to prevent recurrent urinary tract infection: results from arandomized placebo-controlled trial. Clinical Infectious Diseases. 2011;52(1):23–30.
Research SpotlightGeller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms:a randomized controlled trial. Menopause. 2009;16(6):1156–1166.
Tai Chi for Fibromyalgia
Meditative Exercise Therapies
Beyond Drugs:How alternativetreatments can easepainMarch 7, 2011
Journal of Manipulative and Physiological Therapeutics
Menopause Research In 2002, the Womens Health Initiative raised concerns about long-term safety of menopausal hormone therapy. One reason that many women are turning to complementary therapies. In 2005, NIH State-of-the-Science conference on the management of menopause-related symptoms determined that more research is needed to clearly define the natural history of menopause, associated symptoms, and effectiveness and safety of treatments for bothersome symptoms.
NCCAM Menopause ResearchNCCAM supports a number of studies on complementary healthpractices for menopausal symptoms, such as: A trans-NIH initiative to improve scientific measures of hot flashes Research to identify natural plant-based compounds as promising alternatives to traditional menopausal hormone therapy Safety and efficacy and mechanisms of action of black cohosh, red clover, soy supplements, and other botanicals Mind and body therapies like yoga, meditation, hypnotherapy, and acupuncture for reducing hot flashes.
NCCAM Portal Pageon Women’s Health Cancer Fertility/pregnancy Menopause Osteoporosis Osteoarthritis Polycystic Ovary Syndrome Urinary Tract Infection Links to other Resources
AcknowledgementsNHIS CAM Survey Richard Nahin, NCCAM Barbara Stussman, NCCAM Patricia Barnes, NCHS/CDC
National Center forComplementary andAlternative Medicine1-888-644-6226nccam.nih.gov