Research Profiles - Alternative medicine: It’s the impact that counts

The idea of "alternative medicine" can be disconcerting to some. The term is sometimes used – or, more accurately, misused – as code for therapies that are, at best, ineffective or, at worst, potentially harmful. There has been a tendency by many, including people in the business of providing health care, to marginalize complementary and alternative medicine (CAM) as treatments that provide negligible benefits to a minority of Canadians.

The reality, however, is something else again. CAM no longer exists on the fringes of the health care system. It resides alongside conventional health services, in the middle of the mainstream. Almost three-quarters of Canadians have purchased alternative medicine products or services, with nearly 40% reporting that they used them daily. This can range from taking Echinacea to stave off a cold, to trying St. John's Wort to quell anxiety. It can mean supplementing chemotherapy with mindful meditation, undergoing acupuncture treatment to promote healing, or including lowbush blueberries in a diet to boost antioxidant levels.

But what benefits are being derived? That is an area where the Canadian Institutes of Health Research (CIHR) has much to contribute. Dr. Pierre Haddad, for example, is working closely with the Cree of Northern Quebec to investigate the healing properties of traditional remedies. His story, "Learning from the Elders" tells how his team has come to appreciate what modern medicine can learn from age-old knowledge.

Evaluating the efficacy of CAM therapies is not an easy thing. Treatments are often customized to fit the health conditions of the individual patient, making assessment through the standard practice of randomized control trials difficult or impossible. That is why Dr. Sunita Vohra leads a campaign to put CAM therapies to the test by using single-patient clinical trials, called N-of-1 studies. Read about her efforts in "The power of one."

Dr. Heather Boon has made it her goal to ensure that pharmacists can answer their clients' questions when they come looking for information about CAM therapies. The story "A natural need to know" outlines her efforts. Likewise, Dr. Lynda Balneaves has been a driving force in providing cancer patients with reliable sources of information when they want to know what CAM can do for them. Her story is told in "The deciding factor."

When it comes to CAM, those of us involved in health research need to remind ourselves that it is the result that counts. We need to think more about evaluating any given treatment on the basis of its impact – including, for example, health outcomes and patient satisfaction – rather than how or where it is provided. We need to research whether an alternative therapy or a traditional medicine produces a better outcome than a conventional treatment and ensure that sound evidence exists to support its use, so that it might make more people better. The requirement of evidence-based health care applies equally to conventional medicine as it does to CAM.

Dr. Colleen M. Flood
Scientific Director
Institute of Health Services and Policy Research