Options in alternative medicine resources
Options in alternative medicine resources
Are your patients seeking information on complementary and alternative medical approaches for relief of menopausal symptoms such as hot flashes and sleep disturbances? Arm yourself so you can help them make informed decisions in those areas.
"There are a lot of approaches based on hype and people wanting to sell things that may be hard on your pocketbook and may also be hard on your health," notes Sadja Greenwood, MD, MPH, assistant clinical professor with the department of OB/GYN and reproductive sciences at the University of California San Francisco. "It is important to understand what people are interested in, what they're taking, and to be able to sort out what is good and what is bad."
While many forms of complementary and alternative health care have been used for years, providers should look for research evidence in weighing risks and benefits, advocates Ron Chez, MD, professor of OB/GYN in the school of medicine and professor of community and family health in the college of public health at the University of South Florida in Tampa.
"Patient safety means you have some evidence that the benefit exceeds the risk, and all of us who have the privilege of caring for patients really understand that data is what allows us to make the comment on benefit versus risk," he notes. "Although something may have been done for a length of time does not necessarily mean that it is safe or efficacious. If we are going to have a system in which we are thoughtful about what patients are doing, and if it is both effective and efficient in terms of value, then I think it is appropriate to ask for data."
Greenwood points to the Harvard Women's Health Watch monthly newsletter as a good source of information on both conventional and complementary and alternative approaches. (For details on ordering this newsletter or other products mentioned in this article, see resources, p. 93.) The nutritional research offered in Tufts Health and Nutrition Letter also gives providers a good over view of the latest information in that arena.
For botanical information, providers can look to the Boulder, CO-based Herbal Research Foundation, which will perform medical literature searches, Greenwood says. The Foundation, in coordination with the American Botanical Council in Austin, TX, publishes a quarterly journal, Herbalgram, which is good source of research-based information on herbs.
The Office of Alternative Medicine (OAM) at the National Institutes of Health in Bethesda, MD, also offers a wealth of information on complementary and alternative medicine at its World Wide Web site, says Kirtly Parker Jones, MD, associate professor in the department of OB/GYN, at the University of Utah Health Science Center in Salt Lake City. The OAM Clearinghouse offers patient information sheets and other information that can help patients and providers learn more about complementary and alternative approaches.
American Health Consultants, publisher of Contraceptive Technology Update, also publishes Alternative Medicine Alert, a monthly newsletter written by and for clinicians. That publication covers news and research and offers an assessment of alternative medicine techniques.
An integrated approach
The Association for Reproductive Health Professionals (ARHP) in Washington, DC is sponsoring "Women's Health in the Perimenopause: An Integrated Approach," a seminar scheduled for Nov. 20 through 22 in Los Angeles. The seminar will include speakers from both sides of the issues presenting information on treatment of perimenopausal symptoms.
Providers must look objectively at the situation when approached by patients seeking complementary and alternative therapies, says Jones, ARHP board chairwoman. Conventional medicine has been successful in its approaches to contraception, Jones says. In the area of menopause, providers may not have all the answers, she observes. "If we are not a little humble about this, I think we are going to close doors in our own research, as well as close doors with our patients."
Chez offers these tips for working with patients:
· Listen to patients and determine if there is some form of conventional medicine they can use that isn't being used at the present time.
· Determine what the benefits are from complementary and alternative approaches and understand why patients want to access them. Those reasons can be powerful and appropriate, he says, particularly for chronic debilitating diseases where there are no effective conventional treatments.
· Learn about the method patients request, or at least don't denigrate them for using it. If patients are using a method that may be harmful, he says it is the provider's responsibility to warn them. Tell them data are unavailable or you think there's going to be a problem with the method. Urge them not to use the method in question without actually dismissing them from the practice.
"We may not be able to fulfill [patients'] needs, but we at least have to acknowledge that we cannot and that they have the right to seek alternatives," he says. "We have the responsibility when they ask us to help them as much as we can and understand whether the alternative is safe or not."
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