The Role of Complementary and Alternative Medicine in Pain Management

1
The Role of Complementary and Alternative
Medicine in Pain Management

• Maria Tassone, MSc, BScPT
• Rita Kang, MEd, BSW

2
Overview

• Context for Complementary and Alternative
  Medicine (CAM)
• UHN Experiences
• Practice, Education and Research
• Considerations for Integrating CAM

3
CAM Perspectives

• Health care professional
• Director, Allied Health Professional Practice
• Consumer
• Parent

4
What is CAM?

• Complementary and Alternative Medicine is a
  group of diverse medical and health care systems,
  practices, and products that are not presently
  considered to be part of conventional medicine
• - National Centre for Complementary and
  Alternative Medicine http//nccam.nih.gov/health

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Definitions

• Complementary medicine
• with conventional medicine
• Alternative medicine
• in place of conventional medicine
• Integrative medicine
• combines conventional medicine and CAM

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Core Characteristics

• Integration of body, mind and spirit with a
  holistic approach to healing
• Emphasize natural ability of body to heal itself
• Health focus
• Uniqueness of individuals

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Types of CAM

• Whole Body
• Body
• Biological
• Mind Body
• Energy

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Canadian Context

• Women
• Age
• Household income
• Education
• Spirituality
• Chronic conditions
• Consult conventional practitioners
• 71 of Canadians

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Why CAM?

• Preventing illness and improving Q of L
• Gaining sense of control over chronic illness
• Dissatisfaction with conventional medical care
• Dealing with side effects of conventional medical
  care
• Want to pursue all options
• Seeking collaborative relationships with
  practitioners
• Want holistic understanding of health illness

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Ontario Context

• Regulated Health Professions Act
• Chiropractors
• Massage Therapists
• Physiotherapists
• Legislation
• Bill 171 - Health Improvements Act
• Naturopaths and Homeopaths
• Acupuncture

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Patient Safety

• Evidence-based health care
• Research knowledge
• Clinical Experiences
• Patient Perspective
• Definition of knowledge
• Sources of knowledge
• Absence of evidence
• Research capacity and funding

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Princess Margaret Hospital

• Focus on complementary therapies
• Palliative Care
• Art Therapy
• Pet Therapy
• Healing Journey
• group psychotherapy program promotes self-help
  and the teaching of skills related to coping,
  healing and expression

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Toronto Western Hospital

• Artists Health Centre
• complementary and alternative
• creative and performing artists and students
• chiropractor, osteopath, naturopath, massage,
  acupuncture
• Mental Health and Addictions
• Acupuncture

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Toronto General Hospital

• Eating disorders
• In-patient unit
• Complementary medicine focus
• Arts therapy
• Yoga

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Implications for Professional Practice

• Scope of professional practice
• Maximizing scope and collaboration
• Advancing practice
• College regulation
• Quality

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Implications for Education

• Enhancing UHN academic program
• Interprofessional education
• Students providing access to patients

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Research and Innovation

• Role of academic health sciences centres
• New models of care
• Opportunities for collaboration (ie. Canadian
  Interdisciplinary Network for CAM Research )
  http//www.incamresearch.ca/

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Considerations in Pain Management

• Definition of Pain
• Acute vs. Chronic Pain
• Gender
• Evidence

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Considerations for Integrating CAM

• Patient-centred care
• Values
• Regulation
• Access
• Partnerships
• Revenue-generation
• Innovation

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Questions and Discussion