DISCUSSION Saturday, May 27, 10:30-12:30


Complementary and Integrative Medicine Models: Clinical Settings and Research Implications

Speakers: Shay Pintov, MD, Dorit Gamus, MD, PhD, Gustav Dobos, MD, Marja Verhoef, PhD, Mary Hardy, MD, Moshe Frenkel, MD

The recent interest in the integrative practice of CAM and conventional medicine resulted in a variety of integrative medicine (IM) frameworks within health care services.

Since most of the IM settings developed as a reflection of patients needs, policies of particular institutions, tradition and culture of each country, the goal of this session is to bring questions and challenges related to the issue of IM models. The session will cover the issue of IM models from different perspectives, partially based on the Israeli experience. It will include the following topics:

Clinical implementations:
1. CAM in primary care
2. CAM in a hospital setting

Presenters will discuss treatment models/protocols, with the emphasis on: The framework of multi-professional teams (both CAM and conventional practitioners). Case management and treatment modality selection: optimizing outcomes within these multidisciplinary settings. Examples of research projects that emerged out of this framework.

Research implications in these settings:
1. Research methodology in evaluating IM models
2. Discussion

Evaluation of IM models requires research designs that take into account the complexity of the intervention, and may include RCTs, randomized pragmatic designs, observational research, qualitative methods or case studies. In addition, selected outcomes need to reflect the intent and purpose of the IM model. One of the major issues is how to evaluate the impact of integrative teamwork vs. presenting an additional treatment modality for specific conditions. This part of the session will address research issues in the assessment of the presented models in terms of what should be evaluated as an outcome:

1. Potential impact on the patient: symptomatic improvement/ perception of the disease/ perception of the therapists (team-work, better compliance)
2. Impact on the team: MD's & CAM practitioners (therapeutic interaction between MD-CAM practitioners and within different CAM modalities):

  • Does knowledge (awareness) of the therapeutic effect of additional treatment modalities change the attitude towards patients via a different intake or more intimate interaction?
  • Does it have an effect on motivation of the team, co-stimulation, inspiration, respect?
  • May it save costs for the establishment?

 

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