Finding Reliable Information on
Complementary and Alternative Medicine
(CAM)
Elise Cogo, BSc, ND, MLIS
Naturopathic Doctor & Information Specialist
Consultant, Ottawa
Ontario Library Association Super Conference,
February 2011, Toronto
Complementary and
Alternative Medicine (CAM)
• Complementary medicine
• Alternative medicine
• Integrative medicine
• Traditional medicine
• (W)holistic medicine
• Unconventional medicine
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Types of CAM
• Natural products; and certain dietary
therapies
• Energy medicine – e.g., Reiki, magnetic
fields, etc.
• Manipulative and body-based practices –
e.g., chiropractic, osteopathic
manipulation, massage therapy
• Mind-body medicine – e.g., prayer,
meditation, yoga, hypnotherapy, Tai Chi
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Types of CAM
• Movement therapies – e.g., Rolfing,
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pilates, etc.
Traditional Chinese medicine (TCM) –
including acupuncture, etc.
Naturopathic medicine
Homeopathy
Ayurveda; & other whole medical
systems (Ref: NCCAM).
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Massage Therapy
• Registered Massage Therapy (RMT) is
a regulated profession.
• Must have completed a 2-3 year
diploma program from a recognized
massage therapy school.
• Other forms of massage are not
regulated professions.
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Chiropractic
• Doctor of Chiropractic (DC): 4 years
post-grad. at recognized school.
• Regulated in all provinces.
• Assess for disorders related to the
spine, pelvis, extremity joints, and their
effect on the nervous system.
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Naturopathic Medicine
• Combines: botanical medicine, clinical nutrition,
hydrotherapy, homeopathy, naturopathic
manipulation, traditional Chinese medicine /
acupuncture, and prevention and lifestyle
counselling.
• Regulated profession in 4 provinces, including
Ontario; (+ 1 pending).
• 2 accredited schools in Canada.
• Naturopathic Doctor (ND): 4 years post-grad.
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Homeopathic Medicine
• Uses ultra-high dilutions of natural
substances.
• Popular system of health care
especially in Europe and South Asia.
• Product sale is regulated by Health
Canada’s NHPD.
• Not a regulated profession in Canada.
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Traditional Chinese Medicine
(TCM) & Acupuncture
• TCM includes acupuncture, traditional
Chinese herbal medicine, etc.
• Ontario passed the TCM Act in 2006, to
regulate the profession. A Transitional
Council is currently establishing the
new Regulations and standards.
• Regulated in 4 provinces.
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Some Additional
CAM Terms
• Qi gong; Feldenkrais method; Trager;
• Alexander technique; Therapeutic Touch;
• Shaman; curandero; aromatherapy;
• Unani medicine; Tibetan medicine;
• Bowen technique; flower essences;
• Biofeedback; art therapy; macrobiotics;
• Shiatsu; reflexology, etc.
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CAM Use
• 20% of Canadians consulted a
complementary or alternative health
care provider in 2003 (Statistics
Canada, 2005).
• 74% of Canadians have used at least
one complementary or alternative
therapy sometime in their lives (Fraser
Institute, 2007).
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CAM Use
• Canadians spent over $5.6 billion
out-of-pocket for complementary or
alternative therapy treatments in one
year (Fraser Institute, 2007).
• 71% of Canadians regularly take NHPs
like vitamins and minerals, herbal
products, and homeopathic medicines
(NHPD: 2005 Ipsos-Reid survey).
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CAM Use
• Functional Foods and Natural Health
Products Survey 2007 (Statistics
Canada): industry revenue was
$3.7 billion.
• 38% of adults use CAM in the USA
(2007 National Health Interview
Survey).
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CAM Use
• 2007 National Health Interview Survey:
http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm
• 18% of American adults had used a
non-vitamin/ non-mineral natural product
(e.g., fish oil/ omega-3’s, echinacea, etc.) in
the past year.
• These products were the most popular form
of CAM among both adults and children.
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CAM Use
• Massage therapy use in women in
America last year was 25% (American
Massage Therapy Association survey
2010).
• 9% of American adults have used
chiropractic or osteopathic manipulation
(2007 National Health Interview
Survey).
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CAM Use
• Mind-Body Practices: 13% of American
adults had used deep-breathing
exercises, 9% had practiced meditation,
and 6% had practiced yoga.
• Progressive relaxation and guided
imagery were also among the top 10
CAM therapies for adults
(2007 National Health Interview Survey).
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Online CAM
Consumer Resources
• NB - the focus of the online sources
discussed below is on free access for
consumers
• U.S. National Institute of Health’s (NIH)
National Center for Complementary and
Alternative Medicine (NCCAM)
• Provides many resources
• List of Health Topics A-Z is very useful
for consumer health queries
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CAM Resources
• Health Canada’s (HC) Natural Health Products
Directorate (NHPD)
• NHPD’s Compendium of Monographs (also
available in French) give recommended
directions of use for the market approval
(licensing) of many products
• Guidance on how to report a product adverse
reaction/ side-effect to HC’s MedEffect Canada
at: www.healthcanada.gc.ca/medeffect
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Natural Health Products
• Natural health products (NHPs) are a subset of drugs in
Canada, vs. “dietary supplements” as foods in USA.
• NHP Regulations under the Food and Drugs Act in
Canada, since 2004.
• Natural Product Number (NPN); or DIN-HM (homeopathic).
• Vitamins and minerals
• Herbal remedies
• Homeopathic medicines
• Traditional medicines (e.g., TCM)
• Probiotics
• Other products like amino acids and essential fatty
acids.
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CAM Resources
• NIH’s Office of Dietary Supplements (ODS)
• Natural Medicines Comprehensive
Database (NMCD)
• MedlinePlus - Herbs & Supplements
(information from NMCD): consumerfriendly website with many products.
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CAM Resources
• NHS Evidence - complementary and alternative
medicine specialist collection (formerly a
Specialist Library of the UK National Library for
Health)
• Provide Annual Evidence Updates of the highquality types of research on acupuncture and
homeopathy
• Also produces some Annual Evidence Updates
of CAM for several health conditions
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CAM Resources
• U.S. National Cancer Institute’s (NCI)
Office of Cancer Complementary and
Alternative Medicine (OCCAM)
• Includes a FAQ webpage and general
guidance for cancer patients
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CAM Resources
• The Research Council for
Complementary Medicine (RCCM)
• Canadian Interdisciplinary Network
Complementary and Alternative
Medicine Research (IN-CAM)
• Pediatric Complementary and
Alternative Medicine Research and
Education Network (PedCAM)
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CAM Resources
• PedCAM website also provides a good
list of CAM-specific research databases
• Natural Standard database (subscription)
• Alberta CAM Research Network has a
good list of CAM research and
professional organizations:
http://people.ucalgary.ca/~dllorenz/#professional
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CAM Resources
• The Richard and Hinda Rosenthal
Center for Complementary and
Alternative Medicine
• Passeport Santé (French)
• CARE Program: also provides
evidence-based CAM reviews for
several childhood illnesses
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CAM Resources
• CAMline
• Provides evidence-based reviews of
products (NHPs) in patient and
professional versions
• Provides useful information on CAM
professions in Canada
• Has a CAM dictionary
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CAM Resources
• CAM on PubMed (subset search limit)
• PubMed’s Dietary Supplement (DS)
subset (search limit)
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CAM Resources
• The Cochrane Collaboration –
list of CM systematic reviews
• Center for Integrative Medicine
(University of Maryland)/ Cochrane
CAM Field - consumer summaries
• Cochrane CAM Field - glossary of
CAM terms
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CAM Resources
• Integrative Health Institute (Mount Royal
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University) - list of CAM associations
Board of Directors of Drugless Therapy Naturopathy (Ontario)
College of Chiropractors of Ontario
College of Massage Therapists of Ontario
Transitional Council of the College of
Traditional Chinese Medicine Practitioners
and Acupuncturists of Ontario
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CAM Resources
• World Health Organization (WHO)
Traditional Medicine (TM) Fact Sheet
• Website includes details of the WHO
TM global strategy
• Contains list of WHO Collaborating
Centres for TM
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