NCCAM is trying to address that problem with its "Time to Talk" campaign. It encourages physicians to start a conversation about CAM and includes tips for how find time to address it during a brief office visit.
Dr. Josephine Briggs, the NCCAM director, suggests that physicians begin the conversation by asking, "What are you trying to do to be healthy?" Physicians need to recognize that even if they have doubts about a certain CAM modality, patients are generally turning to CAM as a way to be healthy or to help better manage their symptoms, she said. "I think being open to that dialogue and making it a thoughtful one is the way all of us can best help our patients."
She also encouraged physicians to talk to their patients about how they manage pain, since this is often what drives the use of CAM. Ask patients what helps them relieve their pain outside of traditional medications, she suggested, and if they have tried alternative approaches just as relaxation techniques.
Another problem for physicians in talking about CAM is that they may not be familiar with the evidence around a particular CAM treatment. NCCAM is also trying to tackle that. As part of "Time to Talk," they have put together a list of reliable sources on the latest CAM research. And NCCAM is funding a wide portfolio of research on CAM modalities that could potentially be used to treat musculoskeletal conditions, such as tai chi and yoga in the management of fibromyalgia, back pain, and osteoarthritis of the knee.
"I see these as very promising adjuncts for certain patients," Dr. Briggs said. "The question partly is, ‘Is the patient motivated?’ "
NCCAM is also sponsoring studies on dietary supplements. For example, NCCAM funded a large investigation of glucosamine and chondroitin sulfate to treat pain associated with osteoarthritis of the knee in the Glucosamine /Chondroitin Arthritis Intervention Trial (GAIT). The results, which were originally published in 2006, showed that the combination did not provide significant relief from pain. In addition, a number of NCCAM-funded researchers are studying herb-drug interactions to see how over-the-counter dietary supplements could affect traditional treatments for chronic disease.
Dr. Muller, Dr. Briggs, Dr. Kolasinski, and Dr. Manek had no financial conflicts of interest to disclose.