Integrative Medicine @ policy

Today was the conference from early morning. (I do not gather only before the start of their work, it is a conference, such as the Council of the Society has been held from time to time in that.) The main agenda was shown at the meeting with yesterday of Health, Labor and Welfare Minister, it is a review of the recommendations related to promoting integrative medicine research. At the time of the interview, in addition to the Minister, many bureaucratic staff than expected was that of to have attended. So far, with respect to IM / CAM / TM, excuse of bureaucratic mechanisms, traditional medicine to have distributed the research costs, was that. However, Western in developed countries and Asia other than Japan major countries, has a research institute of the National, we are promoting the research and clinical practice as a national policy. In Japan, there is no institution which is a counterpart, has continued to situation. (In the administrative reform, the National agency in Germany method, because it is a flow that, realistic and established the national research institutions to, Although you think that it is not easy for that.) Efficacy, safety, in any of the terms of economic efficiency (cost-effectiveness), that from the multidisciplinary treatment with modern Western medicine, which besides better of integrative medicine approach, including the CAM / TM by EBM, are excellent There it is being recognized. Of course, since the field of medical care there are many stakeholders, but the overnight realization is difficult, philosophy of integrative medicine, we believe that everyone involved is a model that can become happy. Current medical business model, it is possible to leave a condition improvement can be expected in preventable illness and early intervention, patient increases → expensive drugs and medical devices are developed → industry revitalization, and become not You. (For example, diabetes is the typical example.) Patient is a medical consumers, is a model that should not be happy.

Integrated medical approach to low back pain

Professional journal of the month of Complementary and Alternative Medicine, clinical studies showed the effectiveness of integrative medicine approach to low back pain, it has been reported from a group of Eisenberg et al., US Harvard University. (J Altern Complement Med 2012 Apr; 18 (4):. 354-62) In previous research, it has validity to the low back pain due to a separate CAM (complementary and alternative therapy) has been suggested, but verification by integrative medicine model was not enough. Therefore, in this study, with respect to sub-acute low back pain, effectiveness and feasibility of an integrated medical approach that combines CAM therapy has been studied. Specifically, targeting low back pain 20 patients with 3-12 weeks of disease duration, the group usually was carried out treatment only When The group was carried out usual care + integrated medical approach Is divided into two groups with 12 weeks of intervention trials have been made. It should be noted that in the integrative medicine approach, is implemented team medical constituted by the health care workers who received training, Physician, chiropractor, acupuncturist, masseur, nurse practitioners, nutritionists, physical therapists, and occupational therapists have participated. (↓ is setting like.) As an outcome, pain, functional evaluation (Roland-Morris score), was is used such as the SF-12. The results of 12 weeks of intervention, Compared to usual care alone group, In the group was integrated medical approach, bothersomeness (p = 0.02) and a significant reduction in pain (p = 0.005) (improvement), Significant improvement in functional status (p = 0.08) is that was observed. For improvement rate Compared to usual care alone group, In an integrated medical approach enforcement group, it has been shown to significantly greater improvement. (Function; p = 0.02, bothersomeness; p = 0.002, pain score; p = 0.001) Also, in various indicators of the secondary outcomes, we found significant improvement in integrative medicine practitioner group. In addition, the difference in these two groups, had been continued even at the time of 26 weeks, a significant difference was not maintained. From the above data, Against low back pain, integrative medicine approach in foreign There are feasibility, Compared with the normal treatment it is likely to exhibit excellent efficacy.

Complementary and alternative medicine to be provided in the integrated medical academic health center

Professional journal of the month of family medicine (electronic version), studies that have examined the complementary and alternative medicine (CAM), which is provided in the integrated medical academic health center, has been reported from the US group (University of Washington). (Fam Med 2013 May; 45 (5):. 330-4.) And integrated medicine, Is a personalized medicine that oriented the holistic medical patient-oriented, To medical care with a focus on modern Western medicine, also consider that incorporate traditional medicine and complementary and alternative medicine that certain scientific evidence has been shown. In North America, academic health center such as University Hospital of universities and research institutions, has opened a clinic that has advocated an integrated medical care. In this study, In academic health center in the United States, The contents of clinical practice, research and education that clinicians and healthcare professionals who are advocating an integrated medical care have done was investigated. In particular, In integrative medicine clinic 30 facilities of academic health center included (related) Healthcare professionals (MDs, DOs, PAs, nurse practitioners) to the subject, research has been done. Responses from 162 people in 136 patients (84%) was obtained. As a result of the analysis, The CAM, which has been enforced most common, - Breathing techniques (66%), - Herb (61%), - Meditation (44%), - Functional Medicine (34%) was. In addition, many CAM therapies as earlier the clinician to introduce the patient, - Acupuncture (96%), - Massage (92%), - Yoga (85%), - Meditation (79%). It has become the order of. Other, Respondents, It was spent on education of medical students and 20 percent of the time. In addition, 63% of respondents had participated in the study in the past year. From the above data, In the United States of academic health center comes with integrated medical clinic, Typical CAM are practitioner-introduction, It is suggested that has also been done education and research.

Supplement use and the need for communication in cancer integrative medicine

In this month of pain treatment specialist journal (electronic version), and significance of supplement use in cancer integrated medicine, is a review that showed the need for a doctor patient communication, it had been reported from a group of Israel. (J Pain Symptom Manage. 2013 May 23.) Many cancer patients, while utilizing nutritional supplements other than herbs, such information is not disclosed to the oncologist, it is said. Therefore, in this study, In cancer treatment, The efficacy and safety of nutritional supplements reviews have been made. In particular, Major medical database (AltHealthWatch, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine Service Database, Natural Standard Database, and PubMed) from, Jadad score we have analyzed to extract the randomized controlled trials of two or more. (CAM, nutrition supplements, QOL, such as a search word.) As a result of the analysis, Usefulness of nutritional supplements is that has been found. For example, Vitamin E, glutamine, components such as acetyl L- carnitine, The effect of reducing the risk and severity of peripheral sensory neuropathy associated with paclitaxel (paclitaxel) administration of antineoplastic agents of taxane was granted. Also, Vitamin E and glutamine, It was useful for the reduction of oral mucositis associated with radiation therapy and chemotherapy. Other, Probiotics and glutamine, Diarrhea risk caused by chemotherapy was lowered, it is that. From the above data, For nutritional supplements as a complementary therapy to be used in combination with cancer standard treatment, that certain of the clinical significance is suggested, And, About the effectiveness and safety of the supplement product, Between the cancer patients and oncologists, such as the need for open dialogue it is carried out has been discussed.

More important than medicine prefer the psychiatrist in the treatment of depression

If you are looking at a clinical significance of the "relationship" in the medical, In the treatment of depression, more of psychiatrists, is three times more important than the medicine, I've read the research reports that. (J Affect Disord 2006 Jun; 92 (2-3):. 287-90) In the field of psychosomatic medicine and integrative medicine, Relationship between patients and healthcare professionals, have been demonstrated to affect the prognosis of the disease. That is, If the doctor patient relationship is good, At the same medicine, it is more effective, it is better passed, is that. Also in the process of the administration analgesic, there is a comparison test of the mechanical pump, a nurse, Better administration by a nurse, there are several studies that the large analgesic effect. First, as the background of this study, Assessed by the National Institute of Mental Health of the United States NIH (NIMH), In the treatment of depression, Imipramine tricyclic antidepressants, there is a consensus that it is more effective than placebo. (Data of NIMH TDCRP. Imipramine + Clinical management is more effective than placebo + Clinical Management.) But, In this data, not been analyzed clinical significance of healer such as a physician, Contribution to the role and treatment plays the psychiatrist has not been shown. Therefore, in this study, The role of the psychiatrist in the United States NIMH TDCRP has been verified. In particular, Patient 112 persons of data becomes the subject from NIMH TDCRP, · Imipramine + Clinical management group (n = 57, 9 psychiatrists), - Placebo + Clinical Management (n = 55, 9 psychiatrists) But it has been verified. As the evaluation score of depression, BDI score and the HAM-D score has been compared. As a result of the analysis, First, Contribution of each element in the BDI score, Pharmaceuticals: 3.4% (p <.05) Against, Psychiatrist: 9.1% (p <.05) was. That is, In the treatment of depression, Psychiatrist, And will it plays a triple role of antidepressants. In addition, HAM-D score, Pharmaceuticals: 5.9% (p <.05) Psychiatrist: 6.7% (p = .053) was. From the above data, In the treatment of depression, The role of psychiatrist is suggested to be more important than the drug.