1 5/2/2013 Complementary, Alternative & Integrative The terms - PDF document

5/2/2013 Integration of Presentation Sequences Traditional Medicine 1. Definitions : Complementary, Alternative & Integrative Medicine Into Allopathis 2. Global view Healthcare system 3. Malaysia Experiences 4. Model of integration. Dr Zalilah Abdullah Traditional & Complementary Medicine Division Ministry of Health Malaysia. Definitions : Complementary, Alternative & Integrative Definitions : Complementary, Alternative & Integrative Medicine Medicine • Traditional medicine is the sum total of the knowledge, skills, Complementary/alternative medicine (CAM) and practices based on the theories, beliefs, and experiences • They refer to a broad set of health care practices that are not part of indigenous to different cultures, whether explicable or not, used in the that country's own tradition and are not integrated into the dominant maintenance of health as well as in the prevention, diagnosis, health care system. improvement or treatment of physical and mental illness. 1

5/2/2013 Complementary, Alternative & Integrative The terms “ complementary” and “ alternative” are often used interchangeably, but they • describe two different approaches. Alternative medicine is defined as a treatment modality used in place of conventional • medicine. By definition, alternative treatments are not integrated as part of conventional medicine. Complementary medicine , however, makes use of non-conventional treatment • modalities, some of which have known efficacy, in combination with conventional treatment. Both alternative and complementary medicine focus on treatment modalities. • Integrative medicine , on the other hand, is not about specific non -conventional • treatment modalities, but is an approach to treating patients. Sources : The Regional Strategy for Traditional Medicine in the Western Pacific (2011– 2020) Seeking experiences from other countries Patterns of use of T&CM UK Some general points a) Public often choose complementary / traditional medicine to help with a chronic problem or to relieve stress New Zealand b) Majority of clients already had conventional treatment for the same problems China c) New consultations are mainly prompted by recommendations United Kingdom 2

5/2/2013 Concerns of medical profession have about Patterns of use of T&CM complementary/ traditional medicine * 1. Patients are seen by unqualified practitioners - risk of missed or delayed diagnosis. patient 2. Patients may waste money on ineffective treatments whilst discontinuing or declining Lack of effective conventional treatment. Information 3. Conflicting loyalty Both 4. Adverse effects from integration complementary/traditional treatment 5. The claimed benefits of complementary/ Reduce the gaps between traditional medicine are scientifically medical profession and unproven ( yet). T&CM practitioners * Integrating complementary therapies in primary care, David peters professional Malaysia’s Journey to integrative medicine Malaysia Formation of the T&CM Standing Unit of T&CM Committee experiences… was formed 1992 1996 1997 1998 1999 Registration GMP for Formation of Of Traditional the 5 T&CM Medicine Traditional Manufacturer Umbrella Medicine Bodies 3

5/2/2013 Malaysia’s Journey to integrative medicine Malaysia’s Journey to integrative medicine National • Traditional & National Institute of 13 standards Complementary Policy on Natural developed for Traditional & Medicine Act (756 Products, Complementary academic program ( Act) approved by Vaccine National Medicine Integrated Diploma /Bac) Survey Parliament & Biological Hospital 2012 2008 2009 2001 2002 2003 2004 2007 Formation of Global Traditional & T&CM programs in Information The Complementary Universities Hub Medicine Herbal Division Medicine Research National Centre Committee in R & D On Herbal 13 Medicine NATIONAL T&CM POLICY IN 2001 Objectives Policy Practices establish a registry promote rational use Vision ensure T&CM practices in registered facilities facilitate development & integration Integration of Traditional and Complementary regulate practices Medicine (T&CM) into the Malaysian Healthcare System Training T&CM practitioners undo formalised training process for accreditation modern medicine provider had appropriate knowledge ensure the general public had appropriate knowledge Mission Raw Materials sustainability and standardisation Ensure Quality and Safe Use of T&CM practices & Products GACP & GMP strengthen control on production, import & export and products to attain optimal potential in development & protection of IPR healthcare delivery strengthen farmacovigilance Research & Development prioritise & facilitate R&D establish methods & technologies information data based 4

5/2/2013 Sarawak General Duchess Port Dickson Hospital Sultanah Putrajaya Hospital, Hospital of Kent Hospital Hajah Kalsom Hospital WP Kuala Lumpur Sabah Negeri Sembilan Pahang 2007 2008 2009 2010 2011 2012 Practising Integrative Medicine Kepala Batas Sultanah Sultanah Bahiyah Raja Cheras Rehabilitation Cover Story Sultan Hospital, Nur Zahirah Hospital Hospital Perempuan Zainab II Hospital Centre Ismail Hospital, Johor Fit4Life, The Star Pulau Pinang Terengganu Kedah Kelantan Kuala Lumpur 27 July 2008 T&CM Units in Integrated Hospitals under the Ministry of Health 2013 T&CM Services in Integrated Hospitals 11. HOSPITAL REHABILITASI Malay Massage for chronic Acupuncture for chronic Herbal Therapy as Adjunct CHERAS pain and post stroke pain and post stroke Treatment for Cancer Malay Postnatal Treatment Shirodhara management management Patients Hospital Raja Hospital Putrajaya Hospital Putrajaya Perempuan Zainab II Hospital Putrajaya Hospital Sultan Ismail Hospital Sultan Ismail Hospital Putrajaya Hospital Kepala Batas Hospital Sultan Ismail Hospital Raja Hospital Sultanah Nur Hospital Kepala Batas Perempuan Zainab II Zahirah Hospital Sultanah Nur Hospital Duchess of Zahirah Hospital Sultan Ismail Hospital Port Dickson Kent Hospital Duchess of Hospital Umum Kent Hospital Duchess of Sarawak Hospital Umum Kent Sarawak Hospital Port Dickson Hospital Port Dickson Hospital Sultanah Hospital Sultanah Hospital Kepala Batas Bahiyah Hospital Sultanah Bahiyah Hospital Sultanah Bahiyah Hospital Sultanah Hajah Kalsom Hajah Kalsom 5

5/2/2013 Malay massage treatment regime Acupuncture Cherkin et al. (2003) Annals of Internal Chronic Pain Post stroke Medicine, Vol. 138, No 11, p. 898 -907 No of session 5 sesi 20 sesi A review of the evidence for the effectiveness, Regime Every day or every other day Every day or every other day safety and cost of acupuncture, massage therapy and spinal manipulation for back pain Assessment of treatment effectiveness 5th session First 10 session: effectivenss of the acupoint Tsao (2007) Evidence – based Complementary and Alternative Medicine, p.1-15 Second 10 session: Effectiveness of massage therapy for chronic, non Effectiveness of the threatment – malignant pain: A Review. Maximum session 10 30 Chronic Pain Post stroke No of session 3 7 Regime 3 session within a week First week: 3 sesi (3 days in a row or every Second week : 2 sesi other day) Third week : 2 sesi Assessment of treatment Done on 3 session Done on 7 session effectiveness Maximum session 5 10 Acupuncture Malay postnatal care Wellness Postnatal care Treatment 24 hours after discharge from 3 days after discharge from commences postnatal ward hospital Type of Wellness massage + Breastcare massage + hot Compression + treatment body Wrapping ( barut/girdle) No of session One off 6 session 6