U.S. Report Calls for Tighter
Controls
on Complementary Medicine
BMJ 2002; 324:870 (13 April)
Charles Marwick
Washington, DC
Unconventional Complementary medical therapies, medical
treatments such as acupuncture, massage, and herbal, and nutritional
treatments and similar approaches to health care must be evaluated
with the same standards of quality, rigour, and ethics as conventional
medical treatments, states the US Commission on Complementary and
Alternative Medicine.
"First class scientific research is crucial
to helping (people) and those who care for them, make the wisest
health care decisions," said Dr James S. Gordon, the commission's
chairman.
The commission, established two years ago by former
President Bill Clinton, was charged with making legislative and
administrative recommendations to help develop public policies
that would maximise the benefits, if any, of so-called complementary
and alternative medicinal practices. It issued its report at the
end of March.
The report notes an emerging dialogue between complementary,
alternative medicine and conventional medicine and recommends that
efforts should be made to strengthen it. It calls for integrating
proven safe and effective complementary and alternative medicine
practices and products that have been proved to be safe and effective
into conventional health care and recommends increased funding
for research clinical, basic and health services research using
into these medicine treatments.
The report recommends the creation of a central,
co-ordinating office to oversee all activities relating to complementary
and alternative medicine activities in the Department of Health
and Human Services. Declining to make specific comments, a spokesman
for the Department said the panel's report "would be considered."
There is some backing in Congress for complementary
and alternative medicine in Congress, which mandated a centre at
the National Institutes of Health for supporting studies into such
treatments into its use at the National Institutes of Health. Senator
Tom Harkin, a Democrat from Iowa, is one supporter. Commenting
on the commission s report, he said that if its recommendations
were implemented they would help people get the best of both traditional
and complementary medical practices.
Other recommendations by the commission are directed
at the education of practitioners, the dissemination of information
about on complementary and alternative medicine, and reimbursement
for proven treatments. A particular concern was the need to inform
the public of adverse events associated with complementary and
alternative therapy products. It cites dietary supplements as one
example. In 2000, says the report, $17 billion (£12bn;
¬19bn) was spent by more than 158 million Americans on these
agents, yet they are not given the same rigorous testing and oversight
control as prescription drugs.
The report was hardly issued before critics attacked
it. For example, the National Council Against Health Fraud said
it was pointless to spend more money on areas that were unlikely
to yield any benefit and that the report failed to distinguish
between approaches "for which there is some scientific evidence
and those that stretch the realm of logic or are demonstrably unsafe."
Responding, Dr Gordon said that the commission's
job was not to evaluate specific therapies treatments. He pointed
out that increasing numbers of Americans have begun to look to
complementary and alternative medicine for their health care. "Our
report," he said, "highlights the opportunities for evaluating
the ways that are safe and effective."
See Ingrid Naiman's comments on
the above story
|