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Complementary and alternative medicine (CAM) encompasses a large range of therapies outside the domain of mainstream conventional or Western medicine that are used for the purpose of medical intervention, health promotion, or disease prevention. A distinct trend toward the integration of CAM therapies with the practice of conventional medicine is occurring. Hospitals are offering CAM therapies, health maintenance organizations (HMOs) are covering such therapies, a growing number of physicians are using CAM therapies in their practices, and insurance coverage for CAM therapies is increasing. Integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. As a result of increasing interest in CAM and the realization of our limited understanding of these modalities, the National Center for Complementary and Alternative Medicine (NCCAM) was established by a mandate in 1998 to facilitate and conduct research and education on CAM.

The NCCAM at the National Institutes of Health defines CAM as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine,”1 Many terms are used to describe CAM. Complementary medicine describes CAM when it is used in conjunction with conventional medicine. Alternative medicine is used in place of conventional medical care. Integrative medicine is becoming more popular and is the preferred term because it incorporates all appropriate approaches, both conventional medicine and CAM therapies, to achieve optimal health and healing. The Consortium of Academic Health Centers for Integrative Medicine, which consists of 36 prominent medical schools, further defines integrative medicine as “the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing.”2

CAM therapies include alternative/whole medical systems (homeopathy, naturopathy, ayurveda, and traditional oriental medicine), mind-body interventions (meditation, prayer for healing, biofeedback, yoga, and art and music therapy), biologically based therapies (megavitamins, nutritional supplements, and herbs), manipulative and body-based methods (chiropractic manipulations, osteopathy, massage), and energy therapies (Reiki and therapeutic touch).1

The use of CAM is prevalent among adults in the United States.3 Eisenberg and colleagues showed that use of alternative therapies increased from 34% to 42% among adults in the United States from 1990 to 1997.3 In 2002, the National Center for Health Statistics (part of the Centers for Disease Control and Prevention) conducted the National Health Interview Survey of 31,044 adults and found that 62% used some form of CAM in the past 12 months when prayer for health reasons was included.4 Total visits to CAM providers exceeded total visits to all primary care physicians. Out-of-pocket expenditures for CAM are greater than for hospitalization.3

CAM use among parents is the number-one predictor of CAM use among children, which is increasing.5 Studies of CAM use in ...

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