Page 113 - Encyclopedia of Nursing Research

80 n CoMPLEMEnTARY AnD ALTERnATIvE PRACTICES AnD PRoDUCTS

evidence base and by providing more, bet- use of CAPPs among senior citizens, specif-
ter, and detailed information with which to ically in the aging U.S. population. In recent
C craft a nursing management strategy for each national and regional sample studies, 62% to
individual patient. The ultimate purpose of 88% of people 65 years and older used at least
comparative effectiveness research is to assist one CAPP modality compared with 46% of
consumers, clinicians, purchasers, and policy those younger than 65 years (p < .001; Ai &
makers to make informed decisions that will Bolling, 2002; Cheung, Wyman, & Halcon,
improve health care at both the individual 2007; ness, Cirillo, Weir, nisly, & Wallace,
and population levels. 2005). The 2007 national Health Interview
Survey data also provide the first definitive
Ivo Abraham report for out-of-pocket costs for complemen-
Sally Reel tary and alternative therapies among adults
in the United States. The total, $33.9 billion,
equals 1.5% of total 2007 U.S. health care
expenditures (nahin, Barnes, Stussman, &
CoMpleMentary and Bloom, 2009).
alternative praCtiCes In response to the increasing interest of
the American people in the healing potential of
and produCts CAPPs, the federal government created in 1992
the office of Alternative Medicine, elevated
in 1998 to the nCCAM because the Congress
A large percentage of persons worldwide are believed that the widespread public use of
using complementary and alternative prac- CAPPs in the absence of scientific evidence
tices and products (CAPPs), referred to also warranted a more focused research effort at
as “complementary and alternative medi- nIH (nIH/nCCAM, 2010c). The mission of
cine” (CAM) and, more recently, as “inte- nCCAM is to define, through rigorous scien-
grative medicine” (national Institutes of tific investigation, the usefulness and safety
Health, national Center for Complementary of CAPPs and the role they play in improv-
and Alternative Medicine [nIH/nCCAM], ing health and health care. The anecdotes
2010d). The term “integrative health care” is about efficacy and effectiveness of practices
increasingly used by clinicians and research- for which there are not plausible explanations
ers, reflecting findings in the survey liter- are insufficient today, thereby giving impor-
ature that suggest most people use CAPPs tance to well-designed and well-executed
in conjunction with rather than as an alter- research. Beginning with the appointment
native to conventional or mainstream health of the first director of nCCAM in May 1999
care services (nIH/nCCAM, 2007b). and the publication of its first strategic plan
Despite any confusion in use of terms, in September 2000, nCCAM has funded both
recent surveys (Barnes, Bloom, & nahin, 2008; extramural and intramural research focused
nIH/nCCAM, 2007a) indicated that a signifi- on CAPPs-related clinical, translational, and
cant percentage of the adult population in the basic research on the efficacy, safety, and
United States (38.3% or approximately 4 in mechanisms of action of diverse CAM modal-
10 adults) and a small percentage of children ities (nIH/nCCAM, 2010b). Celebrating its
(12% or approximately 1 in 9 children) have 10th anniversary in February 2009, nCCAM
used or are using a variety of these ancient boasts a Web site (http://nccam.nih.gov/) that
and modern CAPPs to treat symptoms and provides educational materials in written and
conditions, ranging from back and other audiovisual form.
musculoskeletal pain to anxiety and/or sleep In addition, nIH has collaborated with
disorders. A parallel trend is the increasing the U.S. national Library of Medicine to