Evidence-based health care and the integration of complementary therapies

In the ongoing intense debates about how to improve health care in the US, one theme about which there is widespread agreement is the need to make our health care system more patient-centered. Important goals for change in our health care systems include greater emphasis on the prevention of disease and better ways to motivate healthy behaviors. The integrative health movement can play an important role in meeting these goals. Empowerment of patients requires broadening information resources, strengthening tools for assessment of wellbeing, broadening understanding of what is meant by evidence-based care and refocusing health care activities. Most complementary care is patient-driven and often patient financed. It is often undertaken as self-care outside our conventional care system. However, in health care settings in the US, there is growing integration of complementary health practices with conventional care. For example, the CDC reported on data from 2007 that found that more than 40% of hospice care providers were offering complementary therapies. And, a survey of VA hospitals indicated that between 2002 and 2010 the portion of surveyed facilities providing complementary approaches increased from 45% to 65%, with the most prominent change being growing incorporation of mind and body therapies into the care of returning veterans. These changes, representative of a broader evolution of health care, are driven by both patient interest and a growing evidence base. NCCIH supported research in the natural products field is contributing to the development of a much-needed evidence-base. The potential value of natural products in promoting health and wellness is an area of research interest and NCCIH is committed to supporting basic and mechanistic studies that can aid us in not only in determining potential promise in the natural products arena, but also in uncovering any safety issues. This important research is essential in the development of an evidence-base to aid decision making at many levels, including decisions by patients and providers but also broader decisions about health care policy.