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MS research update - Combining complementary medicine with traditional treatments - 25 February 2014

Summary

Complementary and alternative medicine (CAM) refers to those forms of treatment that are not widely in use in conventional medicine. This small study looked at how people with MS viewed the risks of combining CAM and conventional drug treatments (CDT) in the management of their MS.

The researchers found that the 11 participants felt that using CAM and CDT together, was safe and risk-free, as they did not feel ill after using the CAM. It is known that some CAM treatments can interact and interfere with some CDTs, but the study found that the participants had given little thought to the potential risks of doing so and the possible negative interactions that could occur.

The study suggests that more needs to be known about the way people use their body sensations and experience as a measure of safety when using CAM and how this can affect communication with their doctors.

Background

It is known that many people with MS use complementary and alternative medicine (CAM) treatments in the management of their disease. Typically people with MS who use CAM also use conventional drug treatments (CDT). Some CAM treatments can interact and interfere with CDT, but little is known about how users consider such risks. This study aimed to find out about how users view the risk of combining CAM and CDT in the management of their MS.

How this study was carried out

The researchers had surveyed members of the Danish MS Society. Just over half (52%) of the 1,865 people with MS who had responded in the survey had used CAM within the past 12 months and most of these people (90%) had used CAM at the same time as conventional treatments.

11 of the survey respondents were selected for in-depth follow up interviews to explore their views on using CAM and conventional medicine together and the potential risks of doing so. The 11 were selected as they were typical of the survey respondents that used CAM and conventional medicine together. All 11 were women, aged between 31 and 39, with a high level of education.

Each participant took part in an interview that lasted between 35 and 65 minutes and focused on their use of CDT and CAM. The interview questions included: "Would you like to tell me about your life with MS?", "In your experience, what affects the development of your MS?", "Why do you use herbal medicine?" and "What are your experiences of using herbal medicine/ other CAM?".

The answers given during the interviews were examined and general themes and opinions were identified.

What was found

The participants felt that using CAM and CDT together, was safe and risk-free. The participants said they thought CAMs, such as herbal medicine, were 'non-chemical' and 'natural'. They also used their body sensations and experience as an indicator of safety, so if they didn't feel ill after using the CAM they concluded it was safe. The participants had great trust in their CAM practitioner and relied on them to make them aware of any possible problems with the CAM they would use. The participants also expressed problems in talking with their usual medical doctor about CAM. Many felt their doctor didn't know about it or did not want to talk about it. Those doctors that did mention the risks of using CAM together with CDT did not give information that was useful or informative, such as the reasons why something could be a problem.

What does it mean?

The study suggests that people using CAM alongside their conventional treatments have given little thought to the potential risks of doing so and the possible negative interactions that could occur. Those questioned had also not received such advice from either their CAM practitioner or their medical doctor.

The authors conclude that more needs to be known about the way people use their body sensations and experience as a measure of safety when using CAM and how this can affect communication with their doctors.

Skovgaard L, Pedersen IK, Verhoef M.
Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis' views on risks of negative interactions between herbal medicine and conventional drug therapies.
BMC Complement Altern Med. 2014 Feb 18;14(1):59.
abstract
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More about complementary and alternative medicine

Complementary and alternative medicine (CAM) refers to those forms of treatment that are not widely in use in conventional medicine. Commonly used therapies include: acupuncture, Chinese medicine, aromatherapy and homoeopathy. CAM is popular with people with MS with studies showing that between a third and a half of people with MS regularly use at least one therapy.

Safety

There are a number of CAM therapeutic approaches that are sometimes helpful in the treatment of MS. However as this study shows there is a widespread belief that CAMs must be safe as they are seen as being 'natural', but this may not always be the case. Like conventional medicines CAMs can have side effects and can also interact with conventional therapies. For example St John's wort is taken by many people to treat depression and it has shown to be effective. However it can have serious interactions with other drugs, including other antidepressants, as well as stopping warfarin (a blood thinning drug) and oral contraceptives from working, leading to the risk of blood clots or unwanted pregnancy in people taking these drugs. Preparations of remedies such as St John's wort can also vary in their strength and effect, so it is not possible to be sure how much you are taking as they are not standardised. It is therefore important that people with MS tell their health professionals if they are taking or considering using any CAMs, so any potential interaction or risk can be discussed.

Finding appropriate therapies

As with most subjects there is a great deal of information about CAM on the internet, but much of this is not impartial or reliable. Also, in contrast to conventional medicine, there is not a great deal of published research evidence on the effectiveness or benefits of CAM. If you are interested in trying a particular therapy you should consult a trusted source where possible for information such as NHS Choices or your MS team.

Always check that a practitioner has appropriate qualifications or is registered with an appropriate regulatory organisation. Be aware of the cost of treatment and how long it is likely to last. Therapies can be expensive, so it is sensible to know when to stop if no benefit is being obtained. Not everything works for everybody, so it would be useful to decide in advance how long it would be reasonable to try something out for before concluding if it is working for you or not.

Research by topic areas...

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Disease modifying treatments

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Drugs in development

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Other treatments

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Epidemiology

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Rehabilitation

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Assessment tools

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Quality of life

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Causes of MS

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Paediatric MS

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Genetics

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Psychological aspects

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Physical activity

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Prognosis

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Stem cells

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Work

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Other

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Cutter G, Kappos L.
Clinical trials in multiple sclerosis.
Handb Clin Neurol. 2014;122:445-53.
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