Complementary and alternative medicine: an introduction to the evidence base

Alternative, complementary, or CAM?

The terminology in this area can be confusing. It would be tempting to define alternative treatments as those that are unproved, and complementary therapies as those that are supported by reasonably sound evidence. Similarly, one might postulate that alternative means “used instead of” and complementary “employed as an add on” therapy. In reality, however, these boundaries often overlap and are often unrecognisable.

Homeopathy, for instance, is used by some clinicians as a replacement for conventional treatments, while others use it as an adjunctive option. Homeopaths are adamant that, for some indications, its use is based on good evidence, while critics insist that it is not. To avoid such debates, the term “CAM” is often employed and, while by no means perfect, seems more adequate than either term alone.

Patients’ reasons for choosing CAM

The reasons for choosing CAM are complex and depend on many factors.1 For instance, a patient with a life threatening condition such as cancer would be motivated by his or …