پاورپوینت کامل Use of Complementary & Alternative Medicine in HIV/AIDS Palliative Care 39 اسلاید در PowerPoint

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پاورپوینت کامل Use of Complementary & Alternative Medicine in HIV/AIDS Palliative Care 39 اسلاید در PowerPoint

اسلاید ۴: Consider a case34yoM, HIV+ x 7 years, reluctantly on ARVs for past 2 yrsHas used wide range of CAM therapies in the past, often not divulging to clinicianJust started acupuncture for n/v related to ARVsWants to start a garlic supp to boost immune system

اسلاید ۵: What is Complementary & Alternative Medicine (CAM)A group of diverse medical and health care systems, practices, and products not presently considered to be part of conventional medicine. (NCCAM)Two types:Healing practices used by general publicPractices used by specific ethnic or religious groupsKaptchuk; 2001, Ann Intern Med 135(3): 196-204

اسلاید ۶: Five Domains of CAMAlternative Medical SystemsMind-Body Interventions Biologically-based treatments Manipulative therapiesEnergy TherapiesA full glossary of terms is available at http://nccam.nih.gov/health/whatiscam/

اسلاید ۷: Who are CAM practitionersEisenberg DM et al, Ann Int Med (2002) 137:965-973.

اسلاید ۸: Why learn about CAMUse of CAM in US has increased by 47% in the past decadeMany insurers and managed care providers now cover some CAM therapiesPatients pay billions of dollars for CAM therapiesCAM therapies may interfere or interact with conventional treatmentWetzl, Ann Intern Med 2003; 138: 191-6

اسلاید ۹: Why do people use CAMPoor health statusA last resortRelief of symptoms Less adverse effects than conventional treatmentsConsistent with patients cultural or health beliefsOnly 4.4% of CAM users do not also use conventional medical care. Dissatisfaction with conventional care did not predict use. Astin; JAMA, 1998; 279:1548-1553Pan; J Pain & Symptom Mgmt 2000; 20: 374-897

اسلاید ۱۰: CAM use in cancer and HIV patientsPatterson (2002) J Alt and Comp Med 8(4):477-485Risa (2002) Int J STD AIDS 13:706-713

اسلاید ۱۱: Specific CAM therapies used in HIV/AIDS & palliative careHerbs & supplementsAcupunctureMassage therapyNaturopathic medicineChiropracticMind-Body therapy

اسلاید ۱۲: Herbs and supplements Most common form of CAM used in US Benefits: Vitamins and nutritional supplements may improve well being Risks: Certain herbal treatments have been shown to interact with medications and in some cases are toxic Most herbs and supplements have not been carefully tested

اسلاید ۱۳: Common uses of herbs & supplements in HIV/AIDS careOmega 3 oil as an anti-inflammatory–used to treat neuropathyHigh dose vitamin, mineral and antioxidant therapy to build immune system and slow disease progressionVitamin therapy–treats wasting, lack of appetite, malabsorption of nutrientsChinese herbs to treat diarrheaSt. John’s Wort as antidepressant, antiviral, anti-inflammatory agent.

اسلاید ۱۴: Effect of a vitamin and mineral supplement on infection incidenceBarringer et al (2003) Ann Int Med 138:365n=130 patientsPercent with infection

اسلاید ۱۵: Herbs and supplements: Recent problems and concernsEchinacea: Some believe it may stimulate the immune system and cause progression of HIV.Milk Thistle: May increase the levels of other