Diversity in Collection Development: Complementary and Alternative Medicine (CAM) Resources orCAM – the New Frontier

Susan Murray

smurray@torontopubliclibrary.ca

Consumer Health Information Service

Toronto Reference Library

MLA, May 17, 2005

CAM - Definitions• Alternative medicine - “other,” a type of

medicine other than the traditional kind of medicine; independent healing systems outside the realm of western medical theory and practice

• Also called complementary medicine or complementary health although this is often used to describe therapies that are used along with mainstream medicine, such as massage therapy

• Also called integrative health

• MeSH term in 1994, previously therapeutic cults

Short History of Medicine

I have an earache…

2000 B.C. Here, eat this root.1000 A.D. That root is heathen, Here, say this prayer.1850 A.D. That prayer is superstition. Here, drink this potion.

1940 A.D. That potion is snake oil. Here, swallow this pill.

1985 A.D. That pill is ineffective. Here, take this antibiotic.

2000A.D. That antibiotic is artificial. Here, eat this root.

Author UnknownCited: The Complementary and Alternative Medicine Information

Source Book. ed. by Alan Rees. Phoenix: Oryx Press, 2001

CAM Use - U.S.• 36% of American adults used some form of

CAM in 2002 – 62% if prayer for health reasons is included

• $50 billion spent on CAM in 2002

- Most often used to treat back pain or back problems, joint pain or stiffness, and anxiety or depression

- Exceptionally high usage by those with life threatening illnesses, such as cancer or HIV/AIDS

• Barnes, PM, Powell-Griner E, McFann K, Nahin, RL. Complementary and alternative medicine use among adults: United States, 2002. Advance data from vital and health statistics, no 343, Hyattsville, Maryland: National Center for Health Statistics.

www.cdc.gov/nchs/nhis.htm

What do Users Ask About CAM?

Consumers:What is it?How does it work?Is it safe?Does it work? For my condition?Where can I locate practitioners/clinics, etc.?How much does it cost?

Health Care Professionals:Is there evidence to support it?

Balanced CAM Collection• Alternative Systems – Ayurvedic Medicine,

TCM, herbalism, naturopathy, homeopathy

Biologically-based therapies – vitamins, herbs, dietary supplements

Body-based therapies – massage, chiropractic

Mind-body therapies – meditation, art therapy, hypnosis, imagery, biofeedback

Energy therapies – Qi Gong, therapeutic touch, reiki, magnetic therapy

Challenges in CAM Selection

• Very diffuse topic area• Much questionable material – fads, selling of

products, untested treatments

• More difficult to judge authority of authors, institutions

• Concern about choosing resources that are potentially harmful

• Difficult to locate specialized publishers• Resources not published, indexed or in English

Licensure Abbreviations• Alternative Medicine Foundation, Inc. Alternative and Complementary Medicine Resource Guide.

http:www.amfoundation.org/geninfo.htm   http:www.amfoundation.org/geninfo.htm

Gancao.net. Titles, initials, translations. http://gancao.net/Referrals/ref.explain.shtml

http://gancao.net/Referrals/ref.explain.shtml

Directory of Hypnotherapy Practitioners. Glossary of qualification abbreviations. http://www.therapypages.com/qualifications.htm http://www.therapypages.com/qualifications.htm

Key to professional titles. In Alternative Medicine: The Definitive Guide. 2d ed. (p. 1113-4). Berkeley, CA: Celestial Arts, 2002

Selection CriteriaPrimary:• Authority – author, institution, training & experience

• Accuracy – type of evidence

• Currency – not as important an issue with CAM

• Point of view – balance? bias?

• Audience level and usefulness• Scope of coverage - contribution to CAM

knowledge base

Secondary:• Organization• Physical format• Cost

Selection of CAM Resources

“ In selecting materials, librarians should not be swayed by whether the treatments have been proven effective, but should collect works on both alternative and orthodox medicine so that consumers are given sufficient information to make choices.”

Kupferberg, N. Alternative medicine goes mainstream.

Library Journal, July 1994:51-55.

Views of Librarians, Medical Students and Physicians About CAM Resources

UBC study investigated the personal and professional opinions of librarians, medical students and doctors regarding the availability of CAM for both medical students and the general public

• Medical students and doctors rejected any restrictions on the library acquiring or circulating these materials

• Librarians were more hesitant about acquiring radical or revolutionary materials that might cause harm

Curry, A, Smith, ST. Information on alternative medicine: a collection management issue. Bull Med Libr Assoc 1998;86(1):95-100.

Evolving Area

• Growing number of publications from mainstream authors and publishers, particularly academic publishers

• Articles in professional medical journals

• Evidence-based material

• Librarian- produced CAM collection guides and websites

CAM Selection Aids - I• The Complementary and Alternative

Medicine Information Source Book. ed. by Alan Rees. Phoenix: Oryx Press, 2001.

- includes core list, reviews of 355 popular books, associations/organizations, magazines/newsletters, reviews of 35 professional texts, and 60 Internet sites reviewed by Tom Flemming

• Rees’ CHI reviews continued by Majors Scientific Books Report: Alan Rees on Consumer Health https://www.majors.com/marketing/marketsite/indexlib.html

CAM Selection Aids - II• CAPHIS – collection development

http://caphis.mlanet.org/resources/index.html

http://caphis.mlanet.org/resources/index.html

e.g. CHIS healthnavigators

• Reviews: Consumer Connections, Library Journal, Choice, Booklist

• listservs: CAMLIB-L, CAPHIS, MEDLIB CAMLIB-L majordomo@library.ucsf.edu

CAM Selection Aids- III• Scanning magazines and journals - BMJ, Lancet, NEJM, JAMA• Journal of Consumer Health on the Internet

http://www.haworthpress.com/web/JCHI http://www.haworthpress.com/web/JCHI - alternative and complementary therapies column that focuses

on an Internet site, a specific diagnosis, or a therapeutic modality: (vol.9(1) 2005 featured Tai Chi

• Vendor catalogues: Login, Majors • Dalhousie University.School of Pharmacy. http://pharmacy.dal.ca/druginfo/alterna.htm http://pharmacy.dal.ca/druginfo/alterna.htm- provides links to publishers’ sites for ordering material on

general CAM, homeopathy, herbal medicine

CAM Selection Aids –Core Lists

• Brandon-Hill Lists discontinued in 2004- continued by Doody Enterprises http://www.

doody.com/dct/ http://www.doody.com/dct/

• Check CHI core lists, such as CAPHIS for CAM books:

http://caphis.mlanet.org/resources/index.html

CAM Electronic Resources – Guides and Lists Rosenthal Center for Complementary and Alternative

Medicine - directory of CAM databases http://www.rosenthal.hs.columbia.edu/Databases.html

http://www.rosenthal.hs.columbia.edu/Databases.html

• Bastyr University – online resources bibliography http://www.bastyr.edu/Library/resources/online/default.asp http://www.bastyr.edu/Library/resources/online/default.asp

• Complementary Therapies on the Internet. By William Mac Beckner and Brian M. Berman. New York: Churchill Livingstone, 2003.

• Guide to Complementary and Alternative Medicine on the Internet. By Lillian R. Brazin. New York: Haworth Information Press, 2003.

• The Herbal Internet Companion: Herbs and Herbal Medicine Online. By David Owen. New York: Haworth Information Press, 2002.

 

CAM Electronic Resources –Selected Website Directories

• Alternative medicine : health care information resources www-hsl.mcmaster.ca/tomflem/altmed.html

www-hsl.mcmaster.ca/tomflem/altmed.html

• The Alternative Medicine Homepage

www.pitt.edu/~cbw/altm.htmlwww.pitt.edu/!cbw/altm.html

CAM Electronic Resources –Selected Websites• CAM on PubMed

www.nlm.nih.gov/nccam/camonpubmed.html www.nlm.nih.gov/nccam/camonpubmed.html

• Canadian Health Network - Complementary and Alternative Health

www.canadian-health-network.ca/ www.canadian-health-network.ca/

• MEDLINEplus: Alternative Medicine www.nlm.nih.gov/medlineplus/alternativemedicine.htmlwww.nlm.nih.gov/medlineplus/alternativemedicine.html

• National Center for Complementary and Alternative Medicine (NCCAM) www.nccam.nih.gov/www.nccam.nih.gov/

CAM Courses

• Evidence-Based Approach to Complementary and Alternative Medicine

- MLA 2005 CE course taught by Stephanie Weldon

• How to Find Good Complementary & Alternative Medicine (CAM) Information on the Web

- MLA accredited online course taught by Diane Kovacs

http://www.kovacs.com/mlacealt.html

CAM Readings• Curry, Ann. Information on Alternative Medicine: A Collection

Management Issue. Bulletin of the Medical Library Association January 1998 86(1):95-100.

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=226331&blobtype=pdf

• Owen, David and Fang, Min-Lin. Information-Seeking Behavior in Complementary and Alternative Medicine (CAM): An Online Survey of Faculty at a Health Sciences Campus. Journal of the Medical Library Association July 2003 91(3):311-321.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=164394

• Walji, Muhammed et al. Efficacy of Quality Criteria to Identify Potentially Harmful Information: A Cross-Sectional Survey of Complementary and Alternative Medicine Web Sites. Journal of Medical Internet Research 6(2)article e21.

http://www.jmir.org/2004/2/e21/