Monitoring Complementary and Alternative Medicine

Making a recommendation

How would you advise Mrs. Thompson about using valerian and danshen?²

How severe or acute is the illness, and how likely is it that the illness can be cured with conventional treatment?
How invasive is conventional treatment? What are the associated toxicities and side effects?
To what extent does the patient understand and voluntarily accept the risks and benefits of CAM treatment?
What does the evidence (if any) indicate about the risks and benefits of the desired CAM treatment?

When you use evidence about safety and efficacy to guide recommendations about CAM, you are likely to find yourself in one of the scenarios listed below.

What are your conclusions from the information you just viewed, and how would move forward? Choose one option each for valerian and danshen, then watch the video on the next screen to see how Dr. Miller advises Mrs. Thompson about valerian based on the available evidence.

Option

1. Evidence supports both safety and efficacy.

How to proceed: Recommend and continue to monitor.

Valerian

Danshen

Option

2. Evidence supports safety, but evidence regarding efficacy is inconclusive.

How to proceed: Tolerate, provide caution, and closely monitor effectiveness.

Valerian

Danshen

Option

3. Evidence supports efficacy, but evidence regarding safety is inconclusive.

How to proceed: Consider tolerating, providing caution, and closely monitor safety.