This book aims to provide an authoritative reference source on complementary and alternative medicine (CAM) for healthcare professionals. The format is clear and concise. The preface is an epitaph to opinion-based medicine that justifies the authors' use of evidence rather than expert opinion. There are two useful, short introductory chapters about the methodology and how to use the book. These are essential reading to help the reader understand the significance of the arrows and symbols used throughout the rest of the book. The next four sections of the book have standardized chapter structures and cover diagnostic methods, therapies, herbal and non-herbal medicines and medical conditions. The treatments and therapies covered are those currently used by patients. The medical conditions discussed are those commonly seen in general practice. In the final section of chapters on general CAM issues the authors from Europe and North America have been given more freedom to express their opinions as well as present data. The European chapter deals largely with evidence from Great Britain and Germany. The chapters on why patients use CAM, safety and economics are issues relevant to all areas of medicine. The chapter on legal and ethical issues in CAM is based on experience in the USA and highlights the complex and changing medical legal environment that will govern any integration of CAM into conventional care.
The accompanying CD-ROM contains the text and, very usefully, Medline-linked references. There is a page of websites for herbal treatments. It would have been helpful to extend this to include appropriate websites for all CAM therapies.
Although the intended audience for this book is wide and general, there is much relevance to rheumatology, particularly as between 30 and 80% of rheumatology out-patients use CAMs, the majority as an adjunct to conventional treatments. This book is a timely and much needed resource. My requirements for this book were threefold. First, to check for interactions between patients' self-medicated, herbal and conventional treatments. Second, to help me with patients who come into the consulting room clutching an Internet printout about an unfamiliar CAM. Third, to look for new advice for patients suffering from conditions that are poorly served by conventional medicine, such as fibromyalgia, chronic fatigue, chronic neck and back pain. My first requirement is well met; the second and third to lesser extents. At least the book provides a starting point for discussion with patients. Certainly the book is rigorously researched and objectively presented, with much emphasis placed on safety of therapies and riskbenefit analysis. All the recommendations are made in the context of conventional medicine and, for this reason, I would feel confident to discuss current and potential treatments with patients based on information from this book.
This book achieves its aims as a reference book about the evidence base for CAM and brings a degree of clarity into a diverse and cloudy area of medicine.