A clinical tool for evaluating complementary and alternative medicine utilization and risk

Complementary and alternative medicine (CAM) is widely used in Canada and throughout the world, making it inevitable that family physicians will encounter CAM use in their patients. CAM therapies are highly variable and are not subject to regulation or oversight, making some such modalities potentially dangerous. Presently, CAM use is discussed during standard history taking, but the information gathered may be of limited utility due to the wide variety of CAM that exists; such diversity makes it practically impossible for one physician to know the risks associated with each CAM. Additionally, some CAM may not identified as such by the patient (eg chiropractic) and may not be reported during a standard patient interview. There currently exists no standardized method of collecting a patient’s history of CAM use, or for assessing risk based on the information collected. Here, we present a clinical tool that helps to screen for use of CAM and stratify patients into risk categories accordingly. It also makes suggestions for management and follow-up of these patients according to their risk category. Included are several quick reference tables to enable physicians to rapidly stratify patients into an appropriate category. This test may help to screen patients for CAM use that puts their health at risk, thereby increasing detection, and enabling timely intervention by the physician to prevent adverse events due to CAM use.