The final CAMbrella conference took place on 29 November 2012, showcasing the fruit of the 3-year pan-European CAM research project - the long-awaited ’’Roadmap for European CAM Research’’ that includes the findings of the work packages and provides conclusions and recommendations for a future research agenda.
To kick off the conference, Dr. Wolfgang Weidenhammer, CAMbrella project coordinator based at University of Munich, recalled that CAMbrella is a so-called coordination action for preparing future research projects, funded by the European Commission’s 7th Framework Programme (FP7) and involving 16 beneficiaries from 12 countries plus one adjunct partner. He stated he was looking very much forward to seeing the impact of the research roadmap, but that another important aspect of the project had been the networking aspect. The key areas under examination in CAMbrella had been the prevalence of CAM use, CAM terminology and definitions, citizens’ needs and demands, definitions, patients’ and providers’ perspectives regarding CAM use, the global perspective, CAM’s legal status and the drawing up of the Roadmap itself, bundled into 7 work packages plus an additional one dealing with dissemination and information.
In his keynote speech, Prof Jarle Aarbakke, Rector at the University of Tromso, Norway, underlined the importance of public funding for research into CAM. This entailed curiosity-driven research to map out the landscape of CAM in EU which would open up strategic choices. He said that the challenges of health systems were the same everywhere since demand for health services exceeded supply, especially during the crisis. No perfect health system model exists but CAM can make a valuable contribution. Norway was already quite involved in CAM research.
Prof Helle Johannessen, University of Southern Denmark talked about the work package dealing with citizens’ attitudes and needs, and stated that existing research was not evenly distributed across Europe, with most papers coming from the UK and Germany. She informed the audience that citizens’ principal source of information on CAM was their personal social network and experience - the Internet was the last resort after friends and family. She stated that advice also depended a lot on the attitudes of GPs. Citizens routinely expressed need for diversity to meet increased demands, and they wanted more research on CAM. However, cost represented a barrier too: there is a clear link between insurance coverage and CAM use. Overall, individuals appreciate the personal approach they receive during CAM consultations, and that these are safe treatments. Clear regulatory and educational frameworks are desirable.
Prof George Lewith , University of Southampton, UK, contributed the patient perspective to the debate and explained that his work package had looked at 87 different studies pertaining to CAM use and quality assessment criteria. He stated that CAM users are mainly women, however the prevalence of use differs widely in EU. People often turned to CAM as they were dissatisfied with conventional care, the top therapies being herbal medicine, homeopathy, chiropractic, acupuncture, reflexology, and nutritional supplements. It was evident that the quality of data across the EU was poor: less than half EU states were able to provide reliable information. There was also much divergence regarding the definition and scope of CAM, hence there is a need for a coherent, comprehensive and rigorous perspective in this field.
Dr. Klaus von Ammon, University of Bern, Switzerland added the providers’ perspective, stating that only 8 scientific papers had been produced on the results of research in practice over the last 30 year. Moreover, data is only available when CAM practitioners are registered. In Switzerland, there is equal and easy access but that is not the case in most other countries. He stated that Issues in this area were the transparent harmonisation of CAM training; continuing medical education and certification; publicly accessible standards of regulation and registration for therapists and products; and the need for state-run studies of demand, outcome and cost-effectiveness.
EPHA member Seamus Connolly of the European Shiatsu Federation revealed that CAM practitioners like himself do not get asked the same questions as CAM doctors since in a number of disciplines, the experience base is more important than formal qualifications. He stated that it was important for both CAM-trained doctors and practitioners to collaborate on a political and institutional level. He added that much of the possibility for change lies within the conventional health system.
Providing a global perspective on CAM use, Prof Torkel Falkenberg of Karolinska Institutet Stockholm stated that a lot of research is being financed in the USA, Australia and India, even China. Overall, a shift in R&D could be observed from efficacy and mechanism to a broader spectre including methodologies and pertaining to context/utilisation, safety, comparative effectiveness, component efficacy, and biological mechanisms. The focus was on popular CAM treatments and where the disease burden is, and both qualitative and comparative research was financed. He said that the EU should consider these trends.
Prof Benno Brinkhaus of the Charite hospital Berlin then presented the Roadmap for European CAM research; stating that it will serve to establish a solid evidence base to make informed decisions for citizens and healthcare providers. Key areas of the roadmap reflected the work packages of CAMbrella: citizens’ use and demands, prevalence, safety, context, effectiveness, research funding, CAM integration, research infrastructure. Important aspects that required research were, for example, related to safety aspects of CAM use, exploring meaning and context factors in clinical trials (including qualitative studies), experimental studies to investigate underlying mechanisms, and looking at different CAM integration models. The crucial question which CAM modalities should be researched first required a consensus process involving all stakeholders, but prevalence of use, expected impact on clinical practice and economic impact were important indicators. He said it was also crucial to build sufficient EU research networks and structures to disseminate information. Hence the plan was to first develop an EU CAM coordination office, followed by the establishment of an EU funded European Centre for CAM.
Dr Peter Zimmermann of the IVAA presented the comments of the CAMbrella Advisory Board, of which EPHA is also a member. These had already been delivered to interested Members of the European Parliament during a workshop on the previous day, including host Angelika Niebler MEP (EPP, Germany), Peter Liese MEP (EPP, Germany), Ioannis Tsoukalas MEP (EPP, Greece) and ITRE Rapporteur Maria Da Graça Carvalho MEP (EPP, Portugal) who stated there would be funding available for CAM research in the Horizon 2020 programme. Dr Zimmermann stated that it was important to close the gap between empirical and academic/scientific approaches through trustful networking, and he delivered the Advisory Board’s call on politicians and policy makers to take up its recommendations.
Summing up the current situation, Prof. Vinjar Fonnebo, director of the Norwegian Institute for CAM research at the University of Tromso stated that “The current EU regulation and education chaos for CAM provision makes it impossible for health professionals to give safety and security to their patients and clients.”
In 2013, EPHA will be holding the first meeting of the new Working Group on CAM and explore synergies with the Roadmap presented at the Final CAMbrella conference.
For further information:
EPHA related articles:
Post-event Press Release & Reporting - Complementary & Alternative Medicine: Innovation and Added Value for European Healthcare
What is Complementary and Alternative Medicine (CAM)?
CAM European Parliament Interest Group on Healthy and Active Ageing