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Are health services research methods a match for CAM?

BACKGROUND
Many complementary and alternative medicine (CAM) researchers believe that a new set of research methods is needed to study CAM. Health services research (HSR) is listed as a new research goal in the National Center for Complementary and Alternative Medicine 2005-2009 strategic plan. Does HSR offer solutions to the research needs of CAM? This article presents an overview of HSR, a summary of the HSR studies that have been published in CAM, and discussions of what HSR might offer CAM and what studies of CAM might offer conventional HSR.


DISCUSSION
Our literature search, which was performed at the University of Arizona, found 84 published CAM HSR studies. A comparison of the search results-mostly surveys of CAM users or providers and economic outcome studies-with the breadth of topics that may be studied using HSR, showed that research in this field has not reached its potential. More work, including studies of interactions between patient, provider, and the system as well as patient-centered outcomes studies, is needed. Several areas in which CAM could benefit from HSR were identified and discussed. These included studies supporting the integration of CAM and conventional medicine, insurance coverage for CAM therapies, the development practice guidelines, and studies of the effectiveness and cost-effectiveness of CAM therapies and whole medical systems. The study of CAM, especially studies focusing on patients' attraction to CAM, may also help expand the topics and methods of conventional HSR.


SUMMARY
HSR methods may address many of CAM's methodological challenges and improve clinical, patient-centered, and economic outcomes across all systems of care-both conventional and CAM.