SCIM

'SCIM' - The effectiveness and cost effectiveness of complementary and alternative medicine (CAM) for multimorbid patients with mental health and musculoskeletal problems in primary care in the UK: a scoping study

The SCIM Study was completed in 2016. The full final report is available on the funder’s website.

Key findings

The study identified that integration of CAM in NHS primary care for patients with mental health and musculoskeletal (MSD-MH) multimorbidity is a potentially fruitful area for further investigation.

CAM was fairly commonly used in England, with some NHS provision. Both NHS and CAM practitioners and the public agreed that CAM has a potential role in NHS primary care for MSD-MH multimorbidity, given the limitations of conventional medicine in this area.

Integrating CAM into the NHS may also be in line with the current NHS agenda for person-centred and self-care.

Five possible priority areas for an RCT were identified:

• yoga for low back pain with anxiety and/or sleep disorder;
• mindfulness for MH alongside a specific MSD;
• acupuncture in an MSD with depression;
• tai chi for depression and low back pain or osteoarthritis; and
• meditative movement for sleep disorders with an MSD.

Feasibility work is needed prior to a definitive trial, particularly regarding intervention design, recruitment and retention, education and information needs of professionals and patients, outcome measures, and follow-up duration.

This study, in particular the literature review, highlighted the need for further research in the area of CAM for MSD, MH and multimorbidity, particularly high quality, large, long-term RCTs measuring effectiveness and cost-effectiveness.

Next steps

Many GPs, commissioners, case study informants and particularly CAM practitioners supported our proposal for a feasibility trial. The project team have now moved on to the next phase of the project to write an application for NIHR funding for a full randomised controlled trial, with pilot phases and process evaluation.

Contact

For further information, contact ava.lorenc@bristol.ac.uk.