John Weeks February 2013 Integrator Round-up covering the topic of Research “Health” Makes the Agenda of the National Institutes of Disease

The National Institutes of Health (NIH) greeted 2013 with a surprising announcement. Fifteen of the NIH’s 28 institutes and centers, including the National Center for Complementary and Alternative Medicine (NCCAM) signed onto an initiative entitled “Implementation and Dissemination in Health.” The NIH program urges studies that “scaffold multiple evidence-based practices within care settings, to meet the needs of complex patients, systems of care, and service integration.” These may include combinations of multiple prevention strategies, treatments and the shared decision-making among teams of practitioners. The critical endpoint is “patient outcomes.” Included are R01, R21 and R03 mechanisms.

Comment: The NIH’s normal portfolio has led more than one observer to suggest that the powerful agency would be more appropriately named the National Institutes of Disease. This program is notable because of its rare focus on the complexities associated with creating “health.” This elevation of “patient outcomes” over biomedical indicators enters a zone where integrative strategies shine. The philosophical focus of complementary, alternative and integrative providers on treating the whole person, using “all appropriate therapies, health professionals and disciplines,” and forming partnership with patients measures up well in this context.

What the NIH needs to do next is to call for new research on strategies that target such health creation. Such a program must be engaged with a similar appreciation for complexities of such interventions and research methods with individualized patient outcomes as endpoints. The NIH’s disease obsession enables the disease-orientation of the medical industry. We’ve barely begun to examine our abilities to reverse disease and create health. What roles can integrative medicine and health have in doing so? Pushing dissemination without funding new research feels a but like putting the cart before the horse. This is a good step though. In its 2011-2015 strategic plan, NCCAM noted consumer interest in health as a motive for their use of “CAM” therapies and practitioners. This program appears to be aligned with that Strategic Objective #3.