As healthcare professionals, one of the main aspects of treating patients is to do what is in the patient's best interest. Sometimes, there is a clear route of treatment. Other times, things are more complicated. One of the four pillars of medical ethics is autonomy - allowing patients to have the power to make their own decisions regarding their treatment. Occasionally, patients may opt for a treatment option outside conventional treatments for their condition. If they inform their doctor about this, the doctor's job is to evaluate these options' efficacy and safety carefully.
Complementary therapies are treatments that do not fall within mainstream medical practice. This means these are not conventional treatment options but are 'complementary' in that they are often used alongside traditional medical care to assist patient recovery. Examples might include acupuncture, homoeopathy and osteopathy. There are many types of complementary therapies so this blog will explore just one type of complementary therapy to give a flavour of what they’re about and the way to research their effectiveness.
The use of aromatic compounds, such as oils to help improve general wellbeing and health is a common practice globally and is the basis of aromatherapy. In the western world, aromatherapy can be seen in many settings, from hospitals to spas and has been reported to improve symptoms of depression and anxiety.
There has been an increase in the use of natural treatment methods for mental health in general, with a clear benefit being reduced side effects (compared to medications used for anxiety/depression). Aromatherapy is often used more frequently in patients with terminal illness diagnoses to manage feelings of anxiety/depression resulting from the diagnosis. For example, patients diagnosed with cancer may experience anxiety symptoms such as restlessness and dizziness. Depression is also common for such patients, with symptoms including low mood and lack of motivation.
When researching complementary therapies for patients, reviewing the literature is critical. This is to ensure treatment options are safe for patient use and have proven successful in their purpose. For example, studies on the effects of aromatherapy have generally reported improvements in the above symptoms.
One study looking at the effects of aromatherapy in post-partum women (at risk of anxiety and depression) measured the impact aromatherapy had on these symptoms. By conducting interviews with the women at different points in the study, the researchers could obtain subjective results in qualitative data. The study reported general improvements in feelings of anxiety and depression in these women, suggesting aromatherapy may be effective for all methods of administration they looked at. Good news, right?
Another aspect of performing your own research on the efficacy of such treatments is to look at the problems of the study. For example, in this case, the sample size was very small. This reduces the accuracy of the data collected and the overall reliability. Another consideration is that this study did not have sufficient follow-up rates. This means any long-term impacts of aromatherapy or the administration of aromatherapy were not investigated. Take a look at the study using the link below and see what other factors you can find that may limit the reliability of this study. Hint: look at study blinding.
To give another example, a different study looked at the effects of aromatherapy in a palliative care setting. A very relevant study that could provide useful information on how effective aromatherapy is for different patients. This study took over six weeks - a longer period than the previous one. It also had just under 4 times the number of participants as the previous study - a much larger sample size. This study was also randomised, thus increasing its reliability of it. Take a look for yourself and see if you can find any issues with this study (it is a bit harder than the previous one). If you are looking for a hint, I would look at the date itself.
Is medication better than complementary therapy?
When it comes to aromatherapy vs medication, the answer is often both. It is unlikely that if a patient wants aromatherapy, this will entirely replace conventional treatments and vice versa. A personalised plan can and should be made between doctor and patients, so both doctor and patient are comfortable with the treatment plan. Whilst it may not be sensible to replace conventional medicine altogether, complementary therapies can supplement healing. On the other hand, some complementary therapies may negatively interact with the medications a patient is taking, so it’s important for both the doctors and the complementary therapists to be in the loop before a decision is made.
And remember, it’s not just medications vs complementary therapy, as there are a whole host of other treatments in place for different conditions. In the case of depression and anxiety, medicines are not the only treatment option available. Other treatments such as CBT (cognitive behavioural therapy) may be implemented instead. Talking treatments have the benefit of no side effects, for example, which may be appealing to patients.
As you can see, many options are available, and a combination of them can be implemented. So, the question is often not as simple as "Complementary therapy vs conventional medical practice".
To conclude, in general, aromatherapy and complementary therapies can have many benefits, but their use must be suitable for the patient. This means checking efficacy, general safety, finding out why the patient would prefer to opt for a complementary therapy and addressing any concerns with traditional approaches. As clinicians, it is our duty to do our own research and act and advise in the patient's best interest.
Study 1: Conrad P, Adams C. The effects of clinical aromatherapy for anxiety and depression in the high risk postpartum woman - a pilot study. Complement Ther Clin Pract. 2012 Aug;18(3):164-8.
Study 2: Wilkinson S, Aldridge J, Salmon I, Cain E, Wilson B. An evaluation of aromatherapy massage in palliative care. Palliat Med. 1999 Sep;13(5):409-17.
Author: Chandan Sekhon
Editor: Dr Latifa Haque