A therapy or medical treatment is the attempted remediation of a health problem, usually following a medical diagnosis. Both words, treatment and therapy, are often abbreviated tx, Tx, or Tx.
As a rule, each therapy has indications and . There are many different types of therapy. Not all therapies are effective. Many therapies can produce unwanted .
Treatment and therapy are often synonymous, especially in the usage of health professionals. However, in the context of mental health, the term therapy may refer specifically to psychotherapy.
Semantic field
The words
care,
therapy,
treatment, and
intervention overlap in a
semantic field, and thus they can be
depending on context. Moving rightward through that order, the
connotation level of
holism decreases and the level of specificity (to instances) increases. Thus, in
health-care contexts (where its
word sense are always
mass noun), the word
care tends to imply a broad idea of everything done to protect or improve someone's health (for example, as in the terms
preventive care and
primary care, which connote ongoing action), although it sometimes implies a narrower idea (for example, in the simplest cases of
wound care or postanesthesia care, a few particular steps are sufficient, and the patient's interaction with the provider of such care is soon finished). In contrast, the word
intervention tends to be specific and concrete, and thus the word is often
count noun; for example, one instance of cardiac catheterization is one intervention performed, and coronary care (noncount) can require a series of interventions (count). At the extreme, the piling on of such countable interventions amounts to interventionism, a flawed model of care lacking holistic —merely treating problems (in billable increments) rather than maintaining health.
Therapy and
treatment, in the middle of the semantic field, can connote either the holism of
care or the discreteness of
intervention, with context conveying the intent in each use. Accordingly, they can be used in both noncount and count senses (for example,
therapy for chronic kidney disease can involve several Kidney dialysis treatments per week).
The words Materia medica and are obscure and obsolete synonyms referring to the study of therapies.
The English word therapy comes via Latin therapīa from and literally means "curing" or "healing".
Types of therapies
Therapy as a treatment for physical or mental condition is based on knowledge usually from one of three separate fields (or a combination of them): conventional medicine (allopathic, Western biomedicine, relying on scientific approach and evidence-based practice), traditional medicine (age-old cultural practices), and alternative medicine (healthcare procedures "not readily integrated into the dominant healthcare model").
[Eskinazi, D., & Mindes, J. (2001). "Alternative medicine: definition, scope and challenges". Asia-Pacific Biotech News, 5(01), 19-25.]
By chronology, priority, or intensity
Levels of care
Levels of care classify
health care into categories of chronology, priority, or intensity, as follows:
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Urgent care handles health issues that need to be handled today but are not necessarily emergencies; the urgent care venue can send a patient to the emergency care level if it turns out to be needed.
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In the United States (and possibly various other countries), urgent care centers also serve another function as their other main purpose: U.S.
/ref>
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Emergency care handles medical emergencies and is a first point of contact or intake for less serious problems, which can be referred to other levels of care as appropriate. This therapy is often given to patients before a definitive diagnosis is made.
[Hansoti, B., Aluisio, A. R., Barry, M. A., Davey, K., Lentz, B. A., Modi, P., ... & Global Emergency Medicine Think Tank Clinical Research Working Group. (2017). Global health and emergency care: defining clinical research priorities. Academic Emergency Medicine, 24(6), 742-753.]
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Intensive care, also called critical care, is care for extremely ill or injured patients. It thus requires high resource intensity, knowledge, and skill, as well as quick decision making.
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Ambulatory care is care provided on an outpatient basis. Typically patients can walk into and out of the clinic under their own power (hence "ambulatory"), usually on the same day. This care type also involves surgery which, according to recent research, offers "generally superior 30-day outcomes relative to inpatient-based care".
[Friedlander, David F. MD, MPH∗,†; Krimphove, Marieke J. MD; Cole, Alexander P. MD∗; Marchese, Maya MS∗; Lipsitz, Stuart R. ScD; Weissman, Joel S. PhD; Schoenfeld, Andrew J. MD, MSc; Ortega, Gezzer MD, MPH; Trinh, Quoc-Dien MD. Where Is the Value in Ambulatory Versus Inpatient Surgery?. Annals of Surgery 273(5):p 909-916, May 2021. | DOI: 10.1097/SLA.0000000000003578]
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Home care is care at home, including care from providers (such as physicians, nurses, and home health aides) making , care from such as family members, and patient self care.
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Primary care is meant to be the main kind of care in general, and ideally a
/ref>
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Secondary care is care provided by medical specialists and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists. A patient reaches secondary care as a next step from primary care, typically by provider referral although sometimes by patient self-initiative. According to a systematic review, fields for development secondary care from patients' viewpoint may be classified into four domains that should usefully guide future improvement of this care stage: "barriers to care, communication, coordination, and relationships and personal value".
[Sampson R, Cooper J, Barbour R, et al (2015). "Patients' perspectives on the medical primary–secondary care interface: systematic review and synthesis of qualitative research." BMJ Open 2015;5:e008708. doi: 10.1136/bmjopen-2015-008708]
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Tertiary care is specialized consultative care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital.
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Follow-up care is additional care during or after convalescence. Aftercare is generally synonymous with follow-up care. One of the key areas of development–Telehealth, including non-clinical services: provider training, administrative meetings, and continuing medical education–offers opportunities to improve access to care, increase provider and patient productivity through reduced travel, potential expenses savings, and the ability to expand services.
[Snoswell CL, Taylor ML, Comans TA, Smith AC, Gray LC, Caffery LJ. (2020) "Determining if Telehealth Can Reduce Health System Costs: Scoping Review". J Med Internet Res 2020;22(10):e17298 doi: 10.2196/17298]
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End-of-life care is care near the end of one's life. It often includes the following:
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Palliative care is supportive care, most especially (but not necessarily) near the end of life.
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Hospice care is palliative care very near the end of life when cure is very unlikely. Its main goal is comfort, both physical and mental. A systematic meta review showed that the most cost-efficient one relates to home-based end-of-life care, including reduced overall "resource use and improved patient and carer outcomes".
[Luta, X., Ottino, B., Hall, P. et al. (2021) "Evidence on the economic value of end-of-life and palliative care interventions: a narrative review of reviews". BMC Palliat Care
/ref>
]
Lines of therapy
Treatment decisions often follow formal or informal
guidelines. Treatment options can often be ranked or prioritized into
lines of therapy:
first-line therapy,
second-line therapy,
third-line therapy, and so on.
First-line therapy (sometimes referred to as
induction therapy,
primary therapy, or
front-line therapy)
[ National Cancer Institute > Dictionary of Cancer Terms > first-line therapy Retrieved July 2010] is the first therapy that will be tried. Its priority over other options is usually either: (1) formally recommended on the basis of
clinical trial evidence for its best-available combination of efficacy, safety, and tolerability or (2) chosen based on the clinical experience of the physician. If a first-line therapy either fails to resolve the issue or produces intolerable
, additional (second-line) therapies may be substituted or added to the treatment regimen, followed by third-line therapies, and so on.
An example of a context in which the formalization of treatment algorithms and the ranking of lines of therapy is very extensive is chemotherapy regimens. Because of the great difficulty in successfully treating some forms of cancer, one line after another may be tried. In oncology the count of therapy lines may reach 10 or even 20.
Often multiple therapies may be tried simultaneously (combination therapy or polytherapy). Thus combination chemotherapy is also called polychemotherapy, whereas chemotherapy with one agent at a time is called single-agent therapy or monotherapy. Single-agent therapy is a care algorithm that focuses on one specific drug or procedure. It utilizes a single therapeutic agent rather than combining multiple ones.[Markham M. (2018). "Single Versus Multiagent Therapy: It's Time to Revisit the Choices." OncologyLive
/ref> Multiagent Therapy is a treatment by two or more drugs or procedures. Comprehensive therapy combines various forms of medical treatment to provide the most effective care for patients.]["Journal objective". Comprehensive Therapy
/ref>
]
Adjuvant therapy is therapy given in addition to the primary, main, or initial treatment, but simultaneously (as opposed to second-line therapy). Neoadjuvant therapy is therapy that is begun before the main therapy. Thus one can consider surgical excision of a tumor as the first-line therapy for a certain type and stage of cancer even though radiotherapy is used before it; the radiotherapy is neoadjuvant (chronologically first but not primary in the sense of the main event). Premedication is conceptually not far from this, but the words are not interchangeable; cytotoxic drugs to put a tumor "on the ropes" before surgery delivers the "knockout punch" are called neoadjuvant chemotherapy, not premedication, whereas things like anesthetics or prophylactic antibiotics before dental surgery are called premedication.
Step therapy or stepladder therapy is a specific type of prioritization by lines of therapy. It is controversial in American health care because unlike conventional decision-making about what constitutes first-line, second-line, and third-line therapy, which in the U.S. reflects safety and efficacy first and cost only according to the patient's wishes, step therapy attempts to mix cost containment by someone other than the patient (third-party payers) into the algorithm.
Therapy freedom refers to prescription for use of an unlicensed medicine (without a marketing authorization issued by the licensing authority of the country)[Gore RK, Chugh PD, Tripathi C, Lhamo Y, Gautam S. (2017). "Pediatric off-label and unlicensed drug use and its implications". Current clinical pharmacology
/ref> and the negotiation between individual and group rights are involved. A comprehensive research in Australia, Czech Republic, India, Israel, Italy, Netherlands, Spain, Serbia, Sweden, UK, and USA showed that the rate of the unlicensed medicine prescription has been reported to range from 0.3 to 35% depending on the country.][Derbyshire Medicines Management. "Prescribing and Guidelines". Retrieved online 20.03.2025: https://www.derbyshiremedicinesmanagement.nhs.uk/assets/Specials/Patient_Information/PIL_-_why_your_GP_has_not_prescribed_an_unlicensed_medicine.pdf
]
By intent
By intervention
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Invasive therapy is achieved either through surgery or through the use of drugs.
[Cousins S, Blencowe NS, Blazeby JM. (2019) What is an invasive procedure? A definition to inform study design, evidence synthesis and research tracking. BMJ Open. 2019 Jul 30;9(7):e028576. doi: 10.1136/bmjopen-2018-028576.] Medical invasive treatments can be divided into two main categories: pharmacotherapy and surgery.[Klein E. What does it mean to call a medical device invasive? Med Health Care Philos. (2023) Sep;26(3):325-334. doi: 10.1007/s11019-023-10147-x.]
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Noninvasive therapies are medical treatments that do not involve entry into the body. It can be classified into five main categories: neurotherapy, physical therapy, occupational therapy, radiation therapy, and psychotherapy.
[Davis NJ, van Koningsbruggen MG. (2013) "Non-invasive" brain stimulation is not non-invasive. Front Syst Neurosci. 2013 Dec 23;7:76. doi: 10.3389/fnsys.2013.00076.]
By therapy composition
Treatments can be classified according to the method of treatment:
matter">
By matter
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by : pharmacotherapy, chemotherapy (also, medical therapy often means specifically pharmacotherapy)
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by : implantation
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cardiac resynchronization therapy
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by specific : molecular therapy (although most drugs are specific molecules, molecular medicine refers in particular to medicine relying on molecular biology)
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by specific :
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by :
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by heavy metals:
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by biometals
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by lithium: lithium therapy
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by potassium: potassium supplementation
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by magnesium: magnesium supplementation
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by chromium: chromium supplementation; phonemic neurological hypochromium therapy
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by copper: copper supplementation
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by nonmetals:
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by water:
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by biological materials (biogenic substances, , , ), including their synthetic equivalents: biotherapy
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by whole
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by constituents or products of organisms
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by plant parts or extracts (but many drugs are derived from plants, even when the term phytotherapy is not used)
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by animal parts: quackery involving shark fins, tiger parts, and so on, often driving threat or endangerment of species
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by : gene therapy
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gene therapy for epilepsy
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gene therapy for osteoarthritis
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gene therapy for color blindness
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gene therapy of the human retina
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gene therapy in Parkinson's disease
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by epigenetics: epigenetic therapy
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by : protein therapy (but many drugs are proteins despite not being called protein therapy)
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by : enzyme replacement therapy
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by : hormone therapy
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hormonal therapy (oncology)
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hormone replacement therapy
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estrogen replacement therapy
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androgen replacement therapy
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hormone replacement therapy (menopause)
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transgender hormone therapy
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feminizing hormone therapy
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masculinizing hormone therapy
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antihormone therapy
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androgen deprivation therapy
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by whole cells: cell therapy (cytotherapy)
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by : stem cell therapy
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by immune cells: see immune system products below
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by immune system products: immunotherapy, host modulatory therapy
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by immune cells:
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T-cell vaccination
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cell transfer therapy
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autologous immune enhancement therapy
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TK cell therapy
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by humoral immunity: antibody therapy
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by whole serum: serotherapy, including antiserum therapy
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by antibody: immunoglobulin therapy
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by monoclonal antibodies: monoclonal antibody therapy
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by urine: urine therapy (some scientific forms; many prescientific or pseudoscientific forms)
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by food and dieting choices:
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by salts (but many drugs are the salts of organic acids, even when drug therapy is not called by names reflecting that)
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by salts in the air
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by natural dry salt air: "taking the cure" in desert locales (especially common in prescientific medicine; for example, one 19th-century way to treat tuberculosis)
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by artificial dry salt air:
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low-humidity forms of speleotherapy
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negative air ionization therapy
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by salt air:
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by natural moist salt air: seaside resort (especially common in prescientific medicine)
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by artificial moist salt air: water vapor forms of speleotherapy
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by salts in the water
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by aroma: aromatherapy
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by other materials with mechanism of action unknown
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by occlusion with duct tape: duct tape occlusion therapy
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By energy
By procedure and human interaction
By animal interaction
By meditation
By reading
By creativity
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By and waking
See also
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Biophilia hypothesis
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Classification of Pharmaco-Therapeutic Referrals
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Compassion-focused therapy
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Emotionally focused therapy
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Greyhound therapy
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Inverse benefit law
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List of therapies
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Mature minor doctrine
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Medication
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Medicine
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Nutraceutical
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Prevention
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Psychedelic therapy
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Therapeutic inertia
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Therapeutic nihilism, the idea that treatment is useless
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Treatment as prevention
External links
