Barriers to the conduct and application of research in complementary and alternative medicine: a systematic review

Yasamin Veziari,Matthew J Leach,Saravana Kumar

doi:10.1186/s12906-017-1660-0

Abstract

BackgroundThe popularity of Complementary and alternative medicine (CAM) has grown considerably over the past few decades. This has been accompanied by increasing public pressure for CAM to be evidence-based. Notwithstanding, the conduct and application of research in CAM faces a number of obstacles. No systematic review has mapped these barriers to date. Therefore, this systematic literature review aimed to explore, identify and map the barriers to the conduct and application of research in CAM.MethodsSystematic searching of MEDLINE, Embase, AMED, CINAHL, The Cochrane library, Google scholar and Google was conducted between February and June 2016 for pertinent publications. Pearling (secondary searching) of retrieved publications was also undertaken. Literature published only in English were included; however, no year limit was placed for searching. Two critical appraisal tools were used to critically appraise descriptive studies and opinion publications.ResultsA total of 21 eligible publications were included in this review; this comprised of eight primary research articles and thirteen opinion publications. A critical appraisal process found two categories of good quality publications while recognising their limitations in terms of descriptive and opinion publications. The synthesised data from the selected publications about the barriers to the conduct and application of research within CAM were captured within two broad components, namely capacity and culture. Capacity encompassed elements such as access, competency, bias, incentives and time. Encompassed within culture were elements relating to the values and complex system of CAM.ConclusionsMultiple barriers exist for the conduct and application of research in CAM. Given the growing popularity of these therapies, it is essential that the evidence base underpinning CAM also continues to expand. Without overt recognition of these barriers, enabling strategies cannot be applied. By addressing these barriers, CAM professions will be able to develop a critical mass and a well-coordinated research effort to assist the integration of evidence – based practice in CAM.

Highlights

The popularity of Complementary and alternative medicine (CAM) has grown considerably over the past few decades
In the United States of America (USA), close to 33.2 million US adults and children use some form of CAM [5]
The purpose of this systematic review was to identify the barriers to the conduct and application of research in CAM

Summary

Introduction

The popularity of Complementary and alternative medicine (CAM) has grown considerably over the past few decades. This has been accompanied by increasing public pressure for CAM to be evidence-based. Despite the growing popularity of CAM, there has been a renewed focus on the evidence-base of CAM [11, 12] with calls for CAM to demonstrate its effectiveness [13]. In Australia, the National Health and Medical Research Council (NHMRC) conducted a series of reviews of CAM to determine their efficacy / effectiveness [15]. An important driver of this renewed focus on the effectiveness of CAM is Evidence Based Practice (EBP) [16]

Methods

Results

Discussion

Conclusion